A friend has cancer that has metastasized from one organ to another. If I want to understand more about what he’s going through, do I look up cancer in the original organ or cancer in the organ it has spread to? Or is it more complex than that?
Thanks!
Maybe I stumbled upon the answer, from the Wikipedia article on metastasis:
" When tumor cells metastasize, the new tumor is called a secondary or metastatic tumor, and its cells are similar to those in the original or primary tumor.[8] This means that if breast cancer metastasizes to the lungs, the secondary tumor is made up of abnormal breast cells, not of abnormal lung cells. The tumor in the lung is then called metastatic breast cancer , not lung cancer ."
I’m sure it’s more complex, but the metastasized tumours will be the same cell type as the primary tumour, so looking that up is probably more informative e.g. if liver cancer metastasizes to the pancreas, it’s not going to be the same as pancreatic cancer.
This is it. Even after it had moved to my lymph nodes, mine was still testicular cancer.
As an example, one way you can tell that prostate cancer has metastasized is if the body still produces PSA (prostate specific antigen), even after the prostate itself is removed, because PSA is produced only by prostate tissue.
But then here’s a contradictory source:
“When cancer starts in one place then spreads to bones, it’s called metastatic bone cancer.”
This is at healthline.com. I take it this isn’t a settled question.
Not to be picky, but that’s not always true.
For example, testicular tumors are not uncommonly of multiple cell types, and the form that metastasizes may be different from the dominant cell type in the primary tumor. Mixed cell type malignancies are also found in other organs with one or more spreading to a new location.
To answer the OP’s question, the natural history of a malignancy is best understood by finding out about the primary. Effects on secondary organs are a separate subject.
That would be a very misleading if not incorrect way to state things. Many primary tumors spread to bone (e.g. lung, breast, prostate, kidney, . . .) but when they do, it’s called metastatic lung cancer, metastatic breast cancer, etc.
This comes up a lot when you take a family history for cancer and people will often say that a relative died of “liver cancer”. In fact, primary liver cancer (i.e. cancer that starts in the liver) is not terribly common (at least in North America and western Europe*) whereas metastases to the liver from a primary non-liver cancer are very, very common. So, in the vast majority of instances, what they really should be saying is their relative died from lung cancer that happened to spread to the liver, or breast cancer that happened to spread to the liver, etc.
*primary liver cancer develops in about 20 percent of people with hepatitis C and around 30 percent of those infected with hepatitis B. So in places with a high prevalence of hepatitis B or C infection, such as southeast and east Asia and sub-Sahara Africa, liver cancer is much more common. If someone from that region is said to have died from liver cancer, it may well be the case that it was a primary liver cancer
I agree! It would be better to have just one way of referring to cancer that started in one location and spread to another.
I’m reminded of when there were four kinds of hepatitis: A, B, Non-A-non-B, and D. Then I heard so many people wanting to call the non-a-non-b “C” and others insisting that that wasn’t its name, and some even saying non-A-non-B-non-C to clarify that it wasn’t C. Then somebody changed the official name to C and the whole problem went away.
Maybe something like that will happen here.
A friend of mine used to work in the heath foods industry, and we were discussing this (in the context of the chronic Hepatitis-B infection I used to have). In the areas of rural China where he sourced nuts from, there were high levels of aspergillus infected nut consumption causing associated aflatoxin-induced liver damage, and high rates of alcohol consumption. These factors combined with high rates of chronic Hepatitis-B to give extremely high primary liver cancer rates.
I would have hoped there was at least one good recent book, aimed at both patients and loved ones, for each type of primary. But there doesn’t always seem to be, and for every general reader mainstream medicine cancer book there may be a dozen that smack of quackery.
This is an example of the sort I would look for, although the word metastasized is not usually used with leukemia: