• Question: if bowel cancer develops slowly, when it spreads, does the cancer speed up depending on the part of the body it attaches to? since it is no longer a bowel cancer but a different located cancer.

    Asked by anon-328029 on 17 Jun 2022.
    • Photo: Sophie Richardson

      Sophie Richardson answered on 17 Jun 2022: last edited 17 Jun 2022 10:25 am

      Even when a bowel cancer spreads to another part of the body, it is still bowel cancer because the cells are originally from the bowel. It isn’t necessarily the location of the tumour that is important, but where the tumour started in the first place. In fact, someone in my lab has been researching cancers where they don’t know where it started because it is so important to know where the cancer first started to understand how to treat them.

      Back to your question though, when a cancer spreads (aka metastasizes) it tends to get more difficult to treat because it now has the ability to travel around the body to different places. It may grow faster in the new location, but this depends on multiple different factors, including what genetic changes the cancer has developed when it has moved to the other location.

      Edit: I’ve just read Karin’s reply and just wanted to add that one thing that is big in cancer research at the moment (and also what my lab does) is liquid biopsies. A liquid biopsy means taking a liquid from the body, like blood, urine or even tears, and analysing this to find information about cancer. This means we don’t have to do an invasive medical procedure to get tumour tissue, so it’s much better for the patient. We can use the information from liquid biopsies to detect a new cancer, track a cancer to see how it is changing in real time and monitor patients to check their treatment is working.

    • Photo: Karin Purshouse

      Karin Purshouse answered on 17 Jun 2022: last edited 17 Jun 2022 9:26 am

      Really great question. I often think this when I read a story in the news about someone who has a cancer that has spread, and then the news story reports that they now have another cancer – which is confusing for the reader!
      If a bowel cancer spreads to the liver or lungs (which is the most common pattern) – it’s still bowel cancer. We call this ‘metastasis’. So even if someone who had a bowel cancer removed, and later it comes back in these classic places, we would still consider this metastatic bowel cancer.

      It is of course possible for someone over their lifetime to get more than one cancer. But we know the spread of cancers reasonably well, and if someone had evidence of a cancer in one of the classic sites in a short time after the diagnosis, this is probably metastatic disease. We don’t call this a new cancer. If we aren’t sure (for example, the pattern doesn’t fit, or it’s a long time after the original cancer) – then we would take a sample (a biopsy) and look under a microscope to check.

      But I think this is often reported in a confusing way in the news, so I can understand your question! Coming back to the speed part – so one thing we don’t understand much about is how cancers change once they move. So for example, if a bowel cancer has spread to the lungs and liver, we don’t biopsy these other places. So it’s very possible that they are biologically different. More importantly, they probably BECOME more biologically different over time i.e. if you treat the cancer, and then later we sometimes see that the cancer has responded well in one place but not in another. We don’t really have a way of tackling this yet! Again, if it’s very different we might consider rebiopsying this, but I think this is going to be a major area of development in the future.

      Great question!

    • Photo: Holly Hall

      Holly Hall answered on 17 Jun 2022:

      This is a super interesting question and something that a lot of research is looking at! I’ll put it in context with my own research at the moment, but I know there are other scientists looking in the lab at this on this website!

      Every cancer has a cell type of origin, and that cell type would be specifically programmed for where it is. But, what is interesting in the bowel is that it is an organ which is constantly under stress and therefore has to regenerate. This is why in the bowel there are special structures where crypt stem cells transform into bowel cells. These stem cells can have mutations, and develop into bowel cancer. My research looks into how each cancer is different/similar to one another – so for bowel cancer patients, their samples look very similar to rectal, colon, stomach, and to a lesser extent pancreas, but look very dissimilar to cancers such as brain tumours.

      So why is it that some tumours can grow elsewhere? We’re not sure – some people think that there are pre-primed locations which are more favourable for certain cancers. Some cancers might break off because they don’t actually like it where they are, or they’ve changed so much that they no longer like it, and actually do much better elsewhere. The cancer cell itself can look totally different or very similar to where it’s come from, so it’s super complicated to make generalised statements!

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