Metastasis is the spread of cancer from the primary neoplasm (tumor) to distant organs. As primary tumors can often be removed by surgery and radiation it is metastases that contribute to the majority of morbidity and mortality associated with cancer.
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Metastasis occurs when malignant tumor cells break away from the original site, attach to the surrounding extracellular matrix and degrade it. This establishes a route for the tumor cells to enter the bloodstream or lymphatic system where they can migrate to other areas of the body. Cells can then begin to grow at a distant site by a process termed 'metastatic colonization'.
Approximately 0.01% of all tumor cells that do enter the bloodstream will eventually form a metastasis. The potential of a tumor cell to metastasize is dependent on both the characteristics of the neoplastic cells and the microenvironment of the host tissue. The metastatic cells must survive and be capable of invasion, embolization and angiogenesis.
Therapy towards metastasis is a complex matter. It is required to be targeted against both the cancer cells and the homeostatic factors that enable metastasis and tumor growth in a distant microenvironment.
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