Which cancers spread where?

This is a brief description of where certain cancers are most likely to spread. It’s not a list of every place where a cancer could spread. For more details on these cancers, see our information on the specific cancer site.

Bladder

Bladder cancer tends to stay in the same area (the pelvis) and grow into nearby tissues such as the pelvic wall. It can also spread to the lungs, liver, and bone.

Brain

Brain tumors rarely spread outside the brain. They mainly grow within the brain and sometimes into the spinal cord.

Breast

Breast cancer most commonly spreads to the bones, but also can spread to the liver, lungs, and brain. As the cancer progresses, it may affect any organ. It can also spread to the skin of the chest (near where the cancer started).

Cervix

Cancer of the cervix tends to grow near where it started, into the vagina and uterus and then other parts of the pelvis, such as the rectum and bladder. It can also grow into the bones and nerves of the spine, and spread to the liver, lungs, and bones.

Colon and rectum

The most common sites for colon or rectal cancer spread are the liver and lungs. These cancers may also spread to nearly any other organ, including the bones and brain.

Rectal cancer can also spread within in the pelvis, where the cancer started. This can be painful because it often grows into nerves and bones in this area.

Esophagus

Esophageal cancer mostly grows near where it started (in the chest and belly). As it progresses, it may grow into nearby organs or major blood vessels, which can make it hard to treat.

Kidney

Kidney (renal) cancer can grow where it started and invade nearby tissues. It can grow from the kidney into the large vein that drains the blood from the kidney (the renal vein). From there it can grow into a large vein that empties into the heart (the inferior vena cava). It can also grow from the kidney into the adrenal gland, which sits on top of the kidney. When it spreads, the lungs and bones are the most common sites.

Leukemia

Because they are already in the blood, leukemias can be considered to have spread throughout the body when they are diagnosed. They can progress by filling the bone marrow with leukemia cells. The normal bone marrow is replaced and cannot make new blood cells.

Some leukemias may spread outside the blood and into the fluid that surrounds the brain and spinal cord. Tumors made up of leukemia cells can also occur in the skin or in other parts of the body, but this is not common. In some types of leukemia, the cancer cells collect in the spleen, causing it to become large. Less often, leukemia cells settle in the liver, causing it to enlarge. In one type of leukemia, the cells deposit in the gums, so that they become red and swollen.

Liver

Liver cancer doesn't often spread outside the liver. It tends to grow throughout the liver as it becomes advanced. If it does spread, it’s most often to the lungs or bones.

Lung

Lung cancer can spread to almost any organ of the body, but most often it will spread to the adrenal glands, liver, bones, or brain. It can also spread to the other lung.

Lymphoma

Lymphoma can affect any part of the body. While most start in the lymph nodes, spleen, and/or bone marrow, some start in lymph tissue in the stomach, intestines, or even the eye socket. Lymphomas can spread within the lymph system to distant parts of the body. Less often, they spread outside the lymph system to other organs, such as the lungs, liver, or bone. Lymphomas can affect the brain and spinal cord, either initially (called primary central nervous system lymphoma) or as spread to the fluid and tissues (the meninges) surrounding the brain and spinal cord. This is called lymphomatous meningitis.

Melanoma

Melanoma can spread anywhere in the body. It first tends to go to lymph nodes near where it started, but then can spread to the brain, lungs, liver, and bones. It can also spread to other areas of skin.

Mouth and throat

Cancers of the mouth, throat, or nasal passages tend to stay in the same area. When they spread, it’s usually to the lungs. Less often they may spread to the liver or bones.

Multiple myeloma

Multiple myeloma can cause tumors called plasmacytomas. These tumors can spread to the bones anywhere in the body, but they rarely spread to other organs.

Ovary

Ovarian cancer most often spreads to the lining of the abdomen (belly) and pelvis (this lining is called the peritoneum), the omentum (a layer of connective tissue that drapes the abdominal cavity like an apron), and organs in the pelvis and belly. It can cause a build-up of fluid and swelling in the abdomen. It can also spread to the outer lining of the lungs and cause fluid to build up there. As it becomes more advanced, it may spread to the lung and liver, or, rarely, to the brain or skin.

Pancreas

Pancreatic cancer mainly stays in the abdomen (belly). It tends to grow into nearby tissues and may spread to the liver or other nearby organs. It can also spread to the lungs.

Prostate

Advanced prostate cancer most often goes to the bones. Much less often, it will spread to other organs, including the lungs and liver.

Stomach

Stomach (gastric) cancer tends to spread to nearby tissues and stay within the abdomen (belly). It may also spread to the liver or distant lymph nodes. Spread to the lungs, bones, and brain is less common.

Uterus

Cancer that starts in the uterus can grow into the vagina as well as nearby tissues in the pelvis. It also commonly spreads to the peritoneum (the lining of the abdominal cavity and pelvis) and the omentum (a layer of connective tissue that drapes the abdominal cavity like an apron). Other sites of cancer spread include the liver, lungs, and, less often, bones.

Source:www.cancer.org

Why cancer cells tend to spread to certain parts of the body?

Where a cancer starts often plays a role in where it will spread. Most cancer cells that break free from the original tumor are carried in the blood or lymph until they get trapped in the next “downstream” organ or set of lymph nodes. Once the cells are there, they can start new tumors. This explains why breast cancer often spreads to underarm lymph nodes, but rarely to lymph nodes in the groin. Likewise, there are many cancers that commonly spread to the lungs. This is because the heart pumps blood from the rest of the body through the lungs’ blood vessels before sending it elsewhere. The liver is a common site of spread for cancer cells that start in the colon because blood from the intestines flows into the liver.

Cancer cells often break away from the main (primary) tumor and travel through the blood and/or lymph system, but they don’t always settle in and start new tumors. Most of the time, the cells that broke away die. When cancer does spread to other organs and start to form new tumors, it’s because of certain genetic changes in the cells that scientists are now starting to understand. Someday, doctors may be able to tell if a person’s cancer is the type that will spread to other organs by looking for these genetic changes. Research is also focusing on treatments that block or target these genetic changes so the cancer cells can’t spread and grow.

Sometimes the patterns of spread cannot be explained by where things are in the body. Some cancer cells are able to find and invade certain sites far away from where they started. For example, advanced prostate cancer often moves into the bones before spreading to other organs. This “homing” pattern may be caused by substances on the cancer cell surfaces that stick to cells in certain organs.

Metastatic Cancer

Key Points

• Metastatic cancer is cancer that has spread from the place where it first started to another place in the body.
• Metastatic cancer has the same name and same type of cancer cells as the original cancer.
• The most common sites of cancer metastasis are, in alphabetical order, the bone, liver, and lung.

1. What is metastatic cancer?

   
   Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. A tumor formed by metastatic cancer cells is called a metastatic tumor or a metastasis. The process by which cancer cells spread to other parts of the body is also called metastasis.
   Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to the lung and forms a metastatic tumor is metastatic breast cancer, not lung cancer.
   Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the expression of certain proteins or the presence of specific chromosome changes.
   Although some types of metastatic cancer can be cured with current treatments, most cannot. Nevertheless, treatments are available for all patients with metastatic cancer. In general, the primary goal of these treatments is to control the growth of the cancer or to relieve symptoms caused by it. In some cases, metastatic cancer treatments may help prolong life. However, most people who die of cancer die of metastatic disease.
   

2. Can any type of cancer form a metastatic tumor?

   
   Virtually all cancers, including cancers of the blood and the lymphatic system (leukemia, multiple myeloma, and lymphoma), can form metastatic tumors. Although rare, the metastasis of blood and lymphatic system cancers to the lung, heart, central nervous system, and other tissues has been reported.
   

3. Where does cancer spread?

   
   The most common sites of cancer metastasis are, in alphabetical order, the bone, liver, and lung. Although most cancers have the ability to spread to many different parts of the body, they usually spread to one site more often than others. The following table shows the most common sites of metastasis, excluding the lymph nodes, for several types of cancer:
   
   

   Cancer type	Main sites of metastasis*
   Bladder	Bone, liver, lung
   Breast	Bone, brain, liver, lung
   Colorectal	Liver, lung, peritoneum
   Kidney	Adrenal gland, bone, brain, liver, lung
   Lung	Adrenal gland, bone, brain, liver, other lung
   Melanoma	Bone, brain, liver, lung, skin/muscle
   Ovary	Liver, lung, peritoneum
   Pancreas	Liver, lung, peritoneum
   Prostate	Adrenal gland, bone, liver, lung
   Stomach	Liver, lung, peritoneum
   Thyroid	Bone, liver, lung
   Uterus	Bone, liver, lung, peritoneum, vagina

   *In alphabetical order. Brain includes the neural tissue of the brain (parenchyma) and the leptomeninges (the two innermost membranes—arachnoid mater and pia mater—of the three membranes known as the meninges that surround the brain and spinal cord; the space between the arachnoid mater and the pia mater contains cerebrospinal fluid). Lung includes the main part of the lung (parenchyma) as well as the pleura (the membrane that covers the lungs and lines the chest cavity).
   

4. How does cancer spread?

   
   Cancer cell metastasis usually involves the following steps:
   
   • Local invasion: Cancer cells invade nearby normal tissue.
   • Intravasation: Cancer cells invade and move through the walls of nearby lymph vesselsor blood vessels.
   • Circulation: Cancer cells move through the lymphatic system and the bloodstream to other parts of the body.
   • Arrest and extravasation: Cancer cells arrest, or stop moving, in small blood vessels called capillaries at a distant location. They then invade the walls of the capillaries and migrate into the surrounding tissue (extravasation).
   • Proliferation: Cancer cells multiply at the distant location to form small tumors known as micrometastases.
   • Angiogenesis: Micrometastases stimulate the growth of new blood vessels to obtain a blood supply. A blood supply is needed to obtain the oxygen and nutrients necessary for continued tumor growth.
     
     
     
   Metastasis. Cancer cells invade lymph nodes and blood vessels near a tumor and spread to other parts of the body.
   Because cancers of the lymphatic system or the blood system are already present inside lymph vessels, lymph nodes, or blood vessels, not all of these steps are needed for their metastasis. Also, the lymphatic system drains into the blood system at two locations in the neck.
   The ability of a cancer cell to metastasize successfully depends on its individual properties; the properties of the noncancerous cells, including immune system cells, present at the original location; and the properties of the cells it encounters in the lymphatic system or the bloodstream and at the final destination in another part of the body. Not all cancer cells, by themselves, have the ability to metastasize. In addition, the noncancerous cells at the original location may be able to block cancer cell metastasis. Furthermore, successfully reaching another location in the body does not guarantee that a metastatic tumor will form. Metastatic cancer cells can lie dormant (not grow) at a distant site for many years before they begin to grow again, if at all.
   

5. Does metastatic cancer have symptoms?

   
   Some people with metastatic tumors do not have symptoms. Their metastases are found by x-rays or other tests.
   When symptoms of metastatic cancer occur, the type and frequency of the symptoms will depend on the size and location of the metastasis. For example, cancer that spreads to the bone is likely to cause pain and can lead to bone fractures. Cancer that spreads to the brain can cause a variety of symptoms, including headaches, seizures, and unsteadiness. Shortness of breath may be a sign of lung metastasis. Abdominal swelling or jaundice (yellowing of the skin) can indicate that cancer has spread to the liver.
   Sometimes a person’s original cancer is discovered only after a metastatic tumor causes symptoms. For example, a man whose prostate cancer has spread to the bones in his pelvis may have lower back pain (caused by the cancer in his bones) before he experiences any symptoms from the original tumor in his prostate.
   

6. Can someone have a metastatic tumor without having a primary cancer?

   
   No. A metastatic tumor is always caused by cancer cells from another part of the body.
   In most cases, when a metastatic tumor is found first, the primary cancer can also be found. The search for the primary cancer may involve lab tests, x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, positron emission tomography (PET) scans, and other procedures.
   However, in some patients, a metastatic tumor is diagnosed but the primary tumor cannot be found, despite extensive tests, because it either is too small or has completely regressed. The pathologist knows that the diagnosed tumor is a metastasis because the cells do not look like those of the organ or tissue in which the tumor was found. Doctors refer to the primary cancer as unknown or occult (hidden), and the patient is said to have cancer of unknown primary origin(CUP).
   .
   

7. If a person who was previously treated for cancer gets diagnosed with cancer a second time, is the new cancer a new primary cancer or metastatic cancer?

   
   The cancer may be a new primary cancer, but, in most cases, it is metastatic cancer.
   

8. What treatments are used for metastatic cancer?

   
   Metastatic cancer may be treated with systemic therapy (chemotherapy, biological therapy,targeted therapy, hormonal therapy), local therapy (surgery, radiation therapy), or a combination of these treatments. The choice of treatment generally depends on the type of primary cancer; the size, location, and number of metastatic tumors; the patient’s age and general health; and the types of treatment the patient has had in the past. In patients with CUP, it is possible to treat the disease even though the primary cancer has not been found.
   

9. Are new treatments for metastatic cancer being developed?

   
   Yes, researchers are studying new ways to kill or stop the growth of primary cancer cells and metastatic cancer cells, including new ways to boost the strength of immune responses against tumors. In addition, researchers are trying to find ways to disrupt individual steps in the metastatic process.
   Before any new treatment can be made widely available to patients, it must be studied in clinical trials (research studies) and found to be safe and effective in treating disease. NCI and many other organizations sponsor clinical trials that take place at hospitals, universities, medical schools, and cancer centers around the country. Clinical trials are a critical step in improving cancer care. The results of previous clinical trials have led to progress not only in the treatment of cancer but also in the detection, diagnosis, and prevention of the disease. Patients interested in taking part in a clinical trial should talk with their doctor.

Source:www.cancer.gov