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Metastasis

Causes, stages, signs and symptoms of metastasis

The definition of metastasis

Metastases is called a secondary tumor nodes spreading to nearby and distant organs. Their impact on human health more serious than the primary tumor.


The causes of metastasis

The increase in the number of cells in metastasis, promotes growth factors that stimulate the formation of vascular and capillary networks within the tumor cells. Such conditions are accordingly favourable for cancer cells and provide it with all the nutrients, while damage to other tissues of the body. Identify the main way of metastasis:

  • Nodal – spread with the lymph through the lymph vessels. Although the lymph nodes are a barrier to tumor cells, and the majority of them there is delayed and destroyed by macrophages, but if the changed cells many, the struggle fruitless.
  • Hematogenous path of blood through the blood vessels, capillaries and veins.
  • Implant way – serous membrane, resulting in malignant tumor can grow of the body wall and into the abdominal or thoracic cavity.

For each group of tumors is inherent in the formation of a certain type of metastasis, from which largely depends the success of treatment. The growth of the cancer to spread, far ahead of the development of the tumor. The emergence and spread of metastasis is possible once the primary node, and in some cases it may take several years, because there are latent (dormant) metastases.

The presence of dormant metastases may happen after a partial treatment of metastasis or primary tumor. Lymphogenous metastases are formed as a result of the detachment of cancer cells from the primary tumor. Penetrating into the lymph vessel, they flow of lymph fall into the nearest or distant lymph nodes. The emergence of lymphogenous metastasis typical of cancer of the stomach, colon, larynx, cervix cancer and melanoma, sometimes sarcomas.

Lymphogenous way of metastasis of most cancers to date, well researched, their clusters are easily detected and timely treatment of patients to prevent metastasis in different parts of the body. In the neck there is a large concentration of metastasis, because that's where lymph nodes represent a vessel that collects lymph from the head, chest, and upper extremities.

Hematogenouscancer metastases arise when cancer, renal cell cancer, chorionepithelioma when cancer cells caught in a blood vessel, blood flow is directed to distant organs – the liver, kidneys, bones, etc. of Small "dust" metastasis, with the development of ascitesassociated with cancerous tumors of the abdominal cavity and the pelvic cavity. In the case of contact of metastasis cancer tumor cells spread through the adjacent serous membranes.

Metastases of malignant tumors are a complication of cancer in later stages. But at an early stage and can form metastases microscopic quantities in the immediate or distant lymph nodes or organs. Only the General or local resistance of the tissues to their high immunopositive properties can stop the growth of the metastasis. Metastasis of a malignant tumor is more dangerous to human life than the primary tumor.

Clinical studies have proven that the frequency of metastasis depends on the stage of tumor development at the beginning of treatment. In cancer patients, past protivoallergicheskuyu therapy it is impossible to predict accurately whether or not the spread of metastasis, so it is recommended after radical treatment to be examined every 3 months during the first two years.

A lot depends on the location of the tumor. For example, cancer of the rectum can cause the appearance of metastasis in inguinal lymph nodes, and prostate cancer in the bones of the pelvis, sacrum, spine. Influences the frequency of metastasis form of tumor growth and histological structure of the tumor. Rapid metastasis and intense growth of metastases observed in melanoma, are less active in exophytic tumours of the gastrointestinal tract.

The age of the patients affect the recurrence of relapses, the young people metastases develop faster, there is a more severe disease than the elderly people. Any oncologist starts with a thorough survey of the state of the lymph nodes. In malignant mammary tumors and skin tumors, metastases are formed in the lymph nodes of the axillary region.

Appear metastases in inguinal lymph nodes in cancers of the lower extremities, the Sacro-gluteal area, external genitals. In the case of malignant tumors of the stomach, kidney, colon, lung lymphogenous and hematogenous metastases to the liver cover. Many cancer cells forming the metastases are destroyed by the immune system. But some of them stopping in the capillaries, acquire a fabric fiber.

Metastases occur only when tissues formed a sufficient number of malignant cells.The spread of metastasis due to the penetration of tumor cells into the pleura, peritoneum or pericardium, in the cavity between the soft and arachnoid meninges of brain and spinal cord can occur in men of recto-vesical space, and in women in the rectouterine space, and the ovaries. Men more often than women are metastases without primary tumor.

These malignant neoplasms can be in different areas of the human body. Microscopic examination usually reveals adenocarcinoma (in the elderly with multiple metastases in the liver, lungs or bones), squamous cell, poorly differentiated cancer (manifested distant metastases affects the lymph nodes of the neck), or undifferentiated cancer.

Most hidden cancer processes present in the lungs, liver and pancreas. The biopsy location and the growth of metastases can accurately establish the diagnosis. It is sometimes possible to recognize the primary tumor, the primary site of localization which may be pancreas, lungs, colon.


The stage of metastasis

Stage of metastasis is an active and gradual process. It is the movement of tumor cells or groups of cells from the tumor nodule to the vascular wall, penetrating into their lumen, next is cell embolism (throw-in) and attaching to the vessel wall in a neighbouring authority, with subsequent invasion into the perivascular tissue. So developing metastatic node.

Stage of development of metastases in different anatomical areas have different effects on body and danger to the life of the patient. It must be remembered that late diagnosis leads to worse prognosis, as have to deal with the need to treat widespread metastases.

Signs and symptoms of metastasis

Common symptoms and signs of cancer there, it all depends on which organ is affected with this disease. So, for example, the defeat of the peritoneum causes ascites, pleural to the development of exudative pleurisy. Metastases to bones of the skeleton, the spine and cause unbearable pain throughout the body, frequent fractures, there is a limitation.

Additionally, there may be signs of spinal cord compression, problems with urination, numbness of the limbs and the abdomen, and fatigue, lack of appetite, thirst, nausea. The symptoms of brain metastasis include alteration of emotional state, headaches, seizures, altered consciousness.

In the process of tumor cell death, the released toxinscause intoxication of the organism. The presence of metastasis in the lungs does not show much of symptoms and no effect on health. Only when there is cough, there is a bloody discharge in the sputum, slight fever, weight loss and shortness of breath becomes clear that the process is already running.


Diagnosis metastasis

Before you start the treatment of metastasis requires the examination of all parts of the body, detecting tumors, therefore, assigned to cytological examination. The emphasis is on the examination of the tumor, its location. It turns out the localization relative to the capillary network formed from blood vessels, through which flows an infected with cancer of the blood.

Always places the primary of metastasis are lymph nodes, liver and lungs. Rarely metastases comprise skeletal muscle, heart muscle, skin, spleen, pancreas. The average locations of metastasis from Central nervous system, skeletal system, kidneys, adrenal glands. Metastases to bones, lungs and adrenal glands to diagnose the prostate, breast and thyroid glands, lungs and kidneys.

Superficial forms of malignant tumors that grow vistillas on the surface (exophytic growth) such as cancer of the skin, less likely to metastasize than tumors that grow into the body wall or organ tissue Exophytic malignant tumors of the stomach more favorable tumors infiltrative forms, which increase the thickness of gastric wall.

For cancer diagnosis and recognition of metastases is used-plain radiography, to traditional ultrasonography. More modern methods, such as radioisotope research tomography, magnetic resonance imaging, positron emission tomography oncologists have the opportunity to determine accurately the magnitude, prevalence and nature of growth of metastases. To reveal the process of their decay, abscesses and sprouting in neighboring organs and tissues, monitoring of the effectiveness of the treatment on the level of regression of metastases.


Treatment of metastasis

The success of treatment of cancer metastasis depends on the volume they occupy, and how professionally diagnosed, because often micrometastases and circulating tumor cells difficult to be detected with conventional methods. It is believed that surgical removal of detected tumor does not give much result and positive outcome. Sometimes removal of the primary tumor leads to an acceleration of growth of metastases due to a known effectbraking.

In the oncological centers with modern diagnostic equipment, new surgical devices and instruments metastasis of cancer is treated very effectively. Using the method of the Cyber knife, proton beam therapy, for critically ill patients with 4th stage of cancer created a program of clinical testing. Early detection and control possible occurrence of metastasis or tumor recurrence, the main task in the struggle for the life expectancy of patients suffering from oncological diseases.

Usually, the best survival is observed in the use of combined methods of therapy. The active chemotherapy and radiotherapy, surgical treatment of single metastases to prevent their further growth at the earliest stages of the disease. Treatment cancer metastasis is a complex process, they are compared with the parent tumor cells exhibit greater resistance to chemotherapy.

Therefore, in some cases, use of systemic therapy, including chemotherapy, hormonal therapy, targeted therapy, surgery, radiotherapy to alleviate symptoms, and in advanced stages to extend the life.

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