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I was told I have lung cancer, but now it has spread to my l

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I was told I have lung cancer, but now it has spread to my liver: Do I now have liver cancer?

July 13th, 2012 - by Dr. Jack West

http://blog.lungevity.org/2012/07/13/i- ... er-cancer/

We’re going to cover a basic concept in cancer, but one that I think plenty of people don’t necessarily know. Every few days someone calls my office for an appointment about their lung cancer, but on further exploration, we learn that they have lung cancer that originated from another body area and spread to the lungs. Someone may think that they have liver cancer, lung cancer, brain cancer, etc, if their cancer travels from the breast to these other areas, but it’s important to recognize that the cancer is still breast cancer, and treatment plans are still based on the site of the original cancer.

For those with lung cancer, it’s worth knowing that if it spreads, it is most commonly to other parts of the lung, to bone, to the brain, to the liver, or to the adrenal glands that sit on top of the kidneys. Why these locations? Why does small cell lung cancer so often go to the brain, but prostate cancer rarely travels to the brain but is almost always characterized by spread to the bones if it metastasizes? The areas that develop metastases typically have a rich blood supply, so many cancer cells in the bloodstream pass through these affected organs, but certain cancer cells have different adhesion molecules, a pattern associated with one type of cancer or another, that makes it more likely to spread to certain areas.

To reiterate, cancer is diagnosed and categorized based on the type of cell from which a cancer developed. The place where cancer begins is called the primary site. This is typically identified based on seeing where the cancer actually is, based on a physical exam and imaging studies, and the appearance of the cancer cells under the microscope, which have an appearance and protein pattern on their surface that usually (but not always) gives a good signal of where the cancer began. The sensitivity of the cancer cells to one type of chemo or targeted therapy vs. others, the growth rate, etc., are typically far more associated with the primary site of the cancer than where it lands.

In addition, certain “local” complications from metastatic spread are treated in a similar way no matter what the primary cancer is. For instance, brain metastases are most commonly treated with radiation, and bone lesions are often treated with radiation if they are causing significant pain, with a medication like Zometa (zoledronate) or XGEVA (denosumab) added to reduce the risk of future skeletal complications.

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