| The idea behind cancer metastasis was originally proposed
by James Ewing in 1928 as the “seed and soil” theory,
which stated that cells must travel from the original tumor as a
“seed” and find a proper host tissue (the “soil”)
in which to implant. In principle, this idea has held true
through further investigation, and two steps are currently believed
to be key to metastasis. First, the kidney cancer cells must
be able to break free from the kidney. All kidney cells are
held in place by anchoring tissue which is known as extracellular
matrix which is made from proteins and carbohydrates. The
purpose of this matrix is to keep the cells in place as well as
provide structural support to the organ. In order for kidney
cancer cells to break free of the matrix, they have to make substances
that break down the matrix components so that they can break free.
Once the kidney cancer cells break free, they then have to be able
to survive on distant organs. This process requires the kidney
cancer cells to make other proteins that recognize and bind to distant
organs.
Once both of these processes have occurred, the kidney cancer becomes non-localized, or metastatic. The process by which cancer cells gain these properties is through mutation of DNA, which is a random process that can take a great deal of time. For this reason, metastatic disease occurs later in the course of cancer.
When kidney cancer metastasizes to a new location, it is referred to as metastatic kidney cancer in the new organ or tissue. Although it resides in a different location, the cancer cells continue to look and behave like kidney cancer cells. This is why some people have “kidney cancer in the lungs,” for example. This is true of all cancers. In fact, a cancer patient is much more likely to have cancer originating in a single organ spread throughout their body than they are to develop multiple different cancer types (or have multiple “primary cancers”).
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