Metastatic Cancer

Metastatic breast cancer means that the breast cancer has spread outside of the breast and outside of the underarm (axillary) lymph nodes. The most common sites of spread are to lymph nodes above the clavicle, in the chest, and to the lung, liver, bones, and brain. Metastatic breast cancer, or Stage IV breast cancer, is not considered curable, but modern treatments do allow for much longer survival with a better quality of life than older treatment regimens. Metastatic breast cancer means that the breast cancer has spread outside of the breast and outside of the underarm (axillary) lymph nodes. The most common sites of spread are to lymph nodes above the clavicle, in the chest, and to the lung, liver, bones, and brain. Metastatic breast cancer, or Stage IV breast cancer, is not considered curable, but modern treatments do allow for much longer survival with a better quality of life than older treatment regimens.

Uncertainty, especially under the circumstances of a cancer diagnosis, is one of most stressful experiences. I recommend exercise, meditation, and relaxation exercises as ways to cope with stress during this time. Check out this book by Dr. Michael Antoni, one of the leading researchers in this area: http://www.amazon.com/Stress-Management-Intervention-Breast-Cancer/dp/1557989419/ref=sr_1_2?s=books&ie=UTF8&qid=1332591278&sr=1-2 I also highly recommend finding online social networks, like on http://www.PatientsLikeMe.com to find and connect with others going through what you are going through. Even though family and friends may be supportive, it can be so helpful to talk to people who have been through or are going through what you are going through. Only they can truly understand your fears and concerns. And, because the people you meet in online social networks are not close family and friends, you may actually be able to speak more freely about your thoughts, feelings and challenges, especially to the extent that some of the challenges involve family and friends reactions to your cancer. Uncertainty, especially under the circumstances of a cancer diagnosis, is one of most stressful experiences. I recommend exercise, meditation, and relaxation exercises as ways to cope with stress during this time. Check out this book by Dr. Michael Antoni, one of the leading researchers in this area: http://www.amazon.com/Stress-Management-Intervention-Breast-Cancer/dp/1557989419/ref=sr_1_2?s=books&ie=UTF8&qid=1332591278&sr=1-2 I also highly recommend finding online social networks, like on http://www.PatientsLikeMe.com to find and connect with others going through what you are going through. Even though family and friends may be supportive, it can be so helpful to talk to people who have been through or are going through what you are going through. Only they can truly understand your fears and concerns. And, because the people you meet in online social networks are not close family and friends, you may actually be able to speak more freely about your thoughts, feelings and challenges, especially to the extent that some of the challenges involve family and friends reactions to your cancer.

Many surgical oncologists will make sure the melanoma has not spread elsewehere in the body by doing several scans. The most widely used is the PET/CT scan for checking everything (except the brain) including the lungs, liver, and bones - all places to which the melanoma could spread. The brain is often scanned with either a CT scan or MRI - unfortunately the brain is one place to which the melanoma can metastasize. Some oncologists are more selective, only scanning the patients with more extensive melanoma - either very thick (>4mm) , thinner (>2mm) with ulceration, or those with lymph node spread. Many surgical oncologists will make sure the melanoma has not spread elsewehere in the body by doing several scans. The most widely used is the PET/CT scan for checking everything (except the brain) including the lungs, liver, and bones - all places to which the melanoma could spread. The brain is often scanned with either a CT scan or MRI - unfortunately the brain is one place to which the melanoma can metastasize. Some oncologists are more selective, only scanning the patients with more extensive melanoma - either very thick (>4mm) , thinner (>2mm) with ulceration, or those with lymph node spread.

If you have metastatic breast cancer and chemotherapy is part of your treatment plan, your doctor may use different tests to determine how well the chemotherapy is working and how you're handling the chemotherapy. These tests may include CT scans, bone scan, MRI, X-rays, laboratory studies, among others. If these tests show that the cancer is growing or that the cancer is showing up in new areas then that may signal a time when the chemotherapy needs to change. Chemotherapy may also change if it is causing too many side effects and problems for you. If you have metastatic breast cancer and chemotherapy is part of your treatment plan, your doctor may use different tests to determine how well the chemotherapy is working and how you're handling the chemotherapy. These tests may include CT scans, bone scan, MRI, X-rays, laboratory studies, among others. If these tests show that the cancer is growing or that the cancer is showing up in new areas then that may signal a time when the chemotherapy needs to change. Chemotherapy may also change if it is causing too many side effects and problems for you.

In general, most chemotherapy medicines can be used to treat metastatic breast cancer until side effects become a problem or the medicine stops being effective. Breast cancer that has metastasized will often require continual treatment whereas treatment in the non-metastatic setting typically has a defined number or duration of treatments. For example, in the non-metastatic setting, a usual care plan includes surgery with or without radiation therapy, and some type of systemic (drug) therapy, with the drug therapy specified as a certain number of cycles (if chemotherapy) or a certain duration of treatment (for example, tamoxifen for 5 years). In metastatic breast cancer, the goal of medicines is to destroy or damage tumor cells and to shrink tumors or keep tumors stable and in order to do that we have to keep patients on treatment most of the time. Sometimes when the cancer is stable we can provide our patients with some time off or drug holiday but most of the time we have to consider some type of systemic therapy. In general, most chemotherapy medicines can be used to treat metastatic breast cancer until side effects become a problem or the medicine stops being effective. Breast cancer that has metastasized will often require continual treatment whereas treatment in the non-metastatic setting typically has a defined number or duration of treatments. For example, in the non-metastatic setting, a usual care plan includes surgery with or without radiation therapy, and some type of systemic (drug) therapy, with the drug therapy specified as a certain number of cycles (if chemotherapy) or a certain duration of treatment (for example, tamoxifen for 5 years). In metastatic breast cancer, the goal of medicines is to destroy or damage tumor cells and to shrink tumors or keep tumors stable and in order to do that we have to keep patients on treatment most of the time. Sometimes when the cancer is stable we can provide our patients with some time off or drug holiday but most of the time we have to consider some type of systemic therapy.

Malignant cells have a unique ability to break off from the mother tumor, float through the blood stream or lymphatics, get stuck somewhere, and not die. In fact they can survive quite well and continue to divide forming a new tumor mass [metastasis]. Then they have this nasty ability to produce a sort of hormone that causes blood vessels to grow to it thereby ensuring their continued survival. Sneaky little suckers. The good news is that some of our newer 'targeted' therapies take advantage of this ability and are effective at killing some of these tumors. Not the most scientific answer but hope this helps. Malignant cells have a unique ability to break off from the mother tumor, float through the blood stream or lymphatics, get stuck somewhere, and not die. In fact they can survive quite well and continue to divide forming a new tumor mass [metastasis]. Then they have this nasty ability to produce a sort of hormone that causes blood vessels to grow to it thereby ensuring their continued survival. Sneaky little suckers. The good news is that some of our newer 'targeted' therapies take advantage of this ability and are effective at killing some of these tumors. Not the most scientific answer but hope this helps.

The term for the movement of cancer to new locations in the body is metastasis. The new tumors that form at those locations are called metastases.

Metastasis occurs in several different ways. Cancer can spread to other parts of the body by:
1. invading a lymphatic vessel and floating to a new location.
2. invading a blood vessel and floating to a new location.
3. directly 'seeding' nearby organs via physical contact. This occurs most frequently with tumors in the abdominal and pelvic area.

To move to the new location, the cancer cells have to crawl over/past other cells and produce enzymes that act like molecular scissors to help them clear a path as they move. Metastasis is an active process. Most normal (non-blood) cells do not migrate around the body so metastasis is a feature of cancer cells.

Learn more about metastasis: http://www.cancerquest.org/metastasis-overview
Learn about formation of metastasis: http://www.cancerquest.org/formation-of-metastases
Learn about routes of metastasis: http://www.cancerquest.org/routes-of-metastasis The term for the movement of cancer to new locations in the body is metastasis. The new tumors that form at those locations are called metastases.

Metastasis occurs in several different ways. Cancer can spread to other parts of the body by:
1. invading a lymphatic vessel and floating to a new location.
2. invading a blood vessel and floating to a new location.
3. directly 'seeding' nearby organs via physical contact. This occurs most frequently with tumors in the abdominal and pelvic area.

To move to the new location, the cancer cells have to crawl over/past other cells and produce enzymes that act like molecular scissors to help them clear a path as they move. Metastasis is an active process. Most normal (non-blood) cells do not migrate around the body so metastasis is a feature of cancer cells.

Learn more about metastasis: http://www.cancerquest.org/metastasis-overview
Learn about formation of metastasis: http://www.cancerquest.org/formation-of-metastases
Learn about routes of metastasis: http://www.cancerquest.org/routes-of-metastasis

Metastasis is the spread of cancer from the site where it originally forms. Metastasis is extremely important in cancer and is responsible for about 90% of the deaths caused by cancer. When cancer spreads to new locations, new tumors can develop. Technically, the term 'cancer' is reserved for tumors that are invasive, that is, they are able to spread to new locations. Growths that are not able to metastasize are called benign. Benign growths can still cause problems or death but they do not leave their original location.

Learn more about metastasis and watch a video of the process: http://www.cancerquest.org/metastasis-overview Metastasis is the spread of cancer from the site where it originally forms. Metastasis is extremely important in cancer and is responsible for about 90% of the deaths caused by cancer. When cancer spreads to new locations, new tumors can develop. Technically, the term 'cancer' is reserved for tumors that are invasive, that is, they are able to spread to new locations. Growths that are not able to metastasize are called benign. Benign growths can still cause problems or death but they do not leave their original location.

Learn more about metastasis and watch a video of the process: http://www.cancerquest.org/metastasis-overview