Tumors are constantly shedding neoplastic cells into the systemic circulation or surrounding lymphatics.

TUMOR
- swelling or enlargement occurring in inflammatory conditions; new growth of tissue characterized by progressive uncontrolled proliferation of cells

METASTASIS
- process by which cancer spreads from the place at which it first arose as a primary tumor to distant locations in the body - ancient Greek word meaning removal from one place to another

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary cancer. Ex. Breast cancer that spreads to the lungs and forms a metastatic tumor is metastatic breast cancer, not lung cancer.

TREATMENT of METASTATIC CANCER

-depends on where the cancer started -about 5% of the time, metastases are discovered but the primary tumor cannot be identified. The treatment of these metastases is dictated by their location rather than their origin.

Virtually all cancers can metastasize. Successfully reaching another location in the body does not guarantee that a metastatic tumor will form.

HOW IT SPREADS
Metastases spread in three ways by local extension from the tumor to the surrounding tissues through the bloodstream to distant sites through the lymphatic system to neighboring or distant lymph nodes. Each kind of cancer may have a typical route of spread.

A metastatic tumor is always caused by cancer cells from another part of the body
The pathologist knows that the diagnosed tumor is a metastasis because the cells do not look like those of the organ or tissue in which the tumor was found. Cancer of Unknown Primary Origin (CUP) patient with unknown or occult (hidden) primary cancer

SIGNS and SYMPTOMS

no or minimal symptoms related to the tumor and their metastases are found during a routine medical evaluation. type and frequency will depend on the size and location of the metastasis. (not the primary tumor) persons original cancer is discovered when the metastatic tumor causes symptoms.

Metastatic Site A cancer which has spread from an initial (primary) site to another one. The tumor is called by the primary site (ex. breast cancer that has spread to the brain is called metastatic breast cancer to the brain). SIGNS AND TREATMENT SYMPTOMS Many cancers may not Treatment of metastatic cancer cause symptoms primarily depends until late stage on the original site although these of the cancer In represent the most some clinical common ones. situations, however, metastases may be treated in specific ways

BRAIN - most common to spread to

the brain are lung and breast cancer.
SIGNS AND SYMPTOMS Headaches Dizziness Blurred vision Other symptoms related to the nervous-system

TREATMENT

Surgery Gamma knife - type of radiation treatment delivered by a machine that focuses multiple radiation beams directly at the involved area. Radiation therapy: In patients with more than one brain metastasis, surgery is not usually an option

SIGNS AND SYMPTOMS Weight loss Fever Nausea Loss of appetite Abdominal pain Fluid in the abdomen (ascites) Yellowing of skin (jaundice) Swelling of legs (edema)

LIVER - most common to metastasize to the liver are colon or other gastrointestinal cancers.

TREATMENT

Surgery Chemotherapy delivered by an implanted pump. This therapy takes advantage of the liver's ability to metabolize some drugs, meaning that the tumor may be exposed to high concentrations of chemotherapy while the rest of the body is

BONE - most common cancers to spread to the bones are prostate, lung and breast cancer SIGNS AND

SYMPTOMS Pain Bone breakage following minor or no injury

TREATMENT

Chemotherapy Radiation therapy If the tumor is not likely to respond to chemotherapy or if the bone involved is a weight-bearing one, the best option is to give radiation focused only on the involved area. Pamidronate: This medication can diminish the progress of bone metastases in

LUNG - Metastases to the lung are common for many types of cancer. SIGNS AND
TREATMENT Chemotherapy: directed against the primary tumor type. Surgery: If the tumor is isolated, it may be surgically removed without causing significant loss of lung function

SYMPTOMS Non-productive cough Cough producing bloody sputum Chest pain Shortness of breath