metastatischen

Metastatischen is the attributive form in German of the term metastatisch, used to describe cancer that has spread from a primary tumor to distant sites. In German medical writing, metastasen denotes the disseminated malignant lesions, and the corresponding English term is metastatic cancer or metastasis. The concept is central to oncology because metastases determine prognosis and treatment strategy more than the original tumor in many cancers.

Metastasis arises through multiple biological steps. Cancer cells detach from the primary lesion, invade surrounding tissues, and enter blood vessels or lymphatics (intravasation). They survive in circulation, arrest in distant capillary beds, exit the vessels (extravasation), and colonize compatible microenvironments. Molecular changes, including epithelial–mesenchymal transition and interactions with the tumor microenvironment, support these processes. The “seed and soil” hypothesis describes why certain cancers favor specific organs.

Common metastatic sites include the liver, lungs, bones, and brain, but patterns vary by tumor type. Breast cancer often spreads to bone and liver; colorectal cancer to liver; prostate cancer to bone; lung cancer to brain and contralateral lung. Metastases can cause symptoms such as pain, organ dysfunction, or neurologic deficits, and they may be detected incidentally on imaging.

Diagnosis relies on imaging (CT, MRI, PET-CT), biopsy for histology and molecular profiling, and, in some cases, serum markers. Staging uses the presence of distant metastases; stage IV denotes metastatic disease, guiding treatment choices.

Treatment aims at disease control and palliation. Systemic therapies—chemotherapy, targeted therapies, and immunotherapy—address disseminated disease, while local therapies (surgery, radiotherapy) may be used for limited metastases or symptom relief. Prognosis varies widely by cancer type, extent of spread, and biology.