Almost zero civilians understand what it means to say one’s cancer is metastatic. That’s probably a good thing. It means no one you love has dealt with it. It means you’ve never had to assimilate this bit of information into your thinking about everyday life.
However, it can be a pain in the ass for people who have metastatic cancer. We spend a lot of time trying to explain it to people who don’t know or people who are misinformed. There are a lot of people who are misinformed. There is a lot of misinformation surrounding cancer, especially metastatic cancer. If you snorted aloud and said “No shit, Sherlock”, welcome to my club.
At the most simple level, metastatic cancer is cancer that has spread from its primary location to another location. This is not the same as a primary cancer being found in lymph nodes nearest the location. That bumps your staging but it does not count as a secondary location. Cancer cells will travel from the primary tumor, usually through the bloodstream, looking for a friendly environment. They will travel throughout the body until they either find that environment or die.
All metastatic cancers are end stage. The more honest descriptor is terminal. All of them. Almost all cancer deaths are due to the disease metastasizing. For most cancers, the staging level is Stage IV. Brain, spinal, leukemia, and a few other cancers use differing staging levels but for all cancers, metastatic disease is expressed as the final level of the disease.
In earlier staging, many cancers can be treated into remission. Remission means the complete disappearance of the cancer. Remission is not always permanent. We don’t have any reliable statistics on the percentage of remitted cancers going metastatic because CONGRESS but that is another essay for another day.
In Stage IV disease, there is no remission. The cancer can never be cured. Instead, depending on the number of secondary distant locations and the general health of the patient, the disease can be treated as an ongoing, chronic, disease – like mine. Or, treatment is palliative, meaning everyone works to keep the patient as comfortable as possible, for as long as possible.
Sometimes, if one is really lucky, a metastatic patient’s treatment can render them NED. NED stands for ‘No Evidence of Disease’. This doesn’t imply the cancer is gone. It means exactly what it states, the cancer is too small to be detected by the usual medical imaging. The tumors, primary and secondary, are not active. If there are new mets, they aren’t detectable yet.
This is me. I’m NED. I was declared NED roughly a year after being diagnosed with Stage IV Breast Cancer. I was one of the ten to fifteen percent of breast cancer patients who are diagnosed with Stage IV Breast Cancer from the get-go. I never had cancer before. Boom, out of nowhere, I’m forty-one and I walk into a doctor’s office with a terminal illness, no family history, no genetic predisposition, none of the usual risk factors. About thirty percent of women who are diagnosed with an earlier stage breast cancer will have the disease go metastatic. I say about because we have no good statistics on this because CONGRESS, but like I said earlier, another essay.
It isn’t easy being me. I spend more time than I would like explaining this kind of thing to people I’ve only just met. Or not explaining because life is short and I am made awful by the discomfort of others. I hope this helps you.
If you want to know more, and who doesn’t want to spend their Friday lunch break learning more about how cancer kills people, here are some of the resources I googled up for you:
A nifty two minute video on how cancer metastasizes
*I would like credit for not geeking out on the etymology of the word ‘metastasis’, but reserve the right to do in the future.