Metastases - Causes, Stages, Signs And Symptoms Of Metastases, Diagnosis And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Metastases

Causes, stages, signs and symptoms of metastases

Definition of metastases

Cancer metastases are secondary tumor nodes that spread to nearby and distant organs. Their impact on human health is more serious than the primary tumor.

Causes of metastases

An increase in the number of cells in metastasis promotes growth factors that stimulate the formation of vascular and capillary networks around tumor cells. Such conditions are correspondingly favorable for the cancer cell and provide it with all the nutrients, while damaging the rest of the body tissues. The main ways of metastasis are distinguished:

• Lymphogenous - spread with lymph through the lymphatic vessels. Although the lymph nodes are a barrier for tumor cells, and most of them are retained and destroyed by macrophages, but if there are many changed cells, then the fight is unsuccessful.
• Hematogenous pathway - with blood through the blood vessels, capillaries and veins.
• The implantation route is through the serous membrane, as a result of which a malignant tumor can grow through the walls of the organ and enter the abdominal or chest cavity.

For each group of neoplasms, the formation of a certain type of metastases is inherent, on which success in treatment depends to a greater extent. The growth of cancer metastases far outstrips tumor development. The emergence and spread of metastases is possible immediately after the appearance of the main node, and in some cases this may take several years, because there are still latent (dormant) metastases.

The presence of dormant metastases occurs after partial treatment of metastases or primary tumor. Lymphogenous cancer metastases form as a result of the detachment of cancer cells from the underlying tumor. Penetrating into the lymphatic vessel, they enter the nearest or distant lymph nodes with the flow of lymph. The occurrence of lymphogenous metastases is characteristic of cancer of the stomach, colon, larynx, cervical cancer and melanomas, sometimes sarcomas.

The lymphogenous pathways of metastasis of most cancers are currently well studied, their accumulations are easily detected, and timely treatment of patients prevents the penetration of metastases to various parts of the body. A large concentration of metastases is noted in the neck, because it is there that the lymph nodes are a kind of vessel that collects lymph from the head, chest and upper limbs.

Hematogenous metastases of cancer occur in sarcoma, hypernephroma, chorionepithelioma, when cancer cells that have entered a blood vessel are sent with blood flow to distant organs - liver, kidneys, skeletal bones, etc. Small "dust" metastases, with the development of ascites, occur with cancerous tumors of the abdominal cavity and the pelvic cavity. In the case of contact metastases of cancer, the tumor cells spread along the adjacent serous membranes.

Cancer metastases are a complication of advanced cancer. But even at an early stage, microscopic metastases can form in the nearest or distant lymph nodes or organs. Only general or local tissue resistance, their high immunoprotective properties, can stop the development of metastases. Malignant tumor metastases are more life-threatening than the primary tumor.

Clinical studies have shown that the frequency of metastasis depends on the stage of tumor development at the time of initiation of treatment. In cancer patients who have undergone anti-oncological therapy, it is impossible to predict accurately whether the spread of metastases is further, therefore, after radical treatment, it is recommended to undergo an examination every 3 months for the first two years.

Much depends on the location of the tumor. For example, a cancer of the rectum can provoke the appearance of metastases in the inguinal lymph nodes, and prostate cancer - in the bones of the pelvis, sacrum, and spine. The form of tumor growth and the histological structure of the tumor affect the frequency of metastasis. Rapid metastasis and intensive growth of metastases is noted in melanoma, less active in exophytic tumors of the gastrointestinal tract.

The age of patients affects the recurrence of relapses, in young people metastases develop faster, there is a more severe course of the disease than in older people. Any examination by an oncologist begins with a thorough examination of the condition of the lymph nodes. In malignant tumors of the breast and skin tumors, metastases form in the lymph nodes of the axillary region.

Metastases appear in the inguinal lymph nodes with cancerous tumors of the lower extremities, the sacro-gluteal zone, and the external genital organs. In the case of malignant tumors of the stomach, kidney, rectum, lung, lymphogenous and hematogenous metastases cover the liver. Many cancer cells that form metastases are destroyed by the immune system. But some of them, lingering in the capillaries, become overgrown with tissue fiber.

Metastases occur only when a sufficient number of malignant cells are formed in the tissues. The spread of metastases due to the penetration of tumor cells into the pleura, peritoneum or pericardium, into the cavity between the pia mater and the spinal cord can be observed in men in the rectal-vesicular space and in women in the rectal-uterine space and ovaries. In men, more often than in women, there are metastases without a primary focus.

Such malignant neoplasms can be found in various areas of the human body. Microscopic examination usually reveals adenocarcinoma (in older people with multiple liver, lung, or bone metastases), squamous cell, poorly differentiated cancer (manifested by distant metastases, affecting the lymph nodes of the neck), or undifferentiated cancer.

Most of all latent oncological processes are present in the lungs, liver and pancreas. Biopsy, location and growth of metastases allow accurate diagnosis. Sometimes it is possible to recognize a primary tumor, the main site of localization of which may be the pancreas, lungs, and colon.

Stages of metastases

The stages of metastasis are an active and gradual process. It consists in the movement of a tumor cell or a group of cells from the tumor node to the vascular wall, penetration into their lumen, then cell embolism (injection) occurs and attachment to the vessel wall in a neighboring organ, followed by invasion into the perivascular tissue. This is how the metastatic node develops.

The stages of development of metastases in different anatomical areas differ in their effect on the body and the danger to the patient's life. It must be remembered that late diagnosis leads to a worse prognosis, since one has to face the need to treat widespread metastases.

Signs and symptoms of metastases

There are no general symptoms and signs of cancer, it all depends on which organ is affected by this serious ailment. So, for example, damage to the peritoneum leads to ascites, pleura - to the development of exudative pleurisy. Metastases to the long bones of the skeleton and the spine cause unbearable pain throughout the body, frequent fractures occur, and there is limited mobility.

In addition, there may be signs of spinal cord compression, problems with urination, numbness of the limbs and abdomen, as well as fatigue, lack of appetite, thirst, and nausea. Symptoms of metastases in the brain include changes in emotional state, headaches, seizures, altered consciousness.

In the process of death of tumor cells, the released toxins cause intoxication of the body. The presence of metastases in the lungs does not show any special symptoms and does not affect well-being. Only when a cough appears, there is spotting in the sputum, a slight increase in body temperature, weight loss and shortness of breath, it becomes clear that the process has already started.

Diagnosis of metastases

Before starting the treatment of metastases, an examination of all parts of the body is required, the identification of the localization of tumors, therefore, a cytological examination is prescribed. Primary attention is paid to the examination of the tumor, its location. The site of localization relative to the capillary network formed from the vessels through which the blood infected with cancer flows is found out.

Always the places of the main metastasis are the lymph nodes, liver and lungs. Less commonly, metastases involve skeletal muscles, heart muscles, skin, spleen, and pancreas. Average indicators of localization of metastases in the central nervous system, skeletal system, kidneys, adrenal glands. Metastases in the bones, lungs and adrenal glands are detected during the diagnosis of the prostate, breast and thyroid glands, lungs and kidneys.

Superficial forms of malignant tumors that grow lining the surface (exophytic growth), for example, with skin cancer, rarely metastasize than tumors that grow into the thickness of the wall or tissue of the organ. Exophytic malignant tumors of the stomach are more favorable than neoplasms of an infiltrative form that increase the thickness of the gastric wall.

To diagnose cancer and recognize metastases, plain radiography and traditional ultrasound examination are used. With more modern methods, such as radioisotope research, computed tomography, magnetic resonance imaging, positron emission tomography, oncologists are able to accurately determine the size, prevalence and nature of the growth of metastases. To identify the process of their decay, suppuration and germination into neighboring organs and tissues, to monitor the effectiveness of treatment according to the level of regression of metastases.

Metastasis treatment

The success of the treatment of cancer metastases depends on how much they occupy, and on how skillfully the diagnosis is carried out, because often micrometastases and circulating tumor cells are difficult to detect using available methods. It is believed that surgical removal of the detected tumor does not give a special result and a positive outcome of the disease. Sometimes removal of the primary tumor leads to an acceleration of the growth of metastases due to a known inhibitory effect.

In cancer centers, thanks to modern diagnostic equipment, new surgical devices and instruments, cancer metastases are treated very effectively. They use the Cyber Knife method, proton-beam therapy, and clinical testing programs have been created for critically ill patients with stage 4 cancer. Early detection and control over the process of the possible appearance of metastases or tumor recurrence is the main task in the struggle for the life expectancy of patients suffering from cancer.

As a rule, the best survival is noted with the use of combination therapies. Carrying out active chemotherapy and radiation therapy, surgical treatment of single metastases can prevent their further growth at the earliest possible stage of the disease. Treatment of cancer metastases is a complex process; they are more resistant to chemotherapy compared to the cells of the maternal tumor.

Therefore, in some cases, systemic therapy is used, including chemotherapy, hormone therapy, targeted therapy, surgery, radiotherapy to relieve symptoms, and in advanced stages to prolong life.

Other treatments:

• Hemlock cancer treatment according to the Tishchenko method
• Cancer treatment with folk remedies
• Selenium is an anti-cancer mineral!
• Unique fruit against cancer
• Transfer factor in cancer treatment
• Temodal is a drug used for cancer

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".