When adenocarcinoma spreads from the initial site, it is described as metastatic. (1) Adenocarcinomas that mestastasize can appear 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)
Adenocarcinoma of the Pancreas
Pancreatic adenocarcinoma is cancer that starts in the ducts of the pancreas, the large gland behind the stomach that helps convert food into fuel. (3) This type of advanced pancreatic cancer 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:
Pain in the upper abdomen that spreads to the backLoss of appetiteWeight lossJaundice (yellowing of the skin or whites of the eyes)DiabetesDepressionBlood clotsFatigue (6)
Adenocarcinoma of the Lung
Adenocarcinoma is the most common type of non-small-cell lung cancer, accounting for about half of all cases. (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 of lung cancer. It’s more likely to develop in women than in men. (8) Common symptoms are:
A persistent cough or coughing up bloodShortness of breathWheezingPain in the chest or shoulders when breathingHoarsenessFrequent respiratory tract infectionsTrouble swallowingFatigueWeight lossLoss of appetiteSwelling in the face or veins in the neckBack or bone painWeakness in the arms or legsHeadaches, seizures, or vision changes (10)
Adenocarcinoma of the Prostate
Prostate cancer begins in the prostate gland, located just below the bladder in men. Nearly all prostate cancers are adenocarcinomas. (1) Physicians are often 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:
Painful urinationBlood in semenDecreased urination forceBone painSwelling in the legsFatigue (12)
Adenocarcinoma of the Esophagus
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 swallowingChest painWeight lossA cough that doesn’t go awayTrouble breathingHoarsenessWorsening heartburn or indigestionJaundice (yellowing of the skin or whites of the eyes)Itchy skinAbdominal pain or discomfort (14,15)
Duodenal Adenocarcinoma
Duodenal adenocarcinoma is a rare and aggressive cancer that begins in the small intestine. (16) Some symptoms are:
Abdominal painNauseaVomitingWeakness or fatigueDark-colored stoolsAnemia (low red blood cell counts)Jaundice (yellowing of the skin or whites of the eyes) (17)
Adenocarcinoma of the Colon
Adenocarcinomas make up about 95 percent of all colon and rectal cancers. (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) A subtype of this cancer, known as mucinous adenocarcinoma, affects about 10 to 15 percent of people with colorectal cancer. 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:
Rectal bleeding or bloody stoolsConstipation, diarrhea, or other changes in bowel habitsAbdominal pain or bloatingNausea or vomitingWeakness or fatigueJaundice (yellowing of the skin or whites of the eyes)Loss of appetiteWeight lossBone pain or fracturesDifficulty breathingConfusion or memory lossHeadacheBlurred or double vision (20)
Adenocarcinoma of the Breast
Most breast cancers are adenocarcinomas because the areas where tumors typically develop (the milk ducts and lobules) contain a lot of glandular tissue. (21) Breast adenocarcinomas can metastasize to the liver, brain, bones, or lungs. (22) Symptoms of metastatic breast adenocarcinoma can include:
Bone, chest, joint, or abdominal painA persistent coughShortness of breathHeadacheMemory problemsChanges in vision or speechWeakness or fatigueWeight lossDifficulty urinatingLoss of appetiteNausea or vomitingJaundice (yellowing of the skin or whites of the eyes)Fever (22)
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. When doctors can’t tell where a metastatic adenocarcinoma started, they call it a metastatic adenocarcinoma of unknown primary. 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? Risk factors for metastatic adenocarcinoma depend on the type, but may include:
Increasing ageA family history of cancerCertain inherited conditionsObesitySmokingHeavy drinkingExposure to radiation therapyCertain infectionsExposure to cancer-causing substances, such as radon, asbestos, arsenic, chromium, and nickel (25)
RELATED: What Are the Risk Factors for Cancer, and Can You Prevent It?
Imaging Computed tomography (CT) scans, magnetic resonance imaging (MRI), and other tests can create detailed pictures of the inside of the body.Biopsy A 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 of biopsies exist.Blood Tests Certain lab tests can help doctors learn more about the cancer. (1,26)
In general, many of these cancers are staged using the following categories:
Stage 0: The cancer hasn’t invaded the local normal organ tissue.Stage 1: This is usually a small cancer that hasn’t grown deeply into nearby tissues and hasn’t spread to the lymph nodes or other parts of the body.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, when adenocarcinoma becomes metastatic, 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) 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:
Surgery Surgeons 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.Radiation Radiation 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.Chemotherapy Chemotherapy uses drugs to kill cancer cells. Doctors may employ it alone or in combination with other treatments. Chemo can relieve symptoms and may prolong survival.Targeted Treatments Targeted therapies attack specific targets on cancer cells. They can be used by themselves or in tandem with other types of treatment.Immunotherapy This 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 a clinical trial can be another way to receive novel treatments not yet in widespread use. ClinicalTrials.gov is a government-run database of trials searchable by location. (1,28) For instance, lung adenocarcinomas tend to metastasize more slowly than other forms of lung cancer. (29) 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)
Adenocarcinoma vs. Mesothelioma
Mesothelioma is a type of cancer that develops in the mesothelium, the thin layer of tissue that covers most of the internal organs. Most cases of mesothelioma affect the tissue that surrounds the lungs. Adenocarcinoma and mesothelioma can have overlapping symptoms, but they are different kinds of cancer. Lung adenocarcinomas affect the glandular cells within lung tissue. Mesothelioma develops in the mesothelium, outside the lungs. Mesothelioma is almost always caused by exposure to asbestos, while lung adenocarcinoma involves other factors, such as tobacco use. (31,32)
