Metastatic Disease

Cancer can spread from its site of origin to other organs in the body, including the liver, lung, bone, and brain. If this occurs, systemic therapies including chemotherapy and/or various biological therapies are typically used in the treatment of such patients under the direction of medical oncologists.

However, increasingly local therapies are being used to eliminate certain depots of metastatic cancer. For patients with small numbers of metastases to the liver, surgical resection, radiofrequency ablation (RFA), cryoablation, and tomotherapy are all treatment options, in addition to systemic therapy or intrahepatic chemotherapy.

Isolated lung metastases may be treated by surgical resection, preferably video-assisted thoracoscopic surgery (VATS), radiofrequency ablation (RFA), cryoablation, or some forms of radiation therapy.

Bone metastases are typically treated with radiation therapy, and sometimes by nuclear medicine specialists using radioisotopes such as strontium or samarium. Radioactive iodine is used only in the treatment of thyroid cancer. Iodine and yttrium anti-CD20 monoclonal antibodies are used specifically for the treatment of B cell lymphoma.

Brain metastases can usually be effectively treated by Gamma Knife, but some patients require radiation to the whole brain.