METASTASIS

LEE, BOYD KENNETH S.

BSN IV - I

What is Cancer?

Cancer defines as a population of

cells that have lost their normal
controls of growth and differentiation
and are proliferating without check.

What is Metastasis?

Metastasis is a migration of cancer. A cancer

cell can break off and replant into a new
location. For example, breast cancer cells can
go from the breast to almost anywhere in the
body. If they plant in the lungs somewhere,
you'll get a tumor there. If you think of it like
the flu, metastasis would be like someone
sneezing on another person and spreading it
to another spot by replanting the disease in
another location through a jump.

HOW DOES THE CANCER CELL

METASTASIS?
3 Stages:
1.
2.
3.

Invasion
Circulation
Colonization

Cancer cells can metastasize in any

part of the body. They do so by
having cells break off from the main
tumor cells into the blood stream and
/ or lymphatic channels and travel
through the other parts of the body
to initiate new tumor. The ability to
invade affects the function of the
normal tissue into which they are
growing.

Metastasis is a multifactorial process

involving
complex
interactions
between tumor cells, vessels (lymph
and vascular system), basement
membrane surrounding those vessel
and the ECM (consist mainly of
collagen).

Tumor cells can spread around the body using one

of two major highways. All tissues are served by
blood vessels (which provide oxygen and
nutrients) and also lymphatic vessels which drain
excess fluid to nearby lymph glands. For many
cancer cells, their first opportunity to escape is to
use the lymphatic drainage system. This is why for
many cancers lymph nodes are biopsied or
removed at surgery to see if the cancer has
spread, and oncologists us the information to
determine the stage of the cancer. Cancer cells
can enter the bloodstream either indirectly via the
lymphatics, or directly from a vessel in the
primary tumor. The bloodstream is a very harsh
environment with a high velocity of flow and full of
immune cells.

Moreover, cancer cells are used to being

attached to the proteinaceous matrix, many
tumor cells die when detached from their
support and have to swim ( detachment
mediated death is called anoikis, another
Greek word describing the death of leaves
from as they detach from trees in the Fall).
The majority of tumor cells get stuck
(arrest) in the first capillary bed that they
float into. This is why colon cancer tends to
metastasize to the liver, etc. This is not
always the case, however, and some tumor
cells end up in distant organs.

How do tumor cells get out of the

bloodstream?

In essence, they attach to the endothelial cells lining

the blood vessels and the endothelial cells retract,
they move apart, to permit the tumor cells to enter
the tissue. This may be a normal reaction of
endothelial cells to immune cells, cells of our immune
systems migrate in and out of the bloodstream all the
time to maintain surveillance. In fact, tumor cells can
disguise themselves as lymphocytes by expressing
similar molecules on their surface that fool the
endothelial cells. These molecules may also
determine their apparent ability to home to specific
organs preferentially, as they may respond to
gradients of chemicals differentially expressed there.