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Stage IV Cancer

If a person gets diagnosed with cancer, their doctor will tell them what stage it is. The cancer stage represents the size of the tumor/cancer and its extent of spread from the origination point.

Stages from 1 to 4 (4 being the most severe) are used to specify cancer and determine how it will affect the human body.

It is essential to know the stage of cancer for several reasons:

  • Treatment Plan: Knowing the stage helps the doctor select the most appropriate treatment approach for the patient. Early-stage cancer would require surgical removal of the tumor, whereas chemotherapy might treat advanced-stage cancer.

  • Aftermath: The patient's recovery usually depends on how early he or she gets their cancer diagnosed. The stage provides them an idea of what may happen next.

  • Research Purposes: Most hospitals use a national database to track the treatment options that work well for individual patients. Researchers can use these records to compare similar cases and discover the most efficient treatments.

What is Stage IV Cancer

A diagnosis of cancer stage 4 suggests that cancer has disseminated or metastasized. This spreading of cancer cells from the primary tumor to other body organs is known as metastasis. Malignant tumors are masses of the body's cells developed from uncontrollable cell division because of mutations in their genes. They do not act like normal cells and sometimes drift away from the original site.

Metastatic dissemination denotes the harmful features of cancer. Targeting metastatic cells is more challenging than cell proliferation of the tumor because of the involvement of several complicated interactions among cancerous growth and stroma.

Two main pathways cancer cells use to spread are:

  • The Lymphatic Pathway - leads to the lymph nodes' invasion and carrying away of cells to nearby organs

  • The Blood Pathway - spreads the cells to distant organs like the liver, bone, brain, or lung

Stage 4 or metastatic cancer is named after its primary cancer; for instance, breast cancer that has reached and invaded the liver will be termed as metastatic breast cancer, not liver cancer. Doctors will treat it as stage 4 breast cancer and not as liver cancer.

TNM Classification

The American Joint Committee on Cancer has developed a cancer classification system, called the TNM system, which most doctors use to assess a patient's cancer stage.

  • T - Tumor: The T ranges from 0 to 4, giving an estimate of the tumor's size and spread into the nearby tissue or organs.

  • N - Lymph nodes: The N values run from 0 to 3. A Higher N classification number indicates a distal spread.

  • M - Metastasis: A tumor has only two M stages, 0 or 1. M0 denotes non-distant metastasis, and M1 suggests that distant metastasis is present.

The M1 score classifies cancer as stage 4; however, the T and N numbers also account for the prognosis of the disease.

Some stage 4 cancers are divided into sub-stages, 4A and 4B.

Spreading of Cancer

Cancer cells reach different parts of the body in a sequence that include the following steps:

  1. Affect and invade the healthy, normal working nearby tissues.

  2. Pass through nearby lymph nodes and blood vessels.

  3. Travel to different body parts through the lymphatic and circulatory systems.

  4. Stay trapped in tiny blood vessels of a distant site, penetrate the blood vessel walls, and enter the surrounding tissue.

  5. Start to grow in invaded tissue resulting in tumor formation.

  6. Induce the growth of new blood vessels that supply blood to the metastatic tumor allowing it to continue growing.

In most cases, spreading cancer cells, at any step, die during this process. But, if the patient's condition favors the spread of cancer cells at each step, new tumors will develop in other body parts. Sometimes, metastatic cancer cells stay inactive at the new site for multiple years before growing again (in case that happens at all).

Stage 4 or metastatic cancer can reach and start to grow in nearly any organ or site of the body. However, some types of cancer would more likely invade particular areas. The list below mentions the most common sites of metastasis for some common cancers:

  • Kidney - Adrenal gland, bone, brain, liver, and lung

  • Bladder - Bone, liver, and lung

  • Colon - Liver, lung, and peritoneum

  • Rectal - Liver, lung, and peritoneum

  • Prostate - Adrenal gland, bone, liver, and lung

  • Ovary - Liver, lung, and peritoneum

  • Uterus - Bone, liver, lung, peritoneum, and vagina

  • Breast - Bone, brain, liver, and lung

  • Lung - Adrenal gland, bone, brain, liver, and lung

  • Melanoma - Bone, brain, liver, lung, skin, and muscle

  • Pancreas - Liver, lung, and peritoneum

  • Stomach - Liver, lung, and peritoneum

  • Thyroid - Bone, liver, and lung

Symptoms

Stage 4 cancer or metastatic cancer usually does not produce symptoms. But when manifestations appear, their nature and frequency depend on the cancerous tumors' size and site.

Some signs of stage 4 cancer, that occur most commonly include:

  • Headache, dizziness, and seizures - in case of cancer spreading to the brain

  • Breathing difficulties - if cancer reaches the lungs

  • Pain and fractures - when cancer cells have reached the bones

  • Jaundice or bloated belly - when metastasis has affected the liver

Diagnosis

Standard Approach

Doctors stage cancer after it is officially diagnosed. The most common standard types of tests performed to diagnose and stage cancers include:

  • Lab tests: They analyze the different molecules, including proteins, present in the patient's biological fluids, such as blood or biopsied tissue specimens. Biomarkers and genetic screening of samples taken from the tumor can assist doctors in selecting the most effective treatment approach and monitoring the patient's overall health throughout the treatment.

  • Imaging tests: Ultrasound, X-ray, MRI, CT, and PET scans provide detailed images of the inside of the body that help identify a tumor and its effects on different organs and blood circulation. Doctors can get a better view of cancer's size and form with these scans.

  • Biopsy: The doctor removes a tiny portion of the tissue from the tumor, which they examine under the microscope to determine if it's malignant and to grade it.

  • Endoscopy: A procedure where a tiny camera is inserted into the body in a thin, flexible tube or attached with wire to view the internal organs. The doctors use the endoscope to biopsy a sample too.

Advanced Early Testing

Cancer cells take several years to form a large tumor to be actually detected by standard tests or cause symptoms. Unfortunately, this is the reason why most patients remain unaware of an early warning for cancer. However, the good news is that various new and little-known tests now determine the chances of cancer development before it has already reached stage two, three, or four.

Silver Cancer Institute and Center for Chronic Disease offers new personalized cancer testing lab tests that include:

  • Genomic cancer testing - detect circulating tumor cells and gene biomarkers

  • Chemosensitivity tests - decide which chemotherapy will work best for the patient

These tests do not just detect cancer earlier than any traditional scan, but they also give the count for cancer cells circulating in the patient's blood, and the type of chemotherapy and natural substances are required to eliminate cancer.

Prognosis

The stage 4 cancer prognosis can be different for every type of cancer. It can be challenging to treat some cancers as they have fewer treatment options; in contrast, others may be less severe and have more options for treatment. Such as, almost 22% of stage 4 breast cancer patients survive for five years or more, but with stage 4 thyroid cancer, nearly 89% of people may live for more than five.

The National Cancer Institute collects and publishes statistics for cancer in their Surveillance, Epidemiology, and End Results (SEER) Program database. SEER and other major registries do not typically classify cancers based on the TNM staging system; instead, they use the following categories:

  • Localized cancers: Cancers that are limited to the area where they first originated.

  • Regional cancers: Cancers that have spread to surrounding tissues, lymph nodes, or organs.

  • Distant cancers: Metastatic cancers that have reached distant organs/parts of the body (stage 4 cancers).

The list below shows five-year survival rates (compared to people without cancer) from the NCI's SEER Database for a "distant" diagnosis of the most common cancers between 2010 to 2016. Lymphoma and leukemia are exceptions because doctors stage them differently.

  • Leukemia - 63.7%

  • Non-Hodgkin lymphoma - 63.3%

  • Thyroid - 54.9%

  • Prostate - 30.2%

  • Breast (female) - 28.1%

  • Melanoma (skin) - 27.3%

  • Uterine (endometrial) - 17.3%

  • Colon and rectal - 14.2%

  • Kidney and renal pelvis - 13.0%

  • Lung and bronchus - 5.8%

  • Bladder - 5.5%

  • Pancreas - 2.9%

A patient's survival rate broadly varies depending on the cancer grade, cancer type, PS score, age, and other factors. A patient's performance status (PS score) contributes a considerable part in determining the prognosis of several malignancies. Other traits can include gender, overall health, and smoking (active or passive).

Treatment of Stage IV Cancer

The type of therapy a patient receives will depend on their primary cancer, its spread, previous treatments, and overall health. Treatment options that exist for most types of stage 4 cancers include:

  • Standard chemotherapy to retard the spread of tumors or destroy cancer cells.

  • Palliative therapy is given at any point during treatment to reduce symptoms instead of removing cancer as a cure.

  • Immunotherapy with drugs that strengthen the immune system to withstand the side effects of treatment and fight cancer cells.

Usually, the purpose of treating metastatic cancer is to stop it or reduce its growth. Although some people may live for years after standard treatments control their cancer, they do not work for every patient.

Rather than treating stage 4 cancer patients with traditional chemotherapy and radiation treatments, Dr. Dean R. Silver treats their condition with a more individualized approach using modalities like detoxification, hormones, vitamins, and dietary changes.

New Genetic Personalized Stage IV Cancer Treatment

The Human Genome Project has initiated the commencement of modern cancer treatment and laid the grounds for personalized medicine, genuinely tailored to every patient based on specific gene mutations detected in their cancer cells.

After extensive evaluation, chemosensitivity and natural substances sensitivity testing have allowed Silver Cancer Institute and Center for Chronic Disease to formulate a unique customized treatment plan for each patient. It includes:

Do not hesitate to call us at 480-860-2030 or visit www.silvercancerinstitute.com for further information on personalized cancer treatments.

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