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JHU - Understanding Cancer Metastasis

Last updated Mar 6, 2023


  • Source:: Understanding Cancer Metastasis | Coursera
  • Instructor:: Kenneth Pienta, Jelani Zarif, Sarah Amend, Haley Axelrod, Kenneth Valkenburg
  • Offered by:: Johns Hopkins University
  • Platform:: Coursera
  • Publish Date::
  • Review Date::

About this Course
Everyone has been, or will be touched by cancer in some way during their lifetime. Thanks to years of dedication and commitment to research we’ve made enormous advances in the prevention and treatment of cancer, But there is still a lot of work to be done. In this course, physicians and scientists at the Johns Hopkins School of Medicine explain how cancer spreads or metastasizes. We’ll describe the major theories of metastasis and then describe the biology behind the steps in metastasis. The course also describes the major organs targeted by metastasis and describes how metastases harm the patient.

# Module 1 – History and Overview of Metastasis

# Introduction

# History of Metastasis

# Introduction to the Sequential Steps of Metastasis

The sequential steps of metastasis can be broken down into 8 steps:

  1. Primary tumor growth
    • Cancer starts to grow at one site. This is termed the “primary tumor” or “primary cancer” of that organ, e.g., breast cancer, lung cancer, prostate cancer.
    • Even after the cancer spreads to other organs, it is still referred to as a cancer of that primary organ.
      • For example, prostate cancer that is found metastasized to the bone is still referred to as prostate cancer.
  2. Angiogenesis
    • A tumor cannot grow to more than a millimeter in size unless it attracts new blood vessels.
    • New blood vessels provide the growing cancer with nutrients and oxygen and provide the cancer cells with a pathway to other sites in the body.
  3. Epithelial-to-mesenchymal Transition (EMT) (motility)
    • Acquisition of a motile phenotype (a cell that can walk around and move versus one that can’t)
      • It is thought that cancer cells undergo a change in phenotype to make them more mesenchymal — cells that lack polarity and are more motile.
    • This allows them to be more invasive and “walk out” of the primary tumor.
  4. Invasion
    • Cancer cells invade the tissue surrounding the cancer.
  5. Intravasation
    • Cancer cells can break through the blood vessel wall and move into the circulation.
  6. Survival in circulation
    • Cancer cells in the circulation must survive turbulent blood flow and escape detection by cells of the immune system that would recognize them as abnormal and try to kill them.
  7. Extravasation
    • When cancer cells reach a target organ, they attach to the blood vessel wall and then invade into the tissue.
  8. Dormancy and subsequent secondary tumor growth
    • Cancer cells in the new tissue or “soil” most likely survive in a dormant state for a period of time before they start to proliferate and form a detectable, clinical metastasis.

# Module 2 – Primary Tumor Growth and Neoangiogenesis

# Tumor Formation: Uncontrolled Cell Division

# The Role of Mutations in Primary Tumor Formation and Evolution

# Neoangiogenesis

# The Primary Tumor Microenvironment

# Module 3 – Invasion and Intravasation

# Epithelial-mesenchymal Transition, Invasion, and Intravision

# Local Tumor Invasion

# Intravasation

# Module 4 – Survival in the Circulation and Extravasation

# Glossary

# The Circulation

# How Cancer Cells Survive while in Circulation

# Becoming a Circulating Tumor Cell (CTC) and Evading Immune Detection

# Homing to a New Site in the Body and Extravasation

# Module 5 – Dormancy and Secondary Tumor Growth

# Metastatic Homing

# Cancer Dormancy

# Properties of Dormat Cancer Cells

# Secondary Growth