Prostate cancer metastasis requires cancer cells to exit the primary tumor in the prostate, survive transit through the heart and lungs, enter the arterial circulation, and establish a tumor within the metastatic site. The initial dissemination of cancer cells from the primary tumor occurs via three routes: venous blood vessels (blue), lymph vessels (green), or nerves (orange). All disseminated cells eventually enter the arterial blood supply where they are carried throughout the body to secondary sites, such as the bone, and extravasate from the blood vessel to colonize the metastatic site. Understanding the selective pressures inherent to these routes to primary tumor dissemination to a metastatic site is essential for understanding the mechanism of cancer spread and will lead to more effective methods of metastasis prevention. Please see the article by de Groot and colleagues (beginning on page 361) for more information. Image featured here
with permission from the source (Tim Phelps © JHU/AAAM 2016, Department of Art as Applied to Medicine, The Johns Hopkins University School of Medicine).
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