How does metastases cause death

When considering deaths from cancer without metastatic disease as an underlying cause, a few different scenarios come to mind. First, we have cases where local tumors affect vital organs, such as airways, brain, heart, and liver.

Second, systemic cancer treatment and its side effects can be fatal by multiple organ failure, bleeding due to thrombocytopenia, infections, interstitial pneumonitis, and tumor lysis syndrome to name a few. Third, surgical treatment and its potential complications can also have a fatal outcome. Fourth, tragically, some patients commit suicide after a cancer diagnosis, however, a recent publication on the SEER database demonstrated this to be more frequent in patients with metastatic disease.

As Norway has a tradition of robust and reliable registries, we set out to find the data to support or refute this truism. Reporting to the Cancer Registry of Norway and the Cause of Death Registry of Norway is mandatory for all physicians, and the latest published evaluation showed a We assumed that cancer death in a patient with metastatic disease would be caused by the metastases and not by the primary tumor, even in the rare occasions when the primary tumor was still intact.

The latest available complete data are from In this year, a total of 10 cancer deaths were registered. Data are also available for primary site and sex. Site stratification is crucial, as some cancer forms are highly aggressive and associated with short survival even though they rarely metastasize, the best example probably being glioblastoma.

When looking at all cancer deaths per year from to , there is surprisingly little change, from 10 in to 10 in The number of cancer deaths registered with metastasis as contributing cause of death on the other hand demonstrates a tripling, from When looking into the details of the latest year with complete data on different tumor groups, our suspicion of substantial variation between tumor groups was confirmed.

For prostate cancer, the rate of cancer deaths registered with metastases as contributing cause was only Breast cancer incidence has been rising over the last decade, while deaths from breast cancer are declining. For all solid tumors, the rate was The reasons it has become such a widely accepted notion are worth some consideration. First, experience from the clinic is consistent with the proportion being in this range.

Second, biological reasoning would also suggest that very few localized tumors are capable of killing the patient. Third, since it has been written in seminal papers by some of the most prominent cancer scientists, it has been given substantial weight.

The proportion of deaths attributed to metastatic disease has been increasing dramatically over the last decade. It seems unlikely that this reflects clinical reality and is more likely due to increased focus on correct registration in death certificates. Based on clinical experience, these numbers still seem far too low, and interviews with staff from the registry confirmed that whereas synchronous metastases ie, metastases diagnosed at the same time as the primary tumor is well reported, metachronous metastases metastases discovered at some later time point are underreported.

As described above, registration rates seem to be improving, but still, based on Norwegian registry data, we unfortunately cannot determine the precise proportion of cancer deaths caused by metastatic disease.

The improving registration rates over the past decade, however, give reason to hope that we will be able to answer this question with robust, reliable data in the future. This work uses data from the Norwegian Cancer Registry. But if a cancer continues to grow, then it can become too much for the body to cope with. Talking about dying can be very difficult and people often avoid the subject. Sharing your feelings can help everyone involved to cope better. Dying is something most people worry about at some point.

Talking about the way the cancer is affecting your body can help to lessen at least some of those worries. What happens in the last days of life is different for everyone. Many people are relieved to find out that they, or their relative, are likely to become unconscious shortly before they die. When someone is dying with cancer, they and their carers can get help and support.

The information here might help at a very emotional and difficult time. In the last weeks of life there are ways to manage your symptoms and keep you comfortable. It can help carers to know what might happen in the final days. Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.

Search for the cancer type you want to find out about. Each section has detailed information about symptoms, diagnosis, treatment, research and coping with cancer. Treatments can include surgery, radiotherapy and drug treatments such as chemotherapy, hormone therapy or targeted cancer drugs. Find out about treatments and how to cope with side effects. About Cancer generously supported by Dangoor Education since Questions about cancer? Call freephone 9 to 5 Monday to Friday or email us.

Skip to main content. Home About cancer Coping with cancer Dying with cancer How can cancer kill you? Not all cancers cause death Firstly, it's important to say that not all cancers cause death.

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Should cause of death from the death certificate be used to examine cancer-specific survival? Assessing the utility of cancer-registry-processed cause of death in calculating cancer-specific survival. Accuracy of death certificates and assessment of factors for misclassification of underlying cause of death. Samuel W. Bailey, PhD. Get the latest research based on your areas of interest.

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