The cancer has metastasized. At what stage of cancer do metastases appear, and what are they? Damage to the cervical lymph nodes

Every day, thousands of abnormal cellular structures appear in the human body, which can later acquire a malignant status. Thanks to the immune system, these cells are destroyed in a timely manner.

But if immune defense for certain reasons, these cells are allowed to pass through, then they multiply unhindered, forming into a tumor.

What are metastases in cancer?

Malignant cells from foci of primary localization spread through blood and lymph flow to other organic structures, forming metastatic foci, which are actually secondary localizations of cancer.

So, metastases are cancer cells that spread throughout the body from the main focus of the tumor process.

When cancer spreads into neighboring tissues, it is called regional metastasis. If malignant cellular structures penetrate into peripheral tissues through the bloodstream or lymphatic fluid, then distant metastasis occurs.

Reasons for the spread

In general, metastasis is caused by certain oncological growth factors that stimulate the formation of capillary and vascular networks around the tumor formation.

As a result, it is created favorable environment for malignant structures, which provides them with the necessary nutrition. In this scenario, metastasis occurs throughout the body.

In general, the spread of malignant cells can occur in different ways:

• With the bloodstream - malignant cells spread hematogenously through veins, capillary structures and vessels throughout the body;
• With lymph flow. Lymph nodes act as a protective barrier for malignant structures and their partial destruction occurs in them. But when there are too many changed cells, macrophages cannot cope with them;
• Implantation or along the membrane of serous tissue.

Metastases of lymphogenous origin are most common in both, and, and.

Hematogenous routes of metastasis are usually observed with late stages chorionepitheliomas and pelvic and abdominal tumors, hypernephroma, etc.

At what stage do they appear and how quickly do they spread?

If a cancer patient does not receive the necessary treatment, then metastases will occur over time in any cancer process, but the timing of appearance is not always clear.

In some oncological pathologies, metastasis occurs within a few months after the formation of the primary tumor focus, while in others it is detected only after several years. Therefore, it is impossible to even tentatively establish the timing of metastasis.

Considering metastasis in the lymph system, we can say that metastases are a sign of the transition of cancer to the second stage of development.

If hematogenous spread of malignant cells appears, then we're talking about about the transition of oncopathology to stage 4. On average, metastases form at stages 3-4 of cancer. That is, in fact, the appearance of metastatic processes determines the stage of the cancer tumor.

Video about how cancer metastasizes:

How do different types of cancer metastasize?

Typically, metastases are detected in the pulmonary structures, liver and lymph nodes. Much less frequently, metastatic foci are found in the heart and skeletal muscles, spleen and pancreas.

Experts have identified a certain pattern of cancer metastasis in different locations:

• Melanoma usually metastasizes to muscle or skin;
• – into a healthy lung, liver and adrenal tissue;
• A malignant tumor in the uterus, stomach and pancreas usually metastasizes to the lungs, liver and abdominal cavity;
• It is mammary glandular and spreads mainly to liver and lung tissues.

Why are they dangerous?

Lethal outcome in cancer pathologies often occurs precisely because of active metastasis rather than due to the presence of a primary tumor. Therefore, metastases are very dangerous.

1. They disrupt vital activities important systems and organs;
2. If metastases appear, the body can no longer resist cancer on its own;
3. Metastasis negatively affects the course of the oncological process and the patient’s condition, worsening it.

Varieties

Metastasis has many options and varieties that differ significantly from each other.

Virchowsky

Virchow's metastasis is localized in the supraclavicular region of the neck and occurs against the background of gastric cancer. This location of the secondary cancer focus is determined by the direction of lymph flow from abdominal cavity.

Malignant cellular structures rise along the lymphatic pathways precisely to the cervical lymph node; they cannot pass further, so they begin to form into a secondary tumor. Virchow metastasis can occur as a result of other abdominal structures.

Krukenbergsky

Such metastases are also characterized by lymphogenous origin and are localized in the ovaries. The share of such secondary tumors accounts for about 35-40% of total number ovarian metastases.

Krukenberg metastases are observed in malignant gastric, mammary glandular, intestinal or bile duct lesions, bladder or cervical cancer.

Schnitzler

Schnitzler metastases are the spread of malignant process into the tissue of the peri-rectal localization and pararectal lymph nodes.

Such metastatic formations can be palpated during rectal digital examination and present as painless lumps.

Most often occurs against the background of stomach cancer.

Osteoblastic

Metastatic tumors that form in bone tissue and promoting the activity of osteoblasts are called osteoblastic. Against the background of increased osteoblastic activity, increased calcium deposition occurs in bone tissue, which contributes to their rapid growth.

Such metastatic foci occur against the background of mammary glandular or prostatic cancer, sarcomas, etc. The prognosis is mostly unfavorable.

Solitary

Metastases of the solitary type are large-nodular single formations localized in the lung, brain and other tissues.

Osteolytic

Osteolytic secondary formations are also localized in bone structures, however, their effect on bones is of a slightly different nature. They destroy bone tissue and activate osteoclasts, which leads to destructive changes in bones.

Symptoms and signs

The clinical picture of metastasis depends on its location and type of primary tumor. Typically, metastases lead to severe dysfunctional changes in the structures of the body.

• With liver metastasis Patients experience itchy skin, jaundice and liver failure;
• Brain metastatic processes lead to rapid;
• Pulmonary metastasis causes bronchopulmonary inflammation, respiratory disorders, etc.;
• Bone metastases are characterized by severe pain throughout the body.

On the skin

Skin metastases occur mainly due to malignant lesions ovaries, lungs and kidneys. Metastatic processes on the skin are of lymphatic or hematogenous origin. In men, such metastases are localized on the abdomen and neck, chest and head, and in women on the chest and abdomen.

Signs of skin metastases:

1. The appearance of formations similar to moles;
2. Change in skin color at the site of metastases;
3. Rapid increase in skin formation;
4. Asthenia;
5. Exhaustion;
6. Drowsiness and weakness;
7. Lack of performance;
8. Painful sensations in the area of ​​the tumor;
9. Weight loss and hyperthermia.

The photo shows what stage 4 cancer looks like with metastases on the skin

If the metastasis has formed on the scalp, it usually looks like a sebaceous cystic formation.

In the ribs

The first signs of rib metastases are intense pain, leading to limited mobility. At later stages, secondary tumor foci can lead to rib fractures that occur even with minor loads.

Cancerous tumors of the thyroid gland, breast, prostate and cervix, liver and lungs, etc. most often metastasize to the ribs. To detect them, it is necessary to carry out.

Heart

Secondary cardiac tumors usually arise from pleural, carcinoma, melanoma or esophageal squamous cell carcinoma, renal and thyroid oncology or.

Signs of cardiac metastases are:

• Pericardial effusion;
• Obstruction of veins in the myocardium;
• Depression of cardiac activity;
• Arrhythmia, myocardial failure.

Peritoneum

Cancer cells can invade any part of the body, particularly the abdominal cavity. Malignant structures settle on the surface of the internal organs and peritoneal walls. They accumulate for quite a long time, gradually forming a secondary tumor.

Such processes in the body are usually accompanied by causing an increase belly. If the tumor begins to disintegrate, then general signs intoxication.

For breast cancer

Metastatic foci in the mammary gland are manifested by the appearance of lumps in the breast, which are easily felt by palpation.

Malignant cells penetrate into the mammary gland through the bloodstream or lymphogenously. The patient feels intense pain in the chest and other uncomfortable sensations.

Distant metastases

The greater the parameters of the primary formation, the earlier the metastatic processes will begin. Typically, the real threat of metastasis occurs when the tumor exceeds a 3-cm diameter.

Together with the bloodstream, malignant cells spread to distant tissues and organs, which indicates the late stages of the tumor process.

• If metastases occur in the skeletal system, then patients experience bone pain, which can seriously reduce their quality of life.
• If breast cancer has metastasized to the lungs, then the patient is worried about shortness of breath, cough and chest pain.
• With nervous system metastasis dizziness and headaches, convulsions and hallucinations, auditory and visual disturbances, coordination disorders, etc. appear.

Regional

Already on early stages Metastases may occur in regional lymph nodes. Typically these are axillary lymph node structures.

But if the primary tumor has formed closer to the center of the chest, then the sternal lymph nodes undergo metastasis.

Subsequently, the cancer process spreads to more distant lymph nodes.

In the intestines

Metastasis to the intestine is accompanied by frequent diarrhea or constipation, blood in the stool, abdominal pain and bloating.

In addition, waste products of cancer formation cause general intoxication of the body, which is manifested by dyspeptic disorders.

Kidney

The main sign of metastasis in the kidneys and adrenal structures is hematuria, which is characterized by the presence of blood in the patient’s urine.

An additional sign of kidney metastasis is pain in lumbar region, constant temperature and weakness, elevated blood pressure and progressive anemia.

Spleen

Metastases in the spleen are extremely rare, because the organ itself is capable of producing substances that destroy malignant cells.

Obvious signs of metastasis include fever, thrombopenia, increased organ size, heaviness and pain. As the secondary tumor grows, the condition worsens and the body becomes exhausted.

Pleura

Pleura lines chest wall and lungs on the inside. It produces a special lubricant that facilitates pulmonary function during breathing. Metastasis to pleural tissue is accompanied by cough, low-grade fever and pain in the sternum.

Stomach

Metastasis in the stomach is quite rare, with tumors spreading here from the uterus, esophagus, breast or lung. Metastasis is accompanied by hyperthermia and lack of appetite, anemia and taste changes, pain in the stomach, etc.

Ovarian

At the initial stages, ovarian metastases do not manifest themselves in any way. Some cancer patients experience a lack of appetite and general weakness, menstrual irregularities and hyperthermia. When the metastasis increases, painful sensations and a bursting feeling appear in the lower abdomen.

Adrenal glands

Many tumors metastasize to the adrenal glands, for example, from the lungs, kidneys, mammary glands, etc.

Such tumor spread causes adrenal insufficiency.

Large secondary formations are almost always accompanied by necrotic processes.

For uterine cancer

Metastasis begins at stage 3 of the oncological process. The spread of malignant cells occurs through the lymphogenous route, and hematogenous spread is possible at the last stage of cancer.

Patients complain of spotting between periods, lumbar pain and pain in the lower abdomen, especially during exercise.

Bladder

Metastatic spread of malignant cells into the bladder structures occurs through the lymphogenous route, mainly from the pelvis or ureter.

At first, symptoms most characteristic of cystitis appear, including frequent urges, lumbar pain, and painful urination.

With the development of metastasis, the condition worsens, and constant hyperthermia, blood in urine, etc.

Pancreas

Pancreatic metastasis is characterized by such manifestations as sudden weight loss and lack of appetite, nausea and vomiting syndrome, epigastric pain and frequent diarrhea.

Sometimes metastases in the pancreas cause some yellowing of the skin and girdle pain in the abdomen.

Throat

Metastatic formations in the throat usually appear from tumors of the mouth, respiratory and digestive organs. Most often, such localization of metastases causes the following symptoms:

• Sores and sores in the throat;
• Swelling of oral tissues;
• Problems speaking, breathing, swallowing;
• Enlarged lymph nodes, etc.

How to detect in the body?

Detection of metastases requires a thorough diagnosis, including:

• Survey radiography;
• Radioisotope diagnostics.

Such procedures make it possible to determine the degree of metastasis, the size of secondary tumors, germination into other tissues and the presence of purulent processes or decay, growth patterns, etc.

Are they visible on ultrasound?

Ultrasound diagnostics is one of the main methods for detecting the metastatic spread of malignant processes.

Such a study is considered quite informative and is widely used in modern diagnostic practice.

How to cure?

Treatment of cancer pathology with metastasis is determined by the location, size and number of secondary foci. Several different techniques are used: surgical removal, And drug therapy.

Surgical treatment

Initially, doctors try to remove the primary formation, which in the future may act as a source of metastases.

Then they proceed directly to the removal of the metastatic foci themselves. To do this, the lymph nodes and adjacent tissue are removed.

When removing secondary formations, the surgeon also cuts off part of the healthy tissue, which may also contain micrometastases.

Radiofrequency ablation

Radiofrequency ablation is now successfully used in the treatment of metastatic spread of tumor processes.

This method involves destroying the tumor through high temperatures created by special electrodes. Electromagnetic currents heat malignant tissues and destroy them. Then the dead cells dry out, and a scar forms in their place.

Medicines

Drug treatment of metastatic tumors involves the use of methods such as and hormonal therapy.

Chemotherapy with antitumor drugs stops the growth and spread of metastases. This technique is often combined with radiation or radiofrequency ablation.

How long do people live with metastases: prognosis

Typically, the presence of metastases in lymph nodes and other organic structures indicates an unfavorable prognosis for oncological pathology.

• Prognosis of metastases in the abdominal cavity. The mortality rate for such metastasis today is 5%. Timely detection of abdominal metastasis and mandatory chemotherapy with appropriate rehabilitation, it greatly increases the patient’s chances of a favorable outcome from oncology treatment.
• To the adrenal glands. Adrenal metastases are usually combined with damage to other organs, so the prognosis depends on the specific clinical situation.
• Mediastinum. Such metastasis, if detected early, can have a positive outcome, however, if detected late, the prognosis is unfavorable.
• Intestines. At timely application to the oncologist there is a tendency for a favorable outcome of the disease. Cure with timely surgical intervention in combination with radiotherapy and chemotherapy occurs on average in half of the patients. In the later stages, the prognosis is disappointing.
• Liver. Without treatment for metastatic liver lesions, survival is 4 months. Upon receipt necessary assistance The patient’s life is extended by one and a half years; additional chemotherapy can give the cancer patient about another year of life.
• Lungs. Unfavorable factors for pulmonary metastasis are its appearance earlier than 12 months after removal of the primary cancer focus, as well as the rapid increase in metastatic tumors. The 5-year survival rate for single metastases and after adequate treatment is about 40%.

Almost all patients with cancer die within a decade, regardless of the presence of metastatic processes. And if they are present, then life expectancy is significantly reduced.

If the patient has terminal (fourth) stage of oncology and there are metastases, then life expectancy is several weeks, and sometimes days, depending on the type of tumor.

Metastatic cancer(cancer metastases) – indicates that cancer tumor has increased, sprouted and is now spreading through the blood and lymph flow.

Cancer metastases today are quite successfully treated in clinics that use the latest advances in oncology - in Israel, Western Europe, and the USA. Modern medicine has recorded thousands of cases of cure for metastatic cancer, and this is a fairly good reason for optimism and for not giving up, but undergoing adequate and professional treatment, which is always available in foreign clinics.

Of course, it is still too early to talk about a 100% cure for metastatic cancer, but significantly prolonging active life and improving its quality is “a gamble that is worth the candle,” and hardly anyone will disagree with this.

The very fact that cancer mortality in last decades lost its “primacy” cardiovascular diseases, that is, decreased, indicates an increase in the effectiveness of treatment of metastatic cancer, but the main thing is that it makes sense and has a place to be.

What is metastatic cancer?

There are 2 types of cancer:

• primary cancer , growing directly from organ tissue;
• , brought in from another organ. In other words, this is what we used to call metastases. Translated from Greek, the word metastasis means movement.

The presence of metastases indicates stage 4 cancer, regardless of the size of the primary tumor. This indicates the spread of cancer and a threat to the patient’s life. There are often cases when a patient is diagnosed with metastatic cancer for the first time when the primary tumor is not diagnosed.

How do tumor cells get from one organ to another?

The entire body is penetrated by blood and lymphatic vessels, and all tissues are washed with blood and lymph, including tumors. Malignant cells enter the lymph or blood and through the vessels - into the systemic and pulmonary circulation, and settle in various organs and there, multiplying, they form metastases.

• Some types of tumors metastasize primarily through the lymphatic vessels - these are epithelial cancers .
• Cells are more likely to spread through blood vessels melanoma and various types of sarcomas .

Mechanism of metastasis formation

Structure malignant tumors differs from normal tissues in its friability, as a result of which cancer cells are separated from the tumor and enter tissue fluid, then into the lymphatic and blood vessels, spread throughout the body, and, settling in organs and bones, rapidly divide, forming secondary tumor foci - metastases.

This process is influenced by many factors - biochemical and immune processes, some of which contribute to the spread of cancer cells, others, on the contrary, block them. Therefore, the process of metastasis can be very active or slow, and this also depends on the degree of malignancy of the tumor.

The intensity of metastasis is influenced by many factors:

• viral infections;
• intoxication;
• alcohol;
• eating disorders;
• avitaminosis;
• nervous stress weakens the immune system and promotes early tumor metastasis;
• blood circulation: in elderly patients with severe vascular atherosclerosis, metastasis occurs more slowly than in young or childhood patients.

Organs most often affected by metastases

A tumor of any location can metastasize to almost any organ.

In principle, metastases can form in almost any part of the body, but most often they are affected:

• liver;
• lungs;
• kidneys;
• skeletal system(spine, pelvic bones and limbs, ribs, skull, sternum);
• central nervous system;
• organ of vision.

The liver and lungs are special organs that pass through themselves blood coming from the whole body, so they are more often affected by metastases. The second place is occupied by the skeletal system, which is very “convenient” for cancer cells to settle in it and develop, due to its special blood circulation and structure. The eyeball and orbit are often affected by metastases in lymphoma and melanoma.

Symptoms of metastatic cancer

Since metastatic cancer is an advanced 4th stage, the so-called minor sign syndrome is characteristic:

Symptoms of metastases can be expressed in varying degrees in different patients.

Local manifestations of metastases depend on their location:

• metastases in the lungs– cough, in the chest, shortness of breath;
• – pain in the hypochondrium, abdominal enlargement, yellowness of the skin;
• – constant pain that is not relieved by analgesics, the appearance of pathological fractures;
• – headaches, seizures, periodic vomiting, disorders of sensitivity, speech, memory, vision and hearing, etc.

In most cases, metastases do not have pronounced local symptoms, and are detected during examination of a patient with a tumor.

Diagnosis of metastatic cancer

Abroad, when examining a cancer patient, the most modern diagnostic technologies are used, which make it possible to identify the presence of secondary tumor foci in organs, tissues, and bones:

• tomographic methods (CT, MRI, PET-CT);
• scintigraphy;
• CT-ultrasound;
• instrumental diagnostics (thoracoscopy, laparoscopy) with biopsy;
• various diagnostic punctures under the control of a tomograph;
• full laboratory research, including immunological, molecular genetic;
• contrast angiography method;
• endoscopic diagnosis with biopsy;
• blood testing for the presence of specific tumor markers;
• examination of all organs, scanning of the skeletal system.

All organs and cavities of the body, the central nervous system, and the skeletal system are subject to examination for cancer.

Treatment of metastatic cancer

The very phrase treatment of metastases can cause a skeptical smile in many. After all, we are accustomed to the fact that if a cancer patient has metastases, he is doomed, and no treatment will help. In principle, this is true where modern technologies are not used, and patients live out their lives on symptomatic treatment– painkillers, heart medications, etc.

Treatment of metastatic cancer abroad is quite possible, and it produces results. Even if patients are not cured in all cases, their lives are extended by years. And this is worth a lot. Foreign oncology clinics have the latest technologies and methods for detecting and removing metastases.

Both systemic and local therapy are used to treat metastases in Israel.

For multiple metastases it is prescribed:

• polychemotherapy courses, in accordance with the sensitivity of the tumor to drugs;
• radiation therapy;
• hormone therapy;
• innovative treatment with biological drugs that block metabolic processes in tumor cells.

The leader is treatment of metastases using radiosurgery, when, under the control of a tomograph, a beam of rays from a gamma knife or cyber scalpel apparatus is directed to the node. Within 1-3 sessions, the metastatic node is destroyed, and healthy tissue remains undamaged. Radiosurgical removal today is performed using the most modern equipment, which ensures greater precision and eliminates burns to healthy tissue.

A huge place in the treatment of metastatic cancer in Israel is occupied by modern technology, which has many drugs that create active and passive anti-cancer immunity. The know-how of this method is the technology of monoclonal antibodies that can search for cancer cells throughout the body and block them. Monoclonal antibodies are also used in combination with radioisotopes and chemotherapy drugs, delivering them to cancer cells. With the advent of this technology, treatment outcomes for metastatic cancer have improved significantly.

How long do people live with metastases?

The Internet is replete with a variety of scary articles about life prognosis for cancer patients with metastases. But this is far from a death sentence. Everyone who decides to fight for their life has a chance. Modern medicine, advanced technologies, innovative drugs and the professionalism of doctors make it possible to significantly prolong the patient’s life or cure cancer forever.

Metastases in the lungs. Forecast

Most often from of this disease Men over 60 years of age are affected. Usually they can be diagnosed in the last stages of the disease, and therefore there is a huge danger to the patient’s life.

The result of treatment depends on several factors:

• extent and location of the primary tumor;
• number and size of metastases;
• TIMELY provision of medical care.

Today, the following methods of treating lung metastases are used: surgery, radiation therapy, chemotherapy, hormone therapy, laser resection, radiosurgery.

Scientists around the world are constantly developing and introducing new treatment methods into their practice. oncological diseases. They are already available to any patient and give him big chance for a cure.

Metastases in the liver. Forecast

Liver metastases are a manifestation of stage 4 cancer. Treatment is comprehensive and includes removal of nodes, chemotherapy, radiotherapy, and immunotherapy.

In modern clinics, surgical excision of nodes is used extremely rarely; less traumatic and more modern methods removal:

There is a stereotypical opinion among representatives of the post-Soviet space that metastases are the end. Today, even in Russia, there are specialized oncology clinics that use almost all the advanced techniques of foreign medicine. It is a well-known fact that Israeli and German doctors managed to save thousands of patients. They managed not only to prolong the life of many patients, but also significantly improved its quality.

It is impossible to give an accurate prognosis for life expectancy with liver metastases.

There are always factors that influence the further outcome:

• stage of the disease;
• size and number of metastases;
• placement of metastases;
• the presence of metastases in other organs.

The prognosis will improve significantly if it is possible to remove the metastasis(s). Much, of course, depends on the type of treatment. Statistics show that 35% of patients live with liver metastases for up to five years. If treatment is refused, the person will live for a maximum of 5 months.

Metastases in the bones. Forecast

IN in this case cell metastasis makes itself known very quickly, and the patient has the opportunity to begin timely fast treatment. Oncologists from the world's leading clinics no longer shrug their shoulders when faced with a similar diagnosis.

After all, there are already methods that can prolong a patient’s life and improve his well-being:

• removal of a metastatic node;
• blocking further spread of cancer cells;
• restoration of bone destroyed by metastasis, or prosthetics;
• restoration of function, removal pain syndrome.

At the same time, the primary cancerous tumor is treated at the same time. If treated correctly, the patient will have up to 5 years of life.

Metastases in the brain. Forecast

Metastasis in the brain is a phenomenon that occurs 7 times more often than primary processes in the head. A complete cure for such patients is impossible, but with proper treatment the patient has a chance to significantly prolong and improve his life.

The main types of treatment for brain metastases are:

• neurosurgery;
• radiation therapy.

The further outcome and result of treatment depends on the size and type of tumor, the location of the primary tumor, as well as the general condition of the patient. Patients should not lose heart, because today new drugs and various methods of therapy are being actively developed, giving many great hope that cancer can be defeated.

You can’t waste yourself on treating metastases folk remedies. This may cause even more harm, but most importantly, precious time will be lost.

Cost of treatment for metastatic cancer

Cancer treatment in general is quite expensive, especially stage 4, no matter where it is carried out. Naturally, a patient planning to go abroad for treatment is always interested in the cost of treatment for metastatic cancer.

It is important to understand the following:

• Firstly, it is always determined individually for each patient, depending on the treatment program chosen for him.
• Secondly, its size will vary depending on different countries, which depends on the state’s pricing policy for medical services for foreign patients.

In this regard, treatment in Israeli clinics is the most affordable, because it is an order of magnitude lower than in Western countries, with the same level of medical technology.

There is nothing more valuable in this world than human life. If you decide to fight for your life, we will lend you a helping hand. Treatment of metastatic cancer abroad is a reality that can improve the patient’s condition and life expectancy.

To get a comprehensive answer about the treatment of cancer metastases, as well as to find out more about the prices for treatment, fill out the website , or contact us at the telephone numbers provided.

Resumption of cancer as a result of relapse or transfer of cancer cells to other organs is possible even after a long period after radical surgery, not to mention the cases where neither the doctor nor the patient knew about neoplasia, the disease was asymptomatic, and no treatment was carried out. Sometimes the first diagnosis of a person who comes to the oncology clinic is metastases in the liver, lungs or other target organs.

This diagnosis really sounds like a death sentence, because even the ignorant understands: the “evil” cell has spread throughout the body, multiplied and formed new malignant foci, which are difficult to count and remove. The oncological process can be eliminated before the cancer cell leaves its place of birth, and metastasis casts doubt on the successful outcome of treatment.

Pathways for cancer cells to spread

Cancer, unlike benign tumors, is not limited to one area. It grows into neighboring tissues and spreads to other organs. The spread of cells that have lost intercellular connections, broken off and set off on a journey throughout the body is metastasis.

This process can be implemented in three ways:

• Lymphogenic. First, the cancer cell penetrates the regional lymph nodes, which are located next to the organ affected by the malignant process. As the tumor progresses, more and more cells are concentrated in the lymph and reach distant lymph nodes located around blood vessels liver, intestines, spleen, adrenal glands, etc.
• Hematogenous, which ensures transport in the blood. Cancer cells move through blood vessels and end up in other places, sometimes very distant from the primary tumor. The most vulnerable in this regard are organs that have a wide network of capillaries, so metastases in the liver and lungs are most common.
• Implantation the pathway realizes the dissemination of cancer cells through the serous membranes (mesothelium). This occurs when the tumor is close to the mesothelium or in the case of a large tumor node, which, increasing, reaches the peritoneum, pleura, and pericardium. By seeding the surface of the serous cover, malignant cells form a process called carcinomatosis. Often this phenomenon is accompanied by the accumulation of fluid in the cavities (ascites, hydrothorax). As a rule, carcinomatosis corresponds to stage 3 or even 4 of the disease and occurs more often in older people, which significantly complicates not only the lives of patients, but also treatment.

spread of metastases throughout the body

Some neoplasias are so aggressive that even in the early stages they can penetrate lymph nodes or other organs (nearby and distant), forming microscopic foci of tumor growth. A lesion is not always able to develop into a full-fledged metastatic tumor. A completely viable cancer cell brought in through the blood or lymph flow can lie low and remain for a long time without growing. This occurs in cases of sufficiently high total or local immunity, which prevents the proliferation of tumor substances.

Thus, untimely or inadequate treatment, or even its absence if neoplasia was not recognized at the beginning of its development, threatens further spread of the tumor process - the transfer of malignant cells, that is, metastasis.

Most often, cancer cells carried away from the primary tumor site settle in target organs (liver, lungs, bones). They often grow much faster than the primary tumor.

Video: principles of metastasis

Lymphogenic route of metastasis

Among all oncological diseases, the bulk of neoplasias are cancers, that is, epithelial tumors (cancer of the uterus, lungs, stomach, etc.). The predominant route of cancer metastasis is the lymphogenous route. Typically, the first blow is delivered to the regional lymph nodes located near the primary tumor site. Thus, the very first metastases in stomach cancer are found in the lymph nodes, which are located along the lesser and greater curvature, around the antrum, in the fundus.

With further progression of the process, cancer cells are transported with the lymph flow and involve other lymph nodes, which can be located at a considerable distance from the primary tumor. In such cases, metastases from gastric cancer can be found in the lymph nodes of the hilum of the spleen, in the mesenteric, para-aortic and even, it would seem, completely in unexpected places. IN advanced stages stomach cancer can be detected Virchow's metastasis in the left supraclavicular lymph node, which reflects a retrograde pathway for the progression of malignant cells against the flow of lymph.

Other examples distant metastases for stomach cancer are Schnitzler and Krukenberg metastases, which occur during the retrograde introduction of malignant cells with lymph into the perirectal tissue (around the rectum) and one or both ovaries (the so-called Krukenberg cancer).

It is worth noting that often asymptomatic stomach cancer is first diagnosed when such distant metastases are detected, for example, a woman consults a doctor with gynecological problems, but receives an unexpected and bad diagnosis (stomach cancer).

One of the most common options epithelial neoplasms is lung cancer, which also tends to metastasize to the lymph nodes. The first “newly created” lesions appear in the peribronchial and bifurcation lymph nodes; later, cancer cells are able to reach the mediastinum, cervical, sub- and supraclavicular areas.

Breast cancer, which is very common these days, also after some time draws lymph nodes into the malignant process, while tumor emboli are found in the parasternal (near the sternum), axillary, and subclavian lymph nodes.

Hematogenous route of cancer cell transfer

The hematogenous route of metastasis, realized through blood vessels, most typical for connective tissue tumors (sarcomas), however, epithelial (cancers) in advanced cases also do not stand aside and often use this route. Some types of tumors may cause metastases to the brain. This is also distant metastasis, which has an extremely unfavorable prognosis, since it not only characterizes an advanced stage of the primary tumor, but is also accompanied by damage to the vital structures of the central nervous system (increased intracranial pressure, cerebral edema and death of the patient in a short period of time).

The liver is a target organ for cancer metastases of all locations

Metastases in the liver are formed from cancer cells delivered there by blood or lymph. They occupy the second place (the first is cirrhosis) among the causes of mortality in diseases of the liver itself.

Most often, metastases to the liver are caused by oncological pathology that originated in gastrointestinal tract, mammary gland, lungs. Less commonly, metastases appear in this target organ in skin, thyroid and pancreatic cancer. Thus, liver metastases can be expected from tumors:

1. Lungs, including mesothelioma (a tumor often associated with exposure to asbestos, the source of which is the serous membrane - the pleura);
2. Cervix;
3. Mammary gland
4. Stomach;
5. Colon and rectum;
6. Kidneys;
7. Testicles;
8. , including melanoma - a tumor of melanin-forming tissue;
9. Bones.

Symptoms of liver metastases

A metastatic tumor in the liver in most cases, in its clinical manifestations, resembles primary hepatocellular carcinoma, the characteristic signs of which (hepatomegaly with pain in the upper abdomen, high activity alkaline phosphatase) are similar to the specific symptoms of liver metastases:

• Signs of general intoxication (weakness, weight loss, loss of appetite, sweating, fever);
• Enlarged liver (hepatomegaly);
• Abdominal pain, ascites;
• Increased activity of liver enzymes, especially alkaline phosphatase (ALP);
• An increase in the content of tumor markers (an increase in the concentration of CEA may indicate the origin of metastases from the gastrointestinal tract, breast or lung).

The presence of metastatic foci in the liver in the case of an asymptomatic course of the primary tumor requires an extensive diagnostic search: ultrasound, scanning, computed tomography, targeted biopsy. Unfortunately, when any tumors metastasize to the liver, the prognosis is pessimistic and the efforts of doctors are in vain, Patients with metastases do not live long: some die after 2 months, and others after six months.

Target organ: lungs

The second place in the frequency of damage to target organs in many malignant processes belongs to the lungs. Tumor cells form a new focus in the lungs, where they arrive mainly through the hematogenous route, less often through the lymphogenous route. Sometimes single metastases in the lungs may remain the only thing for a long time clinical sign oncological pathology. There is even an opinion that such tumors themselves are capable of metastasis. In this case, they will most likely penetrate into nearby lymph nodes.

Metastases to the lungs are characteristic of the following types of neoplasia:

1. Stomach cancer;
2. Cancer of the uterus;
3. Mammary cancer;
4. Colon and rectal cancer;
5. Pancreas cancer;
6. Melanoma;
7. Bone sarcomas;
8. Soft tissue sarcomas (almost always metastasize to the lungs).

Symptoms of metastases in the lungs

Symptoms of metastases in the lungs may long time do not manifest themselves (until the pleura is involved in the process), they are similar to those with a primary tumor (cancer in this organ):

Often metastases in the lungs give clinical manifestations before the primary tumor.

Treatment methods for lung metastases

Treatment depends on many factors: the nature of metastasis, the type and stage of the source of metastases, and the general condition of the patient. Treatment methods for metastatic processes in the lungs do not differ particularly from those for other oncological pathologies:

1. Chemotherapy (of course, a strictly individual approach);
2. Hormone therapy (used if the primary tumor, for example in the breast or prostate, is sensitive to the hormones used for treatment);
3. Radiation therapy (can be used as an independent method or in combination with others).

Single lesions, if they are accessible to surgical intervention, can be removed surgically, however, the condition of the primary tumor (type, location) should be taken into account and radical treatment, based on existing circumstances.

The prognosis for metastases to the lungs is generally unfavorable, since damage to this organ reflects advanced, advanced forms of malignant neoplasms, which are one of the most common causes of mortality from cancer.

Metastases in bones

Secondary tumor nodes in the bones probably occupy third place after metastatic processes in the liver and lungs. Various parts of the spinal column are predominantly affected. Moreover, the clinical manifestations are so pronounced that they significantly affect the patient’s quality of life.

Metastases in the bones give rise to neoplasia of different types and different localizations, for which the spine is a “tidbit” for a new “settlement”:

• Breast, prostate, thyroid glands and ovaries;
• Tumors, liver, rectum;
• Lung and kidney cancer.

Most often, new foci of the malignant process form in the lumbosacral and thoracic regions spine. Often the sites for metastasis are the ribs and femurs, while in the humerus, skull bones and cervical spine they occur relatively rarely. Metastases in the spine and other places, as a rule, give typical symptoms:

1. Muscle weakness accompanied by soreness;
2. Depressive states up to mental disorders;
3. Digestive disorders (nausea, vomiting, constipation, loss of appetite, weight loss);
4. Violations by of cardio-vascular system(a fall blood pressure, arrhythmias);
5. Pathological fractures;
6. In the blood - an increase in calcium levels (hypercalcemia), which, if increased, can lead to kidney damage, coma and death of the patient.

When treating metastases, if the stage of the primary tumor allows and there is at least some hope for a cure (for stage 4 cancer with metastases, hope disappears before our eyes), oncologists adhere to generally accepted treatment algorithms, using:

• Antineoplastic drugs (chemotherapy), if possible. It is hardly advisable to use such a “hard” method of treatment for aggressive stage 4 cancer with metastases, since chemotherapy itself produces a lot of side effects that the patient must endure;
• Radiation therapy is used to directly affect the tumor (treatment) and as a method of pain relief for running forms. It should be noted that it is often possible to bring the primary tumor (depending on its type and location!) to regression and elimination, and subsequently to ensure a long period of remission even in the presence of single foci of metastasis, which in other cases makes it possible to extend life expectancy by several years;
• Treatment of metastatic foci with various drugs pharmaceutical groups, mainly bisphosphonates;
• Surgically removing the diseased bone and replacing it with a prosthesis or bone graft (if possible).

In general, prognosis and life expectancy depend on the type of primary tumor, its location, and the nature of bone metastasis.

Treatment and prognosis

Issues of treatment and prognosis have already been touched upon above, but perhaps, in summing up, it should be repeated somewhat.

There is no specific treatment for metastases. Apply traditional methods: chemotherapy and radiation, which lead to slower growth or partial regression of the tumor, which can alleviate the patient’s suffering and prolong life. Surgical intervention is rarely used when it is possible to remove the tumor along with single metastases.

Timely removal of regional lymph nodes and tumors can sometimes significantly increase life expectancy (10 years or more), but in other cases the prognosis is very serious, for example, the diagnosis of “grade 4 cancer with metastases” is always established if there are distant foci of metastasis even with relatively small sizes primary tumor. In short, the presence of distant metastases clearly makes the prognosis of the malignant process unfavorable.

Video: metastasis is not always a death sentence! Radioembolization for local process in the liver

Oncological disease is an irreversible process. Sooner or later the patient dies of cancer. The only question is: sooner or later? Modern diagnostics and knowledge accumulated in the field of oncology often make it possible to find the primary focus and take emergency measures towards its elimination, but mortality from malignant neoplasms is still at high level. Often due to metastasis, late diagnosis and untimely treatment. The main task of the oncology service is not only to find new methods for detecting tumors in the early stages, but also to make them available to anyone, no matter how remote they live. The educational activities of medical workers also play a significant role, which is aimed at explaining problems, the importance of patient understanding and participation for early treatment and the inadmissibility of self-medication.

Video: stages of oncological processes and metastasis

According to medical data, more than 30,000 abnormal cells are formed in the human body every day, which then become cancerous. The human immune system finds and destroys them. If for some reason the body’s defense system does not work or “misses” cancer cells, then they begin to actively multiply and turn into malignant tumors. Pathogenic cells from the primary focus, using the lymph or blood flow, penetrate into other organs and tissues, forming metastases (metastasis).

What are metastases

Metastases are secondary lesions increase in most malignant tumors. Pathological processes in the body cause the formation of foci in distant and local lymph nodes. These phenomena relate to internal organs:

• lungs;
• liver;
• mammary gland;
• spinal column;
• brain.

Metastasis studies rely on the fact that secondary lesions form almost immediately after the onset of malignant tumor formation. Fragmentary cellular structures through the area of ​​luminal narrowing of the vessel. This type spread is called hematogenous, it can also affect lymphatic structures and this already refers to the lymphogenous path of entraining the number of metastases.

When tumors spread in breast and lung cancer, they affect the brain and are transported with lymphatic fluid and blood. Then they stop in a certain area, leave the vessel and form a site of metastasis. This process develops slowly initial stage, is often asymptomatic, so doctors are unable to notice it right away.

At what stage does cancer appear?

It is impossible to speak unambiguously about the timing of the appearance and spread of metastases throughout the body. For example, cancer metastases spread through the lymphatic system during the transition from stage 1 to stage 2. If the tumors have spread to more distant organ systems, this indicates the 3rd or 4th stage of cancer. It means that different stages The development of the disease is determined by the processes of metastasis, and not vice versa.

Causes

Modern medicine is constantly studying the development of cancer pathologies, but still cannot give an exact answer why cancer appears with metastases. The main problem is determining the mechanism of formation of abnormal cells. If we can solve it, then doctors will be able to prevent their occurrence and cancer will be defeated. In the case of metastases, we need to talk about an advanced disease, which is very difficult to cure. Only aggressive and serious therapy can help, so the main task of all doctors is to prevent the appearance of metastases.

There have been cases in practice where the development of cancer occurs very slowly, over 2-3 years. The accelerated growth of abnormal formations is triggered by mechanisms that have not been studied modern medicine. Doctors can only identify common causes of cancer that develops into a metastatic form:

• severe weakening of the immune system due to concomitant pathologies or enhanced drug therapy;
• the formation of a new branched network of capillaries in the tumor itself;
• at stage 3 of cancer, the first metastases form, which indicate the transition of the disease to the next stage;
• the focus of the pathology is located in places that contribute to the spread of the tumor throughout the human body;
• age of the patient (as a rule, metastases develop more often in young people due to more fast metabolism);
• Secondary lesions occur more often in the infiltrative type of cancer.

Distribution routes

The difference between a malignant tumor and a benign one is that it is not limited to one area of ​​the lesion. Cancer spreads to other organs and grows into neighboring tissues. Metastasis is the journey through the body of cells that have lost intercellular connections. The process occurs in the following ways:

1. Lymphogenic. The cancer cell first enters the regional lymph nodes located next to the organ that has affected the malignant process. As the tumor progresses, more and more cells concentrate in the lymph and penetrate into distant lymph nodes. As a rule, they are localized near the vessels of the liver, spleen, intestines, and adrenal glands.
2. Hematogenous. Metastases are carried along with blood. Cells move through the vessels and end up in other places, sometimes very distant from the primary malignant formation. Often the target organs are those that have a wide capillary network, so the lungs and liver are more often affected.
3. Implantation. This pathway realizes the dissemination of cancer cells through serous membranes(mesothelium). The process develops if the tumor is located close to the mesothelium, the tumor node has reached a large size, which, when enlarged, reaches the pleura, peritoneum, and pericardium. Cancer cells seed the surface of the serous tissue, forming a process called carcinomatosis. Often this process is characterized by the accumulation of fluid in the cavities (hydrothorax, ascites). This route of spread indicates stage 3-4 of the pathology; it most often occurs in elderly patients, which greatly complicates life and treatment of the disease.

Symptoms

Metastatic cancer will manifest itself differently, depending on the location of the secondary lesions. The main symptom of any type of cancer will be pain. The main signs of pathological development include the following manifestations:

1. When metastases enter the brain, a person experiences disorientation, headache, nausea, dizziness, problems with speech and vision, and difficulty walking.
2. If the metastases are in the bones, then there may be no pain. Often the main symptom of the development of pathology is that the bone breaks without damage at all or with minor damage.
3. When cancer metastasizes to the lungs, symptoms occur that indicate other problems. This organ should be checked if a person complains of chest pain, shortness of breath, cough (with blood, dry, wet).
4. In the liver, metastatic tumor is often accompanied sudden weight loss, nausea, jaundice, loss of appetite.
5. The first sign of skin metastases is often the appearance of hard, painful oval or round nodules. They are often skin-colored, red or, if it is melanoma, black or blue. In some cases, several nodules form over a short period of time.

Varieties

There are several types of metastases, so diagnosis of the pathology becomes an important step before treatment. The following types of disease are distinguished:

1. Virchow type. Localized on the neck in the supraclavicular region, it occurs as a complication of gastric cancer. This position of the cancer focus is determined by the direction of lymph flow from the abdominal cavity. Malignant neoplasms rise through the lymph nodes to the cervical node, where they cannot pass further, so they settle there and form a secondary tumor. Virchow metastasis occurs due to the development of cancer of the pancreas, liver, and other abdominal structures.
2. Krukenbergsky. They also have a lymphogenous origin and are localized in the ovaries. These secondary tumors account for about 35-40% of all ovarian metastases. This type appears in malignant lesions bile ducts, intestines, mammary glands, stomach, cervical, bladder cancer.
3. Schnitzler's. The penetration of the malignant process into the tissue of the peri-rectal localization and pararectal lymph nodes is characterized. You can feel such neoplasms during a rectal digital examination; they are painful lumps. Often occur during the development of stomach cancer.
4. Osteoblastic. Cancer metastases form in bone tissue. They promote the activity of osteoblasts, which is why they have this name. Against the background of these processes, active deposition of calcium occurs in bone tissue, which leads to their accelerated growth. Foci occur against the background of thyroid, mammary glandular, prostatic cancer, lymphomas and sarcomas. The prognosis for this disease is often unfavorable.
5. Solitary. This type manifests itself in the form of large-nodular single formations that are localized in the brain, lung tissues.
6. Osteolytic. Secondary tumors are localized in bone structures, but the effect on bones manifests itself differently. They destroy bone tissue and activate osteoclasts, which causes destructive changes.

Stages

As a rule, doctors talk about cancer, but metastases also have a certain gradation, which is marked with the letter M. Only distant formations are taken into account. Highlight next stages:

• Mx – no study has been conducted, so the presence of metastases is unknown;
• Mo – no distant tumor formations were found;
• M1 – distant formations are detected.

Danger of metastasis

In oncological pathologies, death in most cases occurs after metastasis, and not due to the primary tumor. This indicates a high danger of secondary foci, which consists in the following points:

1. They affect the functioning of vital organs and systems.
2. Once metastases appear, the body is no longer able to resist cancer on its own.
3. Anemia may develop.
4. Metastasis has a negative effect on the course of the oncological process and the patient’s condition, which greatly worsens.

How to determine metastases

Effective method diagnostics on early stage secondary neoplasms have not been developed at the moment. There is always a chance that cancer cells migrate. For example, from the mammary gland they can spread to the bones and brain, and colorectal cancer migrates to the liver and lungs. Single detached cells can be detected only at the stage when they have already grown.

The choice of the appropriate test depends on the location of the primary tumor. An oncologist can diagnose metastatic tumors using imaging tests (usually a CT scan). It is possible to do this only when they apparently reach mass; the disease is often at this stage already extremely difficult to treat. Methods for diagnosing metastatic cancer at an early stage significantly increase the patient's likelihood of survival. The following test options are used:

• ultrasound;
• X-ray;
• osteoscintigraphy (scanning the bones of the body);
• MRI (magnetic resonance imaging);
• positron emission tomography;
• CT scan.

A routine blood test can help detect the presence of detached cells if there is an increase in liver enzymes, which indicates metastatic liver cancer. In some situations, even in the presence of the disease, the test shows normal. The data from all tests do not provide final confirmation; they are compared with the presenting symptoms, a general examination of the body, and sometimes a biopsy is performed.

Are metastases visible on ultrasound?

Ultrasonic method research is the main method, if necessary, to detect the presence of metastatic spread of malignant neoplasms. Ultrasound is a highly informative test, which is why it is often prescribed in modern diagnostic practice. As a rule, the patient needs to undergo several examinations to confirm the diagnosis.

Treatment

Secondary foci of malignant neoplasms indicate the transition of the disease to the last stage; the prognosis is often unfavorable. Treatment is selected taking into account the location of the primary tumor, its size and the number of metastases. Several main cancer treatment methods are used for therapy:

• drug therapy;
• radiotherapy;
• surgical removal.

Medicines

Drug treatment involves the use of the following methods: immunotherapy, chemotherapy, hormonal and targeted therapy. Chemotherapy helps stop the growth and spread of secondary lesions. As a rule, this technique is combined with radiofrequency ablation and radiation. Bisphosphonates are widely used in oncology. They are taken orally or administered intravenously. The most popular of this group are the following medications:

1. Zometa. One of the most effective medicines, which belong to the 3rd generation drugs. Helps achieve positive dynamics in hypercalcemia and osteoporosis. The main advantage of the product is its selective action. The drug penetrates well into bone tissue, has minimal side effects, and is well tolerated by patients.
2. Bondronat. Used to fight cancer. This medication is often used by doctors, administered intravenously or taken orally. The product helps relieve pain and reduce the duration of radiation therapy. The dose of the medication is prescribed by the doctor individually.
3. Bonefos. A good medicine that belongs to bone resorption inhibitors. Helps stop the development of the malignant process and slow down the spread of secondary lesions. The drug suppresses the activity of osteoclasts, improves general health patient, reduces the likelihood of new lesions appearing. Bonefos is the best choice in the treatment of breast cancer.

Surgical treatment

Doctors immediately try to remove the primary tumor, which in the future can cause metastases. Next, the secondary formations themselves are directly excised from their localization sites. To do this, lymph nodes and adjacent tissue are removed. During the operation, the surgeon cuts off part of the healthy tissue, because it may contain micrometastases.

Forecast

The appearance of metastatic formations in the human body indicates an unfavorable prognosis for the patient. This indicates the transition of the pathology to the last stage of development. Forecasts for different types metastatic cancer:

1. Metastases in the abdominal cavity. At this stage, the probability of death with this type of pathology is 5%. With timely detection of the disease, chemotherapy and rehabilitation, a person’s chances for a favorable outcome are significantly increased.
2. Adrenal glands. In this case, damage to other organs often occurs, so the outcome largely depends on the specific clinical situation.
3. Mediastinum. Such metastasis in the early stages of detection can result in a positive outcome, but in the later stages the result is unfavorable.
4. Intestines. When contacting an oncologist after the first symptoms appear, there is a tendency to have a favorable prognosis for the disease. Half of the patients experience positive dynamics with timely surgical intervention, which is combined with chemotherapy and radiotherapy. The prognosis at the later stages is disappointing.
5. Liver. Life expectancy for liver damage without treatment is 4 months. If you receive adequate and timely help, a person’s life is extended to 1.5 years, chemotherapy can give another year.
6. Lungs. With single or multiple metastases of this organ unfavorable factor it appears earlier than 12 months after surgery to remove the primary cancer lesion. The 5-year survival rate after a single secondary neoplasm with proper treatment is about 40%.

Video

Metastases are daughter formations of the primary malignant focus, which spread throughout the body through blood and lymph. Affecting all new organic tissues, abnormal cells form secondary foci.

Cancer cells of the main tumor can spread to nearby tissue areas (regional metastasis) or affect peripheral tissues (distant).

Reasons for the spread

Metastasis is the process of dispersal of daughter cancers from the main focus throughout the tissues of the body. Abnormal cells stimulate the formation of their own blood vessels in malignant formation, providing its nutrition, further development new cancer cells, antitumor defense is suppressed.

Thanks to this process, more and more new abnormal cells are formed, separated from the main cancer focus, and dispersed throughout the tissues of the body.

Distribution occurs in several ways:

• With lymph flow (lymphogenous pathway). Active development abnormal cells allows them to overcome protective barriers lymphatic system, penetrate the lymph and spread throughout the body. The lymphogenous type of spread is characteristic of melanomas, sarcomas, stomach, cervical, and colon cancers;
• With blood (hematogenous route). Dispersal of cancer cells occurs through the bloodstream. Hematogenous origin is characteristic of abdominal tumors, neoplasms in the pelvic organs, sarcomas, hypernephroma;
• Implantation propagation occurring by contact.

Features of metastasis of various types of cancer

In most cases, secondary cancer foci are localized in the liver, lymph nodes, and lungs. Infrequently detected in muscles, heart, pancreas and spleen.

There are some features of metastasis of various cancers:

• Lung cancer also affects healthy organs, adrenal tissue, and liver;
• Melanoma in most cases spreads to the liver, skin, muscles, and lungs;
• Cancerous lesions of the kidneys, prostate, and breast “spread” into the tissue of bones, liver, and lungs;
• Cancers of the stomach, pancreas, large intestine, and uterus spread to the liver, lungs, and peritoneum.

At what stage of cancer do metastases appear?

The following stages of cancer are distinguished:

• That is a condition in which the formation is not detected;
• Tis – tumor without secondary neoplasms;
• Stage 1 – cancer that does not metastasize, in most cases, amenable to successful treatment;
• Stage 2 – spread of regional metastases on the body, internal organs (depending on the location of the main focus);
• Stage 3 is characterized by the identification of single removed tumors;
• Stage 4. Spread to nearby and distant organs and tissues is typical. At this stage, patients are tortured severe pain, sudden weight loss, weakness. Stage 4 cancer most often causes death.

Danger of metastasis

In most cases, death occurs due to the spread of daughter tumors, not due to the formation of a primary cancer focus. For the body, secondary formations pose a particular danger:

• The normal functioning of the most important organs and systems becomes impossible;
• With the appearance of metastases, the body is no longer able to resist cancer;
• The spread of daughter foci contributes to the progression of the malignancy process.

Metastatic cancer is dangerous because it is difficult to determine the locations of all secondary foci. For this reason, radiation therapy and surgery cannot completely cure cancer. All subsidiary foci are affected by hormonal, immuno-, and chemotherapy for metastases in the lungs, liver, brain, bones and other organs and tissues. Often similar treatment turns out to be not enough.

Types of metastases

There are different types of metastasis with characteristic features:

• Virchow type. The primary cancerous tumor is localized in the stomach, liver, and pancreas. Cancer cells spread through the lymph flow, stopping in the cervical lymph node (above the collarbone), where a daughter malignant focus is formed;
• Schnitzler's. The main focus affects the stomach. Spread occurs in the pararectal lymphatic angles, rectal area;
• Krukenbergsky. The primary lesion affects the stomach, mammary glands, gallbladder ducts, cervical canal, and bladder. Cancer cells spread through the lymph into the ovaries;
• Solitary. The type is characterized by single cancerous nodes localized in the brain and lung tissues;
• Osteoblastic. Primary foci are formed in the thyroid, mammary glands, lymphomas, sarcomas. Spread occurs in bone tissue, their active growth occurs;
• Osteolytic. Metastases are localized in bone tissue, destroying them.

Metastases in the abdominal cavity

Clinical manifestations of secondary lesions in the abdominal cavity depend on the location of malignant neoplasms and the degree of damage (multiple lesions, solitary metastasis).

Any of the abdominal organs can be affected: liver, stomach, intestines, pancreas, spleen, female reproductive organs. Cancers can form in abdominal wall, retroperitoneal space, affecting its organs: kidneys, ureters, adrenal glands.

The greatest danger is represented by distant metastases - secondary cancer foci formed in peripheral areas, since they are difficult to detect. When a main focus occurs in the organs abdominal area, daughter neoplasms can develop in distant organs and tissues: metastases in the lungs, Virchow-type lesions, metastases in the chest, affecting the ribs.

Spread occurs in 2 ways: through the lymph and bloodstream. The growth of a malignant tumor located close to the peritoneal lymph nodes, in most cases, grows into them. The rapid development of tumor formation leads to penetration into the lymph flow large quantity cancer cells and their distribution to distant organs.

Abnormal cells can reach the most distant organs and form cancerous foci there with the help of the bloodstream (hematogenous pathway). Hematogenous metastases are difficult to detect because they can occur at sites very distant from the primary cancer site.

Symptoms of metastases

How to determine metastases in the body? Characteristic manifestations are caused by the localization of secondary neoplasms, the type of the main focus:

• In the liver, they are characterized by itching of the skin, liver failure, jaundice;
• Secondary lesions in the brain lead to severe encephalopathy;
• Metastases in the lungs are characterized by inflammatory processes and impaired respiratory function;
• Damage to bone tissue is accompanied by severe pain spreading throughout the body.

Skin metastases

Skin lesions develop against the background of lung, kidney, and ovarian cancer. In women, secondary lesions are concentrated in the abdomen and chest; in men, they affect the abdomen and neck.

Symptoms of skin metastases:

• Formation of mole-like formations;
• Rapid growth of neoplasms;
• Change in skin tone in the affected area;
• Asthenic conditions;
• General weakness, fatigue;
• Pain in the area of ​​the tumor;
• Weight loss.

In the ribs

The main foci are tumors of the prostate, cervical canal, lungs, liver, and thyroid gland.

The initial manifestations of secondary formations in the ribs are characterized by severe pain. The pain syndrome hinders movement and does not subside at rest. Subsequently, metastasis provokes pathological fractures that occur even with minor exposure.

Symptoms of muscle metastases

Spread into muscle tissue is uncommon. At the initial stage it is asymptomatic. In the future, compactions can be felt; the growth of a secondary tumor leads to deformation of the muscle tissue. Pain syndrome occurs.

Heart

Spread to the heart occurs against the background of melanoma, carcinoma, leukemia, malignant lesions of the esophagus, kidney, and thyroid gland.

Main features heart damage are:

• Inflammation of the pericardium;
• Heart dysfunction;
• Venous obstruction in the myocardium;
• Arrhythmia

Symptoms of metastases in the abdominal cavity

The clinical picture of lesions in the abdominal cavity depends on the location of the cancerous foci. With small tumor formations, symptoms may not appear, which is the main danger, since such a tumor may not be detected for a long time.

The main symptoms occur when the tumor disintegrates:

• Severe depression;
• General weakness, temperature changes;
• Decreased appetite and weight;
• Attacks of nausea and vomiting.

The concentration of secondary tumors in the liver can provoke a change in the color of the skin and sclera - yellowing, the occurrence of pain, a feeling of fullness on the right under the ribs.

The prognosis for metastases in the abdominal cavity can be favorable with timely detection and adequate treatment. Unfavorable outcome – with stage 4 cancer.

Breast damage

The main manifestations are lumps and pain in the mammary glands. Distant localization of the main tumor in the chest manifests itself:

• Cancer cells in the bones lead to pain throughout the body, decreased mobility;
• Localization of subsidiary tumors in the lungs is accompanied by cough, shortness of breath and pain in the sternum;
• Damage to the nervous system is characterized by headaches, convulsions, and attacks of dizziness.

Regional (nearby) metastases often affect lymph nodes (axillary, sternal).

Metastases in the lungs

Spread to the lungs is, in most cases, asymptomatic. Severe manifestations are present in 20% of patients:

• Constant coughing attacks;
• Dyspnea;
• Mucus or blood produced when coughing;
• Weight loss;
• Temperature up to 38C;
• Soreness, stiffness of the chest.

The latest technologies make it possible to effectively combat metastasis in the lungs with minimal side effects. The most important condition successful treatment is the timely detection of primary and secondary tumors, the extent of damage, general state sick. A timely identified lesion allows one to successfully combat the solitary formation (up to complete healing); a positive prognosis is possible for multiple metastases in the lungs.

It is possible to effectively treat solitary metastases after surgery on the main lesion, using surgical intervention. With the development of multiple formations, hormone treatment is included in the therapeutic course.

Intestines

The main symptoms of spread to the intestines are:

• Stool disorders (diarrhea, constipation), the appearance of bloody clots in the feces;
• Bloating;
• Soreness and feeling of fullness in the intestines.

Stomach

Cancer cells enter the stomach from the lungs, esophagus, uterus, and mammary gland. The growth of secondary neoplasms is accompanied by constant nausea, a feeling of fullness in the stomach, flatulence, taste disturbances. There is practically no pain.

Kidney damage

The main manifestation of metastasis is the appearance of blood in the urine. Associated symptoms: aching, nagging pain in the lumbar region, weakness, fever, anemic condition.

In the spleen

The spread of secondary lesions into this area occurs infrequently. The main symptoms include enlargement of the organ, a feeling of heaviness and pain.

Pleural damage

Secondary tumors in pleural tissues are characterized by constant temperature, pain in the sternum, and coughing attacks.

In the ovaries

At the beginning of the spread there are no symptoms. The growth of metastases is accompanied by pain, bursting sensations in the lower abdomen, decreased appetite, menstrual irregularities, and increased temperature.

To the adrenal glands

Damage to the adrenal glands is accompanied by functional disorders and structural changes.

Metastases in the uterus

The spread of secondary formations occurs at stage 3 of the cancer process. Dispersal of abnormal cells is carried out using lymph flow. Hematogenous metastases appear at stage 4 of oncology.

Damage to the uterus is accompanied by bloody discharge that occurs between menstruation. Pain occurs in the lumbar region, lower abdomen.

Bladder damage

Initially, symptoms similar to those of cystitis appear:

• Frequent urge;
• Lower back pain;
• Pain when urinating.

Pancreas

Damage to the organ is accompanied by a sharp loss of weight, lack of appetite, constant nausea, and regular diarrhea.

Throat lesion

Throat damage occurs due to the spread of cancer cells from the main foci in the mouth, digestive and respiratory systems. In most cases, metastasis manifests itself:

• Ulcerative lesions of the throat;
• Swelling of the oral tissues;
• Impaired swallowing, breathing, speaking;
• Enlarged lymph nodes.

Diagnostics

Diagnostic measures to identify secondary cancer foci include:

• Ultrasound examinations;
• Tomography scans (CT, MRI);
• Radiography;
• Isotope diagnostics;
• Positron emission tomography (PET).

The procedures make it possible to assess the degree of damage, the size and localization of subsidiary tumors, and germination into nearby tissues and organs.

Treatment methods

Treatment methods are determined depending on the concentration, size, and degree of damage by metastases. The surgical method, radio and drug therapy are used.

Surgical method

Initially, the primary cancer focus is removed as the main source of metastasis. After which the daughter malignant neoplasms are eliminated (lymph nodes and adjacent tissue are removed).

When eliminating secondary foci, part of the nearby tissue areas is excised to prevent the risk of persisting micrometastases.

Radiation therapy

The following types of radiation are used: external influence, radiopharmaceuticals, ablation. The method of radiation exposure is determined by the localization of metastases, the degree of damage, and the location of the main cancer focus.

One type of external radiation is stereotactic radiation therapy, which precisely targets the cancer while causing minimal harm to nearby tissue. The disadvantage of this method is the duration of the treatment course.

Radiopharmaceuticals are products that contain radioactive elements. The use is justified for the treatment of cancer, relieving severe pain that occurs with cancer.

RFA - radiofrequency ablation is used to treat certain types of malignant tumors. During the procedure, cancerous tumors are destroyed by thermal effects (heating), electricity, chemicals. As a result of exposure, tumor tissues are destroyed, shriveled and scarred.

Medication direction

When treating with medications, immunotherapy, hormonal therapy, and chemotherapy are used. Methods drug treatment, in most cases, are used in combination with radiation therapy. The complex effect makes it possible to stop the growth and spread of secondary tumors.

Forecast

A favorable prognosis can be observed with timely detection (at the initial stage) and timely treatment.

Prognosis of metastasis at various locations:

• In the abdominal cavity. Treatment will give positive result if detected in a timely manner, use a comprehensive therapeutic approach;
• Metastasis to the adrenal glands, in most cases, is complicated by lesions of other organs. The prognosis is determined by the clinical situation;
• Mediastinal organs. Early detection of secondary tumors gives a chance for a positive outcome;
• Intestinal damage. Early detection, timely surgical treatment, radio- and chemotherapy allow for a successful recovery, on average, in 50% of patients with intestinal cancer;
• Liver. The prognosis is serious. Carrying out the necessary treatment prolongs the patient’s life by approximately 2.5 years;
• Lungs. A person's life, on average, is extended by 5 years with a single metastasis and adequate therapy.

For stage 4 cancer with metastases, the prognosis is disappointing. Life expectancy can range from several days to several weeks.