Metastas-process by which cancer cells spread from the primary (original) tumor site to distant organs or tissues, forming new (secondary) tumors. It is a defining feature of malignant cancers and the leading cause of cancer-related deaths.

Metastasis is the process by which cancer cells spread from the primary (original) tumor site to distant organs or tissues, forming new (secondary) tumors. It is a defining feature of malignant cancers and the leading cause of cancer-related deaths.
Metastasis is a multistep biological process involving a series of coordinated events that allow cancer cells to detach from the original tumor, invade surrounding tissue, travel through the bloodstream or lymphatic system, and establish new tumors elsewhere.

1. Metastasis – The Real Killer

2. Learning Objectives

3. Metastasis - Introduction

4. Benign Tumor Vs Malignant Tumor

5. Hallmarks of Cancer Promote Metastasis

6. Sustained proliferation, replicative immortality, and evading growth suppression allows cancer cells to grow uncontrollably into a tumor mass to invade neighboring tissue Genome instability and an altered metabolism causes cells to become more aggressive and mobile The ability of cells to resist cell death and avoid immune destruction allows them to survive harsh conditions in the metastatic journey Hallmarks of Cancer Promote Metastasis

7. Tumor promoting inflammation aids in metastasis via attracting immune cells to the primary tumor that actually engage with tumor cells and cause them to leave the primary site and enter circulation Angiogenesis , the formation of new blood vessels, provides a way for tumor cells to leave the primary site and enter the bloodstream In short, all the hallmarks promote metastasis and are extremely important Hallmarks of Cancer Promote Metastasis

8. Prevalence of Metastasis in Cancer

9. Metastasis Vs Five- Year Survival Rate

10. Metastasis – A Real Killer

11. TNM Staging

12. TNM Staging – Lymph Nodes

13. TNM Staging – Lymph Nodes

14. TNM Staging – Metastasis

15. TNM Staging

16. TNM Staging

17. Steps of Metastasis

18. Step 1: Primary Tumour Growth (Uncontrolled Cell Division)

19. Step 2: Angiogenesis

20. Step 3: EMT

21. Step 4: Invasion (Breaking through ECM)

22. Step 5: Intravasation (Getting into Blood)

23. Step 5: Intravasation (Getting into Blood)

24. Step 6: Survival in Systematic Circulation

25. Step 6: Survival in Systematic Circulation

26. Prognosis with CTC

27. Step 7: Extravasation (Getting into Destination)

28. Extravasation is the process of cells getting back out of the blood at a secondary site Cells get stuck in tiny capillaries, which are very small blood vessels inside an organ, and then they squeeze there way out into the surrounding tissue Molecular factors that are secreted into the bloodstream by the cells in the tissue attract the CTC to exit the bloodstream and move towards those vectors Step 7: Extravasation (Getting into Destination)

29. CTCs have protrusions that allow them to adhere to the side of a blood vessel wall and stick Cancer cell rolls along the interior surface of the vessel until it eventually is able to squeeze itself through the endothelial cells into the surrounding tissue Once a cell has successfully extravasated , it is no longer referred to as a CTC but rather as a disseminated tumor cell, or DTC Step 7: Extravasation (Getting into Destination)

30. For example, breast cancer tends to metastasize to the bone, but never to the peritoneum Stomach cancer on the other hand, almost always metastasizes to the peritoneum , but very rarely to the bone So how can this be when it seems as though there should be an even chance for any type of cancer cell to wind up any where in the body. Step 7: Extravasation (Getting into Destination) – Homing cancer to organ sites

31. Homing Cancers to Different Organ Sites

32. The Seed and Soil Hypothesis – Stephen Paget

33. Step 8: Dormancy and / or Secondary Tumor Growth

34. Summary of the Metastatic Process