Loading
10 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Metastatic cancer means the original cancer has spread to other parts of the body, most often the bones, liver, lungs or brain. It keeps the name of where it started, is treated with therapies that reach the whole body, and can increasingly be controlled for years; with limited spread it is sometimes treated with the aim of cure.
Metastasis is the process by which cancer cells leave the original tumour, travel through blood or lymph and grow in another organ. A breast cancer that has spread to the liver is still breast cancer and is treated with breast cancer drugs, which is why this page points to the cancer-specific pages for treatment. What metastatic cancers share is the intent and the tools: systemic therapy (chemotherapy, targeted drugs, hormone therapy, immunotherapy) rather than surgery alone; radiotherapy and bone-strengthening drugs for bone metastases; radiosurgery or surgery for brain metastases; and early palliative care alongside treatment, which improves quality of life and in some studies survival. Two ideas have changed the outlook: many metastatic cancers are now chronic conditions controlled for years, and oligometastatic disease, spread limited to a few sites, is increasingly treated with stereotactic radiotherapy or surgery to every site with the aim of long remission, as the SABR-COMET trial suggested. Circulating tumour DNA is beginning to detect and monitor spread from a blood sample.
| Setting | Approach | Guideline |
|---|---|---|
| Widespread metastatic disease | Systemic therapy chosen by the primary cancer and its biomarkers, with early palliative care; see the individual cancer pages. | not mapped |
| Oligometastatic disease | Stereotactic ablative radiotherapy or surgery to all sites in addition to systemic therapy, in selected patients and ideally in trials. | not mapped |
| Bone metastases | Palliative radiotherapy for pain, bone-modifying agents (zoledronic acid or denosumab) to prevent fractures, radium-223 in prostate cancer. | not mapped |
| Brain metastases | Stereotactic radiosurgery for limited lesions, surgery for large symptomatic ones, and brain-penetrant targeted drugs where a driver exists. | not mapped |