What Does It Mean To Be Diagnosed With Metastatic Cancer?

If you are diagnosed with metastatic cancer, it means that the cancer has spread to a different organ from where it started. For example, breast cancer that has metastasized to the bone, lung cancer that has metastasized to the liver. While metastatic cancer cannot be cured, it can often be managed with treatment—meaning you’ll likely be on long-term treatment.

“It all depends upon the cancer, but you can have periods of stability, where a treatment is working and the cancer isn’t growing, and then periods of progression, where the cancer begins to grow, which means it’s time to try a different treatment,” says Gazala Khan, M.D., a medical oncologist with Henry Ford Health. 

“These periods of stability can last anywhere from a few months to a few years. Sometimes, you can have four to six months of aggressive chemotherapy, and then the tumors shrink and the scans look good. This might mean you can go on maintenance chemotherapy for a while. It could also mean that you could have radiation to get rid of what’s left behind and then have a period where you’re not on treatment—where we just check in every two to three months to keep an eye on things.”   

The prognosis for metastatic cancer can vary wildly depending upon the cancer and the person. Here, Dr. Khan answers general questions about metastatic cancer. 

Q: Which cancers are most likely to metastasize? 

A: Pancreatic cancer is most likely to metastasize and it tends to metastasize early—even when the tumor is just the size of a pea. Lung cancer is also more likely to metastasize, but not until the later stages.  

 

We don’t know why pancreatic cancer is most likely to metastasize; it depends upon the genetic structure of the tumor. We do know that cancers with higher amounts of gene mutations are more likely to be more aggressive. And people who carry the TP53 gene mutation, which is often found in pancreatic cancer, are more likely to have aggressive cancers. That’s why it’s important to get genetic testing if you’re considered high risk for cancer.

 

 

A: It depends upon the cancer. Some cancers can be associated with higher survival rates, however some cancers can be quite aggressive. Metastatic pancreatic cancer has a dismal 5-year survival rate of less than 5%. According to komen.org, about one third of women diagnosed with metastatic breast cancer in the United States live at least 5 years after diagnosis, and some may live 10 years or longer after diagnosis. 

 

A: Systemic treatments are necessary for those with metastatic cancer, which means patients are given an IV or pill that reaches all areas of the body, instead of a localized treatment that affects just one part of the body. There are more than 100 different systemic treatment options.   

 

Chemotherapy is a common systemic treatment, as well as targeted therapy and immunotherapy. Targeted therapy targets the specific gene mutation that’s causing the tumor to grow. Some systemic treatments have little to no side effects, others have side effects of fatigue, hair loss and digestive issues. The goal is to find an effective treatment without making someone feel sick.  

 

A: Right now, this is what we know: 90% of cancers are sporadic or random. Only 10% are linked to known, inherited genes. But 20 years ago, we thought all cancers were random. Within the next few decades, as we identify more inherited genetic mutations, the percentage of inherited cancers could increase. 

A: Again, in 90% of people, metastatic cancer is random, but if you previously had cancer, your risk for metastatic cancer is higher than someone who never had cancer before. The thought is that if your body made cancer once, it could do it again.    

 

A: Focus on a positive outcome and think that you’ll fight it—that you’ll win this. Participate in clinical trials, get the best possible care that you can, and when you can, enjoy life to the fullest. Sometimes I see patients five or six years out and they look wonderful, they’re healthy and living life to the fullest, which is just incredible to see. 

Gazala Khan, M.D., is a medical oncologist with Henry Ford Health who specializes in digestive, esophageal, gastrointestinal and pancreatic cancers. She sees patients at Henry Ford Cancer - Detroit and Henry Ford Medical Center – Fairlane.