Predicting if Cancer Will Spread

It's every cancer patient's fear that his or her cancer will spread and become more difficult to treat. Fortunately, new, innovative tools are helping physicians predict, with greater accuracy, whose cancers are most likely to spread. This could have important implications for treating patients.

Metastatic Cancer

When cancer cells break away from the primary tumor and spread to other parts of the body, we say it has metastasized. Tumor cells spread though the blood and lymph systems to other organs, where they may take up residence and develop into a new tumor. You may or may not have symptoms from a metastasized tumor, and your physician may find the new cancer at the same time as the primary tumor, or much later.

Even when cancer metastasizes, the new tumor is the same type of cancer as the original tumor; in other words, if breast cancer cells migrate to the brain, the patient still has breast cancer. The most common solid tumors to metastasize are cancers of the lung, bone, liver, and brain.

Predicting Cancer's Spread

Despite early diagnosis and treatment, about half of cancers metastasize, and patients are more likely to die from cancer that has metastasized than from a primary tumor. New predictive tools offer the hope of improved prevention and treatment opportunities.

Here are a few of the methods cancer researchers are investigating.

Elevated proteins. Scientists know that tumors make a protein called CPE-delta N protein (carboxypepticlase E gene). When levels of this protein are elevated, oncologists can use it as a biomarker to identify which patients are most at risk for metastatic cancer.

Protein regulators. MicroRNAs (miRNAs) are one of the three major macromolecules essential for life (the other two are DNA and proteins). MicroRNAs regulate the activity of proteins. Interestingly, miRNAs can both suppress tumors or help them to grow. MicroRNAs may also be good prognostic and predictive markers for aggressive and metastatic cancer.

Circulating tumor cells. Tumor cells in the blood are associated with metastases. Scientists are discovering improved methods for measuring the volume of circulating tumor cells.

Although they are still in development, all of these methods hold the promise of improved personalized patient care and have the potential to revolutionize cancer therapy. In addition to forecasting which cancers are most likely to spread, researchers may be able to uncover new targeted therapies and project how well patients with aggressive cancers will respond to treatment.

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