The spread of cancer cells around the body, which is known as metastasis, is responsible directly or indirectly for nine out of ten cancer deaths, yet on average only about 5 percent of cancer research funding in Europe is directed toward investigating metastases, according to an editorial in the European Journal of Cancer. Until recently, the reasons why some people developed metastases and others did not had been unclear, but at last there are models and scientific hypotheses that have begun to unravel this process. However, research into metastasis has not attracted the recognition it deserves from funding organizations, they say.

 

Metastasis is the process by which cancer cells split off from the original, primary tumor and travel to other parts of the body via the blood or lymph systems. This leads to the growth of secondary tumors in places such as the bones, brain, lungs and liver, and it is usually these that end up killing the patient. The discrepancy in funding, the authors believe, is similar in other countries such as the United States and Japan, although they say accurate data is difficult to obtain.

 

“Metastasis is a process in cancer that is very poorly understood. It kills patients and therefore we believe that it should be funded better,” says Jonathan Sleeman, head of microvascular pathobiology research at the University of Heidelberg, Germany and one of the guest editors on a special European Journal of Cancer issue on metastasis. “Yet at the European level and, indeed, worldwide, comparatively little emphasis is placed on tackling metastases and in providing appropriate levels of funding for research.”

 

Sleeman says it’s difficult to obtain reliable figures on research funding on metastases and there is wide variation between European countries. But he estimates 5 percent of total cancer research is directed into this area. “Given that metastasis is of central importance to the prognosis and outcome of cancer patients,” he says, “we could argue that in many countries more funding should be directed toward metastasis research."

 

In addition to adequate funding, the authors of the editorial call for effective translational research for metastatic disease to take discoveries made in the laboratory quickly into new and better treatments for cancer patients, clinical trials to be designed so that they include information on metastases, and for clinicians and scientists to work more closely together to design clinical trials that assess the development of new metastases.

“Metastatic disease, therefore, represents a major public health problem, affecting cancer patients and their families, as well as healthcare systems and the broader economy,” writes Sleeman along with the issue’s other guest editor, Professor Patricia Steeg, chief of the Women's Cancers Section, Laboratory of Molecular Pharmacology at the National Cancer Institute, Bethesda, Maryland. “Despite this, progress in developing treatments for metastatic disease remains slow,” write Sleeman and Steeg.