Mesothelioma Might Spread Via Your Airways

The fact that you need to inhale and exhale could explain why you and your doctor are having little or no luck in stopping mesothelioma from spreading from your chest to other parts of your body.

The conventional understanding of how cancer spreads is that tumors travel to distant sites in your body via your bloodstream after uprooting themselves from the place where they started and grew.

Cancer cells pull off this little feat by producing a protein that allows them to break free from one tissue surface and replant themselves on another somewhere else.

This is called hematogenous spread.

But now, researchers in Canada and Australia have come to the conclusion that cancer cells relocate through a process known as aerogenous metastasis.

In other words, cancer cells travel through your airways. The thing that propels them along on their journey is your respiration — the breaths you take.

Or, at least that’s what happens if the cancer cells have originated on or in your lungs, scientists clarify.

Mesothelioma and Adenocarcinoma Have Similarities

The researchers wrote about this discovery in the American Journal of Roentgenology.

So far, aerogenous metastasis is a phenomenon observable only in patients with the adenocarcinoma form of lung cancer.

Adenocarcinoma is not the same as mesothelioma, but the two lung cancers have enough in common that it’s easy to imagine the problem of aerogenous metastasis applying to mesothelioma too.

The researchers contend that the possibility of airways carrying adenocarcinomas means that therapies need to be retargeted at the mechanisms of aerogenous travel itself.

For example, some scientists believe it would be useful to direct pharmaceutical firepower at the proteins and processes permitting cancer cells to hoist anchor and float freely, either in blood or oxygen.

The study authors suggest that clinical teams trying to treat adenocarcinomas include pathologists and geneticists to complement the oncologists and radiation specialists. Respiratory care practitioners would probably be a good idea to include on any such team as well.

Aerogenous Spread Is an Under-Recognized Problem

The research — “Aerogenous Metastases: A Potential Game Changer in the Diagnosis and Management of Primary Lung Adenocarcinoma” — was authored primarily at the University of Ottawa in Canada. Contributing was Southcoast Radiology in Australia.

The authors contend that it is essential clinicians accurately distinguish aerogenous metastases from other types of spreads. Careful imaging of a target metastasis can help achieve this.

To arrive at that and other conclusions, the researchers analyzed current literature on aerogenous metastasis. The works they studied advised treating as suspicious any persistent or growing centrilobular nodules that show up on a CT scan. These are to be considered prime candidates for aerogenous spread.

Genomic profiling may be good “for proving monoclonality when aerogenous metastasis is suspected,” they added.