Metastatic Cancer: Symptoms, Diagnosis & Treatment Explained

Metastatic Cancer: Symptoms, Diagnosis & Treatment Explained

Hearing that cancer has spread to another part of the body can be frightening for the patient as well as the family. Many people immediately think that there are no treatment options left. But metastatic cancer does not always mean that treatment has stopped.

Depending on the type of cancer, where it has spread, and the person's overall health, doctors may use different treatments to control the disease, reduce symptoms and improve quality of life. In some situations, minimally invasive procedures can also help manage problems caused by advanced cancer.

Let's understand metastatic cancer, its symptoms, diagnosis and the treatment options that may be considered.

What Is Metastatic Cancer?

Metastatic cancer is cancer that has spread from the place where it first started to another part of the body.

For example, breast cancer may later spread to the bones, while lung cancer can spread to the liver, brain or bones. This happens when cancer cells move through the bloodstream or lymphatic system and begin growing somewhere else.

It is also commonly referred to as stage 4 cancer. However, the name of the cancer is still based on where it originally started. Breast cancer that spreads to the liver is still breast cancer, not liver cancer.

The liver, lungs, bones and brain are some of the common areas where cancer can spread, although the pattern can be different for each type of cancer.

Symptoms of Metastatic Cancer

There isn't one particular symptom that confirms metastatic cancer. The signs can vary depending on where the cancer has spread.

When Cancer Spreads to the Bones

Some people may develop persistent bone pain. It may feel like a deep ache and can sometimes become worse at night. In advanced cases, the affected bone may become weak and fracture more easily.

When Cancer Spreads to the Lungs

A cough that doesn't settle, chest discomfort or shortness of breath can occur. Some people may notice that activities such as climbing stairs or walking, which were previously easy, have suddenly become difficult.

When Cancer Spreads to the Liver

Possible symptoms include loss of appetite, unexplained weight loss, discomfort or heaviness on the right side of the abdomen and, in some cases, yellowing of the skin or eyes.

When Cancer Spreads to the Brain

Headaches, dizziness, changes in vision, weakness, confusion or seizures can occur when cancer affects the brain.

There can also be more general symptoms such as tiredness, unexplained weight loss or a lump that continues to increase in size.

These symptoms don't automatically mean that cancer has spread. Many common health problems can cause similar complaints. But symptoms that persist or keep getting worse should not be ignored, particularly if the person has a previous history of cancer.

How Is Metastatic Cancer Diagnosed?

Doctors usually need more than one test to understand what is happening.

Imaging tests such as CT scans, MRI scans and PET-CT can help identify abnormal areas and show whether the cancer has spread to other organs. Blood tests may also be performed as part of the overall assessment.

In many cases, a biopsy is important. During a biopsy, a small tissue sample is taken from the suspicious area and examined in the laboratory.

Some biopsies can be performed using image guidance. A doctor may use ultrasound or CT imaging to guide a thin needle to the required area. This can avoid the need for a large surgical procedure.

The tissue can also be tested for specific molecular or biological features. These results may help the oncology team decide whether targeted medicines, hormone treatment or immunotherapy could be useful.

Treatment Options for Metastatic Cancer

Treatment is not exactly the same for every patient.

For one person, the main aim may be to slow down the cancer. For another, reducing pain or improving breathing may be the immediate priority. In many cases, both disease control and symptom relief are important.

Depending on the cancer, treatment may include:

• Chemotherapy
• Targeted therapy
• Hormone therapy
• Immunotherapy
• Radiation therapy
• Surgery in selected situations
• Interventional radiology procedures
• Palliative and supportive care

Radiation therapy, for example, may be used to control pain from a bone tumour or treat certain areas affected by cancer. Surgery can also be helpful in selected cases, but a major operation is not suitable for every patient with metastatic disease.

Interventional Radiology: Cancer Treatment Without Major Surgery

Interventional radiology is an important part of cancer care in selected patients.

Instead of making a large surgical incision, an interventional radiologist uses imaging such as CT, ultrasound or X-ray to guide a needle or thin catheter to the area being treated. The procedure is generally performed through a small entry point, with local anaesthesia and sometimes sedation.

Depending on the condition, procedures may include:

Tumour Ablation

A needle can be placed directly into a suitable tumour, where heat or extreme cold is used to destroy cancerous tissue. Ablation may be considered for selected tumours in areas such as the liver, lung, kidney or bone.

Embolisation

In embolisation, the blood supply to a tumour is deliberately blocked. Certain procedures can also deliver chemotherapy or radiation to the tumour through its blood supply.

Cementoplasty

If cancer has weakened a bone and caused significant pain, medical cement may be injected into the affected area to provide stability and help reduce discomfort.

Nerve Blocks

Cancer pain can sometimes remain difficult to control even with medicines. In selected patients, image-guided nerve blocks may provide additional pain relief.

Drainage and Stenting

Advanced cancer can sometimes cause fluid to collect around the lungs or inside the abdomen. It may also block ducts or other passages. Image-guided drainage and stenting procedures can help manage these problems.

Port Placement

A venous access port can be placed under the skin to make repeated chemotherapy or other intravenous treatments easier for some patients.

Interventional radiology does not usually replace chemotherapy, immunotherapy or other cancer treatments. Instead, it can be used alongside them when a particular procedure is appropriate.

For some patients, treating a painful tumour, draining excess fluid or opening a blocked passage can make a noticeable difference to everyday life.

Palliative Care Is Also Part of Cancer Treatment

The word "palliative" can worry families, but palliative care does not mean that cancer treatment has necessarily stopped.

Its focus is on helping the patient feel better and manage symptoms such as pain, nausea, breathlessness, poor appetite, sleep problems and emotional stress.

Palliative care can be provided alongside cancer-directed treatment. For example, if fluid has built up in the abdomen and is making it difficult for a patient to eat, sleep or move comfortably, draining that fluid may provide meaningful relief.

Similarly, treating a painful bone lesion can sometimes help a person move around more comfortably.

The aim is simple: better symptom control and a better quality of life.

Questions to Ask Your Cancer Specialist

If you or a family member has metastatic cancer, it is reasonable to understand all the available options.

You can ask:

• Where has the cancer spread?
• What is the main goal of the proposed treatment?
• Are there treatments available to control the cancer?
• Could radiation or an image-guided procedure help with symptoms?
• Would a minimally invasive procedure be suitable?
• What side effects should we expect?
• Would a multidisciplinary team be involved in the treatment plan?

Getting a second opinion can also be useful, particularly when the treatment options are complex or a major procedure has been suggested.

Metastatic Cancer Needs Individualised Care

Metastatic cancer is a serious condition, but treatment decisions are not the same for everyone. The type of cancer, location of the spread, previous treatment, symptoms and overall health all matter.

Modern cancer care can involve several specialists working together. In selected patients, interventional radiology may provide minimally invasive options for tumour treatment or symptom relief without the need for major surgery.

At IR Facilities, Dr. Sandeep Sharma provides interventional radiology-based care for selected cancer-related conditions. Whether an image-guided procedure is appropriate depends on the patient's individual diagnosis and imaging findings.

If you are dealing with metastatic cancer, discuss your case with your treating cancer specialist and ask what options are appropriate for your particular situation.