Multiple Choice
Metastasis is best defined as:
a) The uncontrolled growth of benign cells
b) The invasion of cancer cells into nearby tissue only
c) The spread of cancer cells from a primary tumor to distant sites
d) The immune response to malignant cells
c) The spread of cancer cells from a primary tumor to distant sites
The spread of cancer through body cavities is called __________ spread.
transcoelomic
Metastasis can occur even if the primary tumor remains small.
True
Metastasis begins when benign cells invade nearby tissue.
Metastasis begins when malignant cells invade nearby tissue.
Name the three main routes of metastasis and briefly describe one of them
Transcoelomic (spread across body cavities), lymphatic (via lymph nodes and vessels), hematogenous (via blood vessels).
Which route of metastasis involves the blood vessels?
a) Lymphatic
b) Transcoelomic
c) Hematogenous
d) Peritoneal
c) Hematogenous
Cancer cells that travel through lymph nodes use the __________ system.
lymphatic
The peritoneum separates organs but also limits cancer spread.
False (the peritoneum can facilitate spread, not limit it)
Hematogenous spread occurs exclusively through the lymphatic system.
Hematogenous spread occurs through the bloodstream.
Why are organs such as the liver and lungs common sites of metastasis?
The liver and lungs receive large volumes of blood and act as filtration sites, increasing exposure to circulating cancer cells.
Ovarian cancer commonly spreads via the peritoneum to:
a) The lungs
b) The brain
c) The liver surface
d) The bone marrow
c) The liver surface
Small secondary tumors formed at distant sites are called __________.
lymphatic
The peritoneum separates organs but also limits cancer spread.
True
Micrometastases are large, fully developed tumors.
Micrometastases are small, early-stage secondary tumors.
Why are organs such as the liver and lungs common sites of metastasis?
Lymphatic vessels transport cancer cells to lymph nodes and eventually drain into the bloodstream, enabling further spread.
Why is hematogenous spread particularly effective?
a) Blood vessels exist only near tumors
b) Blood circulation reaches most organs
c) Cancer cells prefer oxygen-rich tissue
d) The immune system is absent in blood
b) Blood circulation reaches most organs
The theory stating that cancer cells need a suitable microenvironment is known as the __________ and soil theory.
seed
Prostate cancer most commonly metastasizes to the liver.
False (prostate cancer most commonly metastasizes to bone)
Micrometastases are large, fully developed tumors.
Stephen Paget proposed the seed and soil theory of metastasis.
Explain one difference between Paget’s and Ewing’s theories of metastasis.
Paget emphasized microenvironment compatibility (seed and soil), while Ewing focused on anatomical drainage patterns.
Micrometastases are:
a) Primary tumors before invasion
b) Benign secondary growths
c) Small clusters of cancer cells at a new site
d) Inflammatory lesions caused by cancer
c) Small clusters of cancer cells at a new site
Synthetic immune-signaling molecules used in therapy are called __________.
interleukins
Immunotherapy aims to strengthen the immune system’s response to cancer cells
False (prostate cancer most commonly metastasizes to bone)
Interleukins are normally secreted by cancer cells.
Interleukins are normally secreted by immune cells.
Why is understanding metastasis essential for treating advanced-stage cancer?
Understanding metastasis is crucial because it is responsible for most cancer-related deaths and guides targeted treatment strategies.