All cancers can, at a more or less advanced stage of the disease or in a period of remission, evolve towards a metastatic cancer.
Then begins a cohabitation with a pathology that can be treated, but which will never be cured.
What is metastatic cancer?
Metastatic cancer results in the migration of cancer cells from a primary cancer, called metastases, to other organs (liver, brain, lungs, bone, peritoneum) or lymph nodes.
It is not a new cancer because it is composed of the same type of cancer cells as the initial cancer. For example, when breast cancer spreads to bone, cancer cells in the bones are breast cancer cells. We are talking about metastatic breast cancer and not bone cancer.
How is it spread?
Metastatic cancer can spread to tissues surrounding the primary tumor or pass through the lymphatic system. Cancer cells can also travel via the arterial or venous bloodstream.
When multiple organs are affected, we also talk about generalized cancer.
Metastases: warning signals
- Hepatic metastases (liver): heaviness and pain in the liver.
- Tumor metastases (in the brain): nausea, vomiting, vertigo, confusion of the concentration.
- Pulmonary metastases (to the lungs): persistent cough, shortness of breath, difficulty breathing.
- Bone metastases: pain.
Other signs: tiredness, pain loss of appetite, headache, mood swings, abnormal bleeding.
"The whole difficulty in trying to identify the metastatic phase early is to detect the cancer cells before they have damaged another organ, but unfortunately we realized that even if we do scans, MRIs or scintigraphies repeated, we never do it at the right time to discover them, explains Dr. Mahasti Saghatchian, oncologist specialized in breast cancer (Institut Gustave Roussy, Villejuif).
In the monitoring of a person in remission, no systematic examination can detect these metastases. It can occur 5 or 10 years after the initial cancer. So you can not do control tests every year. "
What are the treatments ?
Some metastases, which are said to be resectable, can be removed by surgery. Others may be treated with chemotherapy or targeted therapies .
"Research is the way of the future to try to detect metastases, according to Dr. Saghatchian.Today , we have at our disposal molecular biological tools that allow by a blood sample to find small fragments of DNA tumoral (genetic information of the cancer cell) in the blood Many studies try to know if they can detect them very early to quickly eliminate them.
For patients and their families, access to research and innovation is therefore paramount. Being able to access tumor analyzes to establish personalized treatments, access protocols or seek early detection of metastases ... All this gives everyone the chance to have better treatments available to heal. Because every day counts. "
Can we heal?
"In very exceptional cases, it is possible to cure a metastatic cancer, but this is very rare, says the expert.The disease is not curable but treatable.We manage to reduce the metastasis and control the disease to avoid complications.
But eventually, we will not eliminate cancer cells. That's why we talk about chronic disease. Many patients will live with continuous treatments.
Supportive care such as pain management in palliative care or socio-aesthetic workshops are important accompaniments. In the case of metastatic cancer, there is a coexistence between the cancer and the patient so those are key as important as the treatments.
Studies show that offering them early in the disease can have a positive impact on their quality of life and survival. Patients need to be able to access it quickly so that, perhaps, they can gain months of survival and avoid a rapid deterioration in overall health. "
