Mesothelioma Metastasis I Factors Affecting Spread (2024)

When Does Mesothelioma Metastasize?

Mesothelioma metastasizes when tumor cells move to new areas. Distant metastases occur in 10% to 50% of stage 4 mesothelioma cases. Cancer cells can spread locally, regionally and distantly.

In stages 1, 2 and 3, cancer cells spread locally within the bodily cavity where they developed and regionally to lymph nodes. Only in stage 4 can mesothelioma metastasize to distant parts of the body.

It is generally more common for mesothelioma to continue spreading throughout the cavity where it originally formed. This is known in the medical field as a local spread.

Doctors detect cancer progression through diagnostic imaging tests. These include MRIs, PET or CT scans. Symptoms not generally associated with mesothelioma may be a signs cancer has spread. At that time, your doctor will perform tests or biopsies to look for distant metastases.

Where Does Mesothelioma Metastasize?

Metastatic mesothelioma can spread to several organs, such as the liver, lungs, kidneys, adrenal glands or spleen. Metastasis happens when cancer cells travel to distant sites. They may move through the bloodstream or lymph system. After mesothelioma cells have spread, they can invade organs and form secondary tumors.

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Expert Take | Dr. Jacques Fontaine: Learn how mesothelioma spreads to other organs.

Cancer cells reach the bloodstream through angiogenesis. This process forms new capillaries in the body from existing blood vessels. Researchers are studying ways to promote and block angiogenesis. These drugs are anti-angiogenic medications. They may be the key to slowing or halting the spread of cancer.

Drugs in clinical trials for mesothelioma metastasis include semaxanib (SU5416), thalidomide and tetrathiomolybdate. In studies, the three medications have stabilized the disease.

Metastatic Pleural Mesothelioma

Mounting research has shown that pleural mesothelioma spreads to distant organs. But for many years, doctors believed pleural mesothelioma was primarily a localized disease.

Cancer spreading to the brain and central nervous system is much rarer. In stage 4, pleural mesothelioma metastasizes to distant sites in more than 10% of cases.

If cancer has spread to distant parts of the body, treatment options tend to be palliative in nature. These therapies relieve symptoms and provide comfort rather than cure the disease.

Metastatic Peritoneal Mesothelioma

In the early stages, peritoneal mesothelioma does not spread beyond the peritoneal cavity. This area contains the stomach, spleen, liver, intestines and other abdominal organs.

The most frequent sites of peritoneal metastases include the liver, visceral peritoneal lining and abdominal lymph nodes. Less common sites include the lungs, heart, brain, bone and kidneys.

As the disease progresses, cancer cells spread to near and distant organs. About 50% of peritoneal mesothelioma cases have distant metastases found at autopsy.

Metastatic Pericardial and Testicular Mesothelioma

The local spread of pericardial mesothelioma usually involves the pleura, lung and mediastinum. Pericardial mesothelioma metastasizes in about 25% to 45% of cases. Frequent sites are the regional lymph nodes, lungs and kidneys.

As testicular mesothelioma progresses, it tends to spread from the tunica vagin*lis. Target sites are retroperitoneal lymph nodes followed by inguinal and iliac lymph nodes. Metastasis in this variant is rare. When it occurs, it spreads to thoracic and lumbar vertebrae, omentum, liver and lungs.

What Other Factors Influence Metastasis?

Factors such as cancer stage, tumor cell type and response to treatment can influence metastasis. Some patients may have a lower risk if they have an early-stage diagnosis with a favorable cell type that responds well to treatment.

Doctors use a mesothelioma staging system to help gauge the progression of mesothelioma, and metastasis happens in stage 4 mesothelioma. This is the most difficult stage to treat because the cancer is spreading into vital organs. At this stage of development, treatment includes palliative, symptom-controlling care. This leads to a life expectancy of less than a year.

What Are the Symptoms of Metastatic Mesothelioma?

Symptoms of metastatic mesothelioma include abdominal pain, changes in blood pressure or memory loss, among others. It can be difficult for doctors to detect when mesothelioma has metastasized. Distant spread occurs late in cancer development. It doesn’t always cause noticeable symptoms.

If metastatic cancer symptoms arise, they usually affect the new location. Some symptoms of mesothelioma metastases mimic common symptoms of mesothelioma and other cancers. Doctors often discover metastases by chance after imaging scans or other tests.

Treating Metastatic Mesothelioma

Treatment with chemotherapy can delay metastasis, while radiation therapy may prevent local recurrence. Anti-angiogenesis drugs can slow or stop mesothelioma metastasis.

In combination with chemotherapy, Tumor Treating Fields can delay or prevent mesothelioma from spreading. Immunotherapy is a newer treatment against metastasis. Receiving it before surgery may reduce the rate of metastasis.

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Expert Take | Dr. Jacques Fontaine: Learn about the treatment options for metastatic mesothelioma.

A mesothelioma specialist can recommend the best course of treatment after metastasis. Medications and physical therapies can treat pain caused by distant metastases.

In addition to location and cell type, life expectancy may be affected by patient factors such as age and overall health, as well as available treatment options in each specific case. Life span is also affected by the cancer’s stage of development.

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