LUNG CANCER METASTASIS CELL BEHAVIOR
1.171 Analogies to Normal Cellular Behavior
Metastasis, the movement of cancer cells to normal organs and structures seems
strange. However, the processes associated with metastasis are not unique to
cancer cells and the ability of cells to travel to different areas of the body
is a normal and necessary process to maintain health. For example, circulating
white blood cells must be able to exit the blood through the capillaries and
enter infected tissues in response to the injury. During early development of an
embryo, cells that become the embryo’s placenta must be able to invade the
mother’s womb to allow the developing embryo to attach and grow. Healing of a
cut requires the movement of different types of cells to cover the wound and
re-form skin and blood vessels. Each of these processes is tightly controlled
such that the invasion is limited in time and space.
The body would likely repair the leg by replenishing cells and repairing damaged
sources of blood supply. With a cancer, the body believes the area is damaged,
so it connects with neighboring sources of blood and nourishment to replenish
the damaged area. In truth, many cancers do reflect damage to DNA, but the
remedy the body creates simply spreads the cancer, rather than repair the
damage.
Comparisons to the behavior of normal cells can be made:
“It is also important to remember that expression of invasion promoter genes is
not a purely pathological phenomenon seen only in cancer. Certain normal cell
types demonstrate different elements of the phenotype as part of their usual
functions. Thus, leukocytes resemble metastatic cells in many ways since they
must leave the bone marrow and move, via the circulation, to specific sites
elsewhere in the body where they must penetrate to sites of infection and
inflammation. Similarly, embryonic cells must move between developing tissues in
a way that can be likened to tumor cell invasion.... Therefore, expression of
the invasive phenotype by cancer cells should be thought of more as the
activation of normal cellular programmes in an inappropriate cellular context,
than as the expression of completely novel phenotypes. In this way, it may be
possible to understand how and why the genes of invasion are expressed so
aberrantly in tumor cells and, therefore, to generate more mechanism-based and
effective treatments.” (1) Vile, at 24
1.172 Tumors Are Categorized Based Upon the Extent of Metastasis
Cancers are categorized based upon the extent of metastasis (as well as growth).
Non-small cell lung cancers (the largest type of lung cancer) are classified
from stage 1 to stage 4. Stage 1 tumors are limited to a defined area in a
single part of the lung. Stage 4 means the tumor has metastasiZes to another
organ, with stages 2 and 3 assessing the extent of movement to adjoining or
distant lymph nodes. Stage one cancers are usually treated with surgical removal
of the tumor, while stage four metastatic tumors treated with chemotherapy.
1.3 METASTATIC CANCER CELLS RETAIN THE CHARACTERISTICS OF THEIR ORIGIN
One writer explains:
“Even though cancers enlarge, invade adjacent body parts, and travel to distant
metastatic locations, they remain unchanged. The characteristics of human
tumors, with rare exceptions, are fixed for the life of every tumor, regardless
of where or when distant metastasises of the tumor are found. In 1874, Dr. W.
Moxon, an English pathologist, described rectum in liver, referring to rectal
tumors that were growing in their original unchanged forms after metastasizing
to the liver.... a prostate tumor that is diagnosed early prostate specific
antigen (PSA) was detected in the blood will continue to produce PSA years later
at a metastatic site.” Dermer, (3) at 46-47
This book is about lung cancer, or more specifically tumors which originate in
the lung. Thus, we may discuss metastasis to other organs, which will still be
treated as lung cancer in most respects.
1.7 HOW CANCER SPREADS
There are two basic ways that cancers metastasize, that is spread to other
organs. The most common route is by channels that exist in every part of the
body called lymph channels. Lymph channels are a fine network of vessels that
carry the liquid portion of the blood from different parts of the body.
Returning to the bloodstream, the lymph is filtered through lymph nodes and
returns to a large lymph vessel near the heart. Given the flow of lymph to and
from the lymph nodes, we can understand why the finding of cancerous cells in
the lymph nodes will be critical. If the tumor has moved to a lymph node, its
potential for dissemination throughout the body increases. A tumor which is
detected and removed before a lymph node becomes cancerous has a far better
prognosis than one which has infiltrated a nearby lymph node.
1.71 Regional and Other Lymph Nodes
In staging the patient, that is ascertaining his status, doctors consider
whether the lymph nodes are cancerous, and where the
cancerous nodes are located. The spread of a tumor to a lymph node located near
the tumor, or a regional node, is less serious than the spread to one further
away, indicating a greater spread of the tumor. A surgeon will generally obtain
samples or biopsies from lymph nodes to ascertain the status of lymph nodes, and
treatment will depend upon that assessment.
1.72 Blood Vessels
A tumor may also spread through the body through a blood vessel. There are
various tests to ascertain the extent of cancer in the blood, however, blood
vessels cannot be individually assessed as lymph nodes usually are.
This site contains over 450 pages of detailed information about treatment, research, caregiver support, chemotherapy, gene therapy, insurance issues and legal questions, along with excerpts from our book, Lung Cancer and Mesothelioma(2005). Order our book from www.xlibris.com or www.amazon.com, or review the chapter excerpts below.
EGFR INHIBITORS TARCEVA AND IRESSA
Tarceva and lung cancer
Analysis of Tarceva, Iressa and epidermal growth factor inhibitors. Also
see Iressa
BAC
and Iressa. (Discusses results with Iressa and BAC for
non-smokers)
EGFR cell test (Review of cell tests to determine which
tumors are EGFR positive and therefore responsive to Tarceva.
Non-smoker's lung cancer
(review of treatment for non-smoker's lung cancer and recent research).
HKI 272 AND LUNG CANCER
ANTI-ANGIOGENIC
TREATMENTS
Cox2 inhibitors and lung
cancer (how Cox-2 inhibitors like Celebrex may inhibit the spread of cancer
with limited side effects)
Anti-angiogenic
drug overview discussion of drugs to limit cancer metastasis.
TREATMENT BY TYPE AND STAGE
stage 1 non small
lung cancer
stage 2 lung cancer
treatment
stage
3 non-small cell lung cancer treatment
stage 4 non
small cell lung cancer
Small
cell lung cancer staging and treatment standard and other staging
methods,
surgical options, chemotherapy and drug resistance.
LUNG CANCER AND NON-SMOKERS
Non-smoker's lung cancer
(review of treatment for non-smoker's lung cancer and recent research).
TREATMENTS CHEMOTHERAPY,
RADIATION AND SURGERY
Chemotherapy
(What is chemotherapy)
Surgery overview
LUNG CANCER INSURANCE ISSUES
Practical questions for the Lung Cancer Patient and Family
health
insurance issues
MEDICAL
MALPRACTICE CLAIMS
Over 70% of lung tumors
are diagnosed at advanced stages, reducing the patient's opportunity for long
term survival.
In some instances, a doctor's failure to promptly diagnose a lung tumor, and order
or interpret appropriate tests may be malpractice. Our office handles
failure to diagnose lung cancer cases in New Jersey and New York.
medical malpractice
lung cancer claims
cancer malpractice statute of limitations
New
York Cancer Malpractice claims medical malpractice and clinical practice guidelines
New Jersey cancer malpractice
claims
medical malpractice
liability
Medical malpractice jury instruction
New York Medical malpractice law
medical
malpractice pre-existing cause
workers' compensation doctor liability for malpractice
cancer, malpractice and informed consent
article
on missed and delayed diagnosis and malpractice claims
MESOTHELIOMA PAGES
Mesothelioma chemotherapy
Mesothelioma medical treatment
Mesothelioma surgery
pleuropneumonectomy for mesothelioma
Mesothelioma Immunotherapy
Mesothelioma overview
mesothelioma gene therapy
OCCUPATIONAL EXPOSURE TO ASBESTOS & SILICA
After smoking exposure to dusts such as
asbestos and silica are the leading causes of lung cancer.
Workers exposed to asbestos or silica may have worker's compensation claims
a claims against the product manufacturers
Asbestos and Lung Cancer,
compensation for lung cancer
www.silicosissilica.com
Silica and lung cancer, types
of silica exposure,
Benzene and leukemia.
Exposure to benzene
OTHER CANCER MALPRACTICE CLAIMS
cervical cancer malpractice articles,
cervical cancer malpractice
cervical cancer malpractice and New York statute
of limitations
LINKS
Links
(links to other sites
on various topics).
LUNG CANCER ORGANIZATIONS
Lung cancer patients should consider joining Alcase, an effective lung cancer advocacy group and review materials from the Cuneo Lung Study Team, and the European Lung Cancer Working Party.
BOOK EXCERPTS
Lung cancer and Mesothelioma ( The book Lung Cancer and Mesothelioma in Word format, formatting
varies from published version)
What is
cancer basic concepts of cancer development, growth factors, oncogenes.
cancer terminology partial and complete response, methods of evaluating
drugs, causation,
how lung cancer develops concepts of genetic damage and alteration,
screening and identification of tumors
diagnostic tools and their accuracy Chest x-ray, Ct Scan, Pet Scan,
Types of lung cancer Small cell and non-small cell distinctions
Iressa Analysis of Iressa and epidermal growth factor inhibitors.
Cancer weight loss and fatigue Cachexia, lung cancer pain and fatigue.
Anti-angiogenic drug overview discussion of drugs to limit cancer
metastasis.
Small cell lung cancer staging and treatment standard and other staging
methods,
surgical options, chemotherapy and drug resistance.
health insurance issues
Overview of Mesothelioma
surgery and radiation for mesothelioma
chemotherapy for mesothelioma
Standard of care for diagnosis of lung cancer
Resource sources
Lung cancer family history and diet
Other
books on Lung Cancer
BOOK REVIEWS
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emotional burden of Lung Cancer upon the patient and their families and ways to
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Cancer through a Carer's Eyes", "The very
mention of the word Cancer, strikes fear into all of us.... From personal
experience I know that knowledge is the key to providing a better "quality of
life" for the cancer patient. Better understanding of the stages of the disease
and of methods and medications available to treat the pain and symptoms caused
by it, allow for the patient and those who care for them, to make informed
decisions regarding their care. In this way, they are able to regain some
control over their lives. Rarely does one find all the information they need in
one book, however I believe Howard's well researched and comprehensive book
"Lung Cancer & Mesothelioma", is quite unique. It provides a wealth of relevant
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medical trials, available treatments and medications, insight and discussion
regarding the emotional burden of cancer upon the patient and their families and
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Profile
Howard Gutman is a New Jersey attorney based in Parsippany, New Jersey who has handled numerous legal claims involving pulmonary tumors. A member of the board of directors of a leading cancer support group and a caregiver, he is the author of the new book Lung Cancer and Mesothelioma. In his legal capacity, he has appeared on Good Day New York, spoken at the National Press Club and been interviewed by NBC Nightly News.
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DISCLAIMER This page is not intended to provide medical advice or treatment. Some of the information on this site may not be relevant to your condition, and all advice should be obtained from a physician. The materials herein are intended to provide general information and no representation or made as to its completeness or accuracy.
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