什么是转移性腺癌？这种晚期癌症的类型，原因和治疗

Adenocarcinoma is a癌症类型那种形式粘液-secreting gland cells, which are found in tissues that line internal organs.

When adenocarcinoma spreads from the initial site, it is described as metastatic. (1)

Metastatic adenocarcinoma can crop up in different parts of the body. Sometimes doctors can’t tell where the cancer started, which makes it harder to know the best treatment. (2)

Different types of metastatic adenocarcinoma are classified by where they first developed. The following are some of the main categories.

转移性胰腺腺癌

Metastatic pancreatic adenocarcinoma is cancer that starts in the ducts of thepancreas, the large gland behind the stomach that helps convert food into fuel. (3)

This type of advanced胰腺癌is one of the hardest to treat, with a five-year survival rate of 8.5 percent. (4)

Pancreatic adenocarcinomas often metastasize, spreading within the abdominal cavity, to the bones, or to organs such as the liver, lungs, and brain. (5)

Signs and symptoms of metastatic pancreatic adenocarcinoma may include:

• 围困到后面的上腹部疼痛
• Loss of appetite
• Weight loss
• 黄疸（yellowing of the skin or whites of the eyes)
• Diabetes
• Depression
• Blood clots
• 疲劳（6)

肺的转移性腺癌

腺癌是最常见的类型non-small-cell lung cancer，占所有案件的一半。（7) It usually develops in smaller airways in the outer portion of the lung. (8)

When adenocarcinoma in a lung metastasizes, cancer cells typically spread to the other lung or to the adrenal glands, bones, brain, or liver. (9)

Lung adenocarcinoma tends to spread more slowly than other kinds oflung cancer。It’s more likely to develop in women than in men. (8)

常见的症状是：

• A persistent咳嗽要么咳嗽ing up blood
• Shortness of breath
• Wheezing
• 呼吸时胸部或肩部的疼痛
• Hoarseness
• 频繁的呼吸道感染
• Trouble swallowing
• 疲劳
• Weight loss
• Loss of appetite
• Swelling in the face or veins in the neck
• Back or bone pain
• 手臂或腿部的弱点
• Headaches, seizures, or vision changes (10.)

Metastatic Adenocarcinoma of the Prostate

Prostatecancer begins in theprostate gland, located just below the bladder in men.

近乎全部prostate cancersare adenocarcinomas. (1) Physicians are typically able to diagnose prostate adenocarcinomas early, before the cancer metastasizes.

When prostate metastatic adenocarcinomas do occur, they may develop in areas such as the lymph nodes, bones, liver, lungs, or brain. (11.)

Symptoms may include:

• 痛苦的排尿
• Blood in semen
• 排尿减少
• Bone pain
• 腿部肿胀
• 疲劳（12.)

食道的转移性腺癌

Adenocarcinoma is the most common form of esophageal cancer in the United States, usually affecting white men. (13.)

This cancer most often starts in the glands that line the lower part of the esophagus, the long tube that runs from the throat to the stomach. (1)

When esophageal adenocarcinomas metastasize, cancer cells may travel to the lymph nodes, lungs, liver, bones, adrenal glands, or brain. (14.)

Symptoms may include:

• Difficulty swallowing
• Chest pain
• Weight loss
• 一个不会消失的咳嗽
• Trouble breathing
• Hoarseness
• 恶化heartburn要么indigestion
• 黄疸（黄色的皮肤或白色的白人）
• 痒皮
• Abdominal pain要么discomfort (14,15.)

Metastatic Duodenal Adenocarcinoma

Metastatic duodenal adenocarcinoma is a rare and aggressive cancer that begins in the small intestine. (16.)

Some symptoms are:

• Abdominal pain
• Nausea
• Vomiting
• Weakness or fatigue
• 黑色凳子
• Anemia（low red blood cell counts)
• 黄疸（黄色的皮肤或白色的白人）（17.)

Metastatic Adenocarcinoma of the Colon

Adenocarcinomas make up about 95 percent of all结肠癌和直肠癌s。（1)

These cancers begin in the intestinal gland cells in the inside lining of the colon, then can metastasize to the liver, lungs, brain, lymph nodes, or lining of the abdominal cavity. (18.)

这种癌症的亚型，称为粘液腺癌，影响约10％至15％的人结直肠癌。Mucinous adenocarcinomas are characterized by excess mucus secretion. They’re usually diagnosed at a later stage than adenocarcinomas, and the outlook isn’t as good. (19.)

Symptoms of metastatic adenocarcinoma of the colon may include:

• 直肠出血要么bloody stools
• Constipation, diarrhea, or other changes in bowel habits
• 腹痛或腹痛bloating
• Nausea or vomiting
• Weakness or fatigue
• 黄疸（黄色的皮肤或白色的白人）
• Loss of appetite
• Weight loss
• 骨痛或骨折
• 呼吸困难
• Confusion ormemory loss
• Headache
• 模糊或双重视野（20.)

乳房的转移性腺癌

Mostbreast cancers是腺癌，因为肿瘤通常发育的区域（牛奶管道和小叶叶）含有大量腺体组织。（21.)

乳腺腺癌可以转移到肝脏，脑，骨骼或肺部。（22.)

我可以转移性乳腺腺癌的症状nclude:

• Bone, chest, joint, or abdominal pain
• 持续咳嗽
• Shortness of breath
• Headache
• 记忆问题
• 视力变化或演讲
• Weakness or fatigue
• Weight loss
• Difficulty urinating
• Loss of appetite
• Nausea or vomiting
• 黄疸（黄色的皮肤或白色的白人）
• Fever (23.)

Metastatic Adenocarcinoma of Unknown Primary

In a small number of cases, doctors may have trouble identifying the original site of a metastatic cancer, since few tumors have specific features that reveal where they started.

当医生无法讲解转移性腺癌开始时，他们称之为未知初级的转移性腺癌。

Scientists estimate that adenocarcinomas account for around 60 percent of metastatic cancers of unknown primary. (2)

Related:What Are Some of the Signs and Symptoms of Cancer?

Doctors don’t know exactly what causes metastatic adenocarcinoma, but they believe that, as with other cancers, changes (mutations) in the DNA of cells disrupt normal function. (24.)

Risk factors for metastatic adenocarcinoma depend on the type, but may include:

• Increasing age
• A family history of cancer
• 某些遗传条件
• Obesity
• Smoking
• 沉重的饮酒
• 暴露于放射治疗
• 某些感染
• 暴露于癌症导致的物质，如氡，石棉，砷，chromium, and nickel (25.)

Related:What Are the Risk Factors for Cancer, and Can You Prevent It?

Doctors may use one or severaltests诊断转移性腺癌。这些包括：

• 成像Computed tomography（CT) scans, magnetic resonance imaging (MRI），其他测试可以创建身体内部的详细照片。
• BiopsyA surgeon removes a small sample of tissue and analyzes it in the lab, a process that can help reveal where the cancer started. Several different types ofbiopsiesexist.
• Blood tests某些实验室测试可以帮助医生了解有关癌症的更多信息。（1，26.)

Doctors“stage” a cancerto determine its extent and help form a treatment plan. There are different staging systems for metastatic adenocarcinoma, depending on the type.

In general, many of these cancers are staged using the following categories:

• Stage 0: The cancer hasn’t invaded the local normal organ tissue.
• 第1阶段：这通常是一种小癌症，这些癌症尚未深入到附近的组织中，并且没有蔓延到身体的淋巴结或其他部位。
• Stages 2 and 3: The cancer has grown more deeply into nearby tissues and may have also metastasized to nearby lymph nodes, but not to more distant parts of the body.
• Stage 4: This is the most-advanced stage, which describes cancer that has metastasized to other areas in the body.

Sometimes, doctors add a letter or another number to the stage to describe the cancer in more detail. (24,27.)

Treatmentfor metastatic adenocarcinoma depends on where the cancer began in the body as well as overall therapy goals.

For instance, some people with advanced cancer might choose only to undergo treatments to make them more comfortable, while others may want to pursue aggressive therapies in an attempt to cure the disease.

Treatment options may include:

• SurgerySurgeons can remove cancerous tissue and some surrounding tissue. Surgery may not be an option if the cancer is very advanced or has spread to certain areas. Sometimes, the main goal of surgery is to relieve symptoms and make patients more comfortable.
• RadiationRadiation therapy uses high energy X-rays or particles to kill cancer cells. With metastatic cancer, it’s often utilized to shrink tumors and reduce pain.
• ChemotherapyChemotherapy使用药物杀死癌细胞。医生可以单独使用或与其他治疗结合使用。Chemo可以缓解症状，可能延长存活。
• Targeted treatments有针对性的疗法攻击癌细胞上的特定目标。它们可以自身使用或与其他类型的治疗一起使用。
• ImmunotherapyThis treatment uses the body’s own immune system to fight cancer.

Other therapies may be available beyond the ones listed above; a doctor can outline all the options available to each patient.

Participating in aclinical trialcan be another way to receive novel treatments not yet in widespread use.ClinicalTrials.gov是一个由地点可搜索的政府运行的试验数据库。（1，28.)

Is Metastatic Adenocarcinoma a Fast- or Slow-Growing Cancer?

Adenocarcinoma can be considered fast-growing or slow-growing depending on how long the cancer takes to metastasize.

For instance, lung adenocarcinomas tend to metastasize more slowly than other forms of lung cancer. (29.)

Adenocarcinoma is a subtype of carcinoma, with the differences in the two terms coming down to the types of tissue affected.

Carcinoma, the most common kind of cancer, starts in the epithelial tissue that lines internal organs like the liver and kidneys. Adenocarcinoma is a more specific term that refers to a carcinoma that begins in the mucus-secreting glands in epithelial tissue.

Each type of cancer can metastasize from a wide range of primary sites to other areas of the body, and they’re sometimes treated similarly. (1,30.)

Metastatic Adenocarcinoma vs. Mesothelioma

间皮瘤是一种在中皮中发展的癌症，覆盖大部分内器官的薄膜。大多数间皮瘤病例影响围绕肺部的组织。

腺癌和间皮瘤可以具有重叠的症状，但它们是不同种类的癌症。肺腺癌会影响肺组织内的腺细胞。间皮瘤在肺部外部发展。

间皮瘤几乎总是通过暴露于石棉而引起的，而肺腺癌涉及其他因素，例如烟草使用。（31.,32.)