"We now want to test other types of cancer drugs for their effects on the single steps of metastasis formation. Thanks to these insights, it may be possible to discover new substances that allow us to treat existing metastases effectively, or even prevent them from developing at all". --- "Dr Frank Winkler, LMU Munich
So you were diagnosed with cancer, but you caught it in time--- it's been stopped cold, killed by aggressive chemo and a series of radiation treatments.
Congratulations! You beat it. The tumor is gone, the cancer is gone. Open the champagne.
So you think. So you hope. But think again.
Here is the number one thing you need to know about your primary cancer--- it's a mother ship, for even more deadly cancer shuttle craft, which travel throughout your body in search of new territory to invade and conquer.
That's right. It's not the primary cancer that usually kills you. What more often kills are its outgrowths, its outposts, its traveling offspring, its deadly children, called metastases.
About one-fourth of all cancer patients develop invading secondary cancer growths--- metastases--- in the brain.
This brain invasion usually occurs long after successful treatment of the primary tumor. And by now it's the 11th hour--- the metastases prognosis is almost always very poor.
Metastaces, secondary tumors, often grow, invading patients who have, or have had, lung, breast or skin cancers.
Brain metastases invade the brain and torment many patients, with headaches and nausea, and much worse--- neurological symptoms such as paralysis, and aphasia (loss of the ability to speak).
And we don't know why, really. Growth of brain metastases baffle medical science researchers.
Metastaces are very difficult to treat. Up to now, therapies only slowed, not cured, them.
Is there no hope?
Let's look at what we DO know--- okay, we said that the primary tumor is like a mother ship, birthing and sending forth many more invasive tumors (metastases) to come.
We know that, if you don't act to stop the metastases from appearing and traveling throughout the body, you die.
So how do we stop the metastases from establishing new deadlier cancers wherever they land?
There is new hope, hope based on an anti-cancer drug called Avastin.
Neurologist Dr. Frank Winkler (of LMU Munich), and his team of researchers have discovered a startling new approach to metastases containment.
Winkler's team found a sequence of stages that lead some tumor cells to establish metastases, while others fail to form new tumors.
By testing the effects of Avastin, the Munich team found more--- by blocking formation of new blood vessels, the anti-cancer drug can slow down or stop the emergence of metastases.
"Unfortunately, brain metastases are now being seen more often than in the past", says Dr. Frank Winkler, who leads the Neurooncology Research Group at the LMU's Neurological Clinic in Munich. "Improvements in the treatment of malignancy have enhanced survival times. But this also means that more patients are at risk of developing brain metastases."
"In contrast to previous reports, intravascular growth is not sufficient to induce a metastasis", reports Winkler. "We observed that such cells must then escape into the surrounding tissue by passing through tiny gaps between the cells of the vessel wall. In the third step, they have to stick to the outer surface of the vessel, where micrometastases, consisting of four to fifty cells, can develop. "
The secondary tumor needs a constant supply of nutrients in order to grow unchecked. Winkler's imaging experiments revealed the hurdles that cancer cells must overcome in order to form metastases.
Winkler said, "Each one of the steps can go awry. Cells may not get out of the circulation, may fail to adhere to the outer vessel wall or be unable to induce angiogenesis". In the absence of angiogenesis, even cells that had attached to the outer vessel wall and proliferated strongly at first eventually died."
As Winkler and his colleagues confirmed, many cancer cells can remain in a resting state for long periods, and then suddenly begin to grow again. "This is why metastases often appear years after successful therapy of the original tumor", he says. It turns out that direct contact with a blood vessel is also essential for the survival of resting tumor cells.
These new findings should soon help metastases victims worldwide.
Winkler's team's discovery that the anti-cancer drug Avastin blocks the angiogenesis step, is a huge breakthrough.
"We now want to test other types of cancer drugs for their effects on the single steps of metastasis formation", says Winkler. "Thanks to these insights, it may be possible to discover new substances that allow us to treat existing metastases effectively, or even prevent them from developing at all".
Source: Ludwig-Maximilians-Universität München