When cancer spreads from its original location into other parts of the body, it is called metastatic cancer.
Metastatic cancer happens when cancer cells “break off” from the original tumor and migrate through one of three methods: The cancer enters the tissues surrounding the tumor; the cancer travels through the bloodstream to other locations; or it enters the lymphatic system and goes into the lymph nodes.
Sometimes known as stage IV cancer, metastatic cancer also can spread to just about anywhere in the body. However, most common cancers frequently spread to the liver, lungs or bones.
As part of its ongoing mission to eliminate cancer, Johnson & Johnson has been working on innovations to treat metastatic lung, prostate and bladder cancers. “Because we now understand the biology of cancer much more than in the past, we are able to develop therapies to take advantage of that understanding,” says Robert Somer, M.D., Senior Medical Leader of Late Development Oncology at Johnson & Johnson Innovative Medicine. “And in doing so, we can help those who are most in need.”
For National Cancer Prevention Month, here’s information about the types of cancers that are most likely to metastasize, common misconceptions about these diseases and the innovative therapies to treat them.
What types of cancer are most likely to metastasize?
Generally, most cancers have the potential to metastasize, Dr. Somer says. But whether they actually do depends on the type, size and location of the tumor. Several other factors cause cancer to migrate, such as an attack on the immune system, lack of oxygen and nutrients in the tissue, lactic acid accumulation in the blood and cell death.
Cancers that are most likely to metastasize include breast, colon, lung, ovarian, pancreatic, prostate and thyroid. Melanoma, a type of skin cancer, can also metastasize, whereas basal cell carcinoma, another skin cancer, typically doesn’t, says Dr. Somer.
Where cancer spreads will usually depend on the type. For example, when prostate cancer metastasizes it tends to spread to the bones; lung cancer, to the adrenal glands, bones, brain, liver and other lung; and bladder cancer to the lymph nodes, liver and lungs.
Diagnosing metastatic cancer
Metastatic cancer doesn’t always cause symptoms, and when it does, patients may not immediately make the connection. However, symptoms like pain and fractures can be signs the cancer has spread to the bones; headaches or dizziness can indicate that the cancer may have spread to the brain; shortness of breath, to the lung; and jaundice or bloating, to the liver. The process of determining if cancer has spread and to where it has spread is called staging.
Depending on the type of cancer, doctors may use blood tests, bone scans, biopsies, imaging tests, ultrasounds and X-rays to diagnose metastatic cancer and determine its stage, as well as whether it has spread.
Important to note: When cancer spreads to other parts of the body, it still has the same type of cancer cells as the primary tumor. For instance, if prostate cancer spreads to the bones, the cells are still prostate cancer cells so it’s called metastatic prostate cancer, not bone cancer.
What’s the survival rate of metastatic cancer?
A common misconception about metastatic cancer is that it’s always fatal. That may have been true in the past, but advances in treatments over the past several years are extending survival rates.
“When somebody gets diagnosed with metastatic cancer or stage IV cancer, they potentially believe it’s going to be fatal or incurable,” Dr. Somer says. “But in many instances cancer has become a chronic illness. It’s not uncommon that patients are now living years with their disease.”
Every cancer has a different survival rate, he explains. For example, the five-year survival rate for metastatic prostate cancer is nearly 100% for early-stage tumors, but only 12% for metastatic pancreatic cancer.
Since 1990, the number of people living with metastatic breast, lung, prostate, colorectal and bladder cancer and metastatic melanoma has increased, according to a study published in the Journal of the National Cancer Institute. Research also suggests long-term survival will increase by almost 47% by the year 2040.
How is metastatic cancer treated?
Treatments vary depending on the type of metastatic cancer and the individual patient but usually focus on slowing or stopping the cancer’s growth and controlling and minimizing symptoms.
Dr. Somer says chemotherapy was the primary treatment for metastatic cancer when he started treating patients over 20 years ago. While it is still used in some instances, therapies now exist that target specific pathways that a cancer may use to grow and metastasize; these are called “targeted therapies,” according to Dr. Somer.
Another option is immunotherapy, which is able to “harness your own immune system to fight cancer,” says Dr. Somer. Cancer may develop ways to hide from your immune system, and that enables it to grow and spread. Immunotherapy, which boosts your natural defenses to find and attack cancer cells, “has been an incredible advance for cancer treatments,” he adds.
In its quest to get in front of cancer, Johnson & Johnson has been working to develop treatments for patients with metastatic lung, bladder and prostate cancers. The company has created chemotherapy-free targeted therapies for these diseases, which Dr. Somer says may be more effective than other treatments and better tolerated by patients.
The company continues to work on new innovations for metastatic cancer and has clinical trials underway, he adds. This is more important than ever since age is a major risk factor for cancer; as the population ages, cancer rates will likely increase.
“It is crucial that we focus on developing new cancer treatments, especially now that our understanding of cancer biology has advanced significantly. This progress allows us to target specific pathways and immune treatments, ultimately making therapies more precise and less toxic,” says Dr. Somer. “At Johnson & Johnson, we continue to push the boundaries of science and won’t be satisfied until cancer is eliminated.”
