If I understand correctly when tumor grows, it can reach blood vessel and then spread through it to another organ - it called metastasis.

How do cancer cells then are spreading through blood? Do they just flow the same as another blood cells? Or maybe they connect to erythrocyte and drive on them?

Also, it will be useful if you provide metastasized cancer cells sizes, at least ranges

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    $\begingroup$ Sorry I'm having a hard time understanding how the first sentence connects with the rest of the question... What is the relationship between angiogenesis and metastasis? Also, you'd be better to narrow it down quite a bit... "Cancer" is a huge subject with tons of different types. Please edit to clarify $\endgroup$ – rotaredom Apr 14 '20 at 16:24
  • $\begingroup$ @rotaredom, sorry maybe I used wrong words, English is not my native language. Is it more clear now for You? $\endgroup$ – Артур Клочко Apr 14 '20 at 17:30

A short and abbreviated summary:

When tumors grow to a certain size, they will start to develop a "tumor microenvironment", which is a umbrella term for all kinds of cells and tissue beneficial to the tumor, in most cases fibroblasts (cancer-associated fibroblasts) and macrophages (tumor-associated macrophages), but it depends on the specific kind of tumor and its organ. As tumor cells exhibit a drastically increased metabolism, they will begin to suffer from hypoxia (low oxygen concentration), which is signaled via several different biochemical pathways to the microenvironment and leads toward angiogenesis, the creation of new, often malformed, blood vessels, towards the tumor mass. The tumor can now increase its mass further due to the continual metabolic supply and the cells can undergo a process called "epithelial-mesenchymal transition", which will allow the tumor cells to "detach" themselves from the primary organ (intravasation), enter the blood system and colonize "pre-metastatic niches" => new tissues and organs. Some tumors are able to prime distant organs for metastasis via the secretion of specific factors and in many cases tumors show a distinct preference to metastasize in particular organs.

Sources: Ralf et al (2007): Molecular regulation of angiogenesis and lymphangiogenesis Costa-Silva et al (2015): Pancreatic cancer exosomes initiate pre-metastatic niche formation in the liver Egeblad et al (2010): Tumors as organs: complex tissues that interface with the entire organism Bu et al (2019): Biological heterogeneity and versatility of cancer-associated fibroblasts in the tumor microenvironment Jang et al (2019): Integrins, CAFs and Mechanical Forces in the Progression of Cancer

  • $\begingroup$ Thank You, this answer is informative and useful, but, unfortunately doesn’t directly answer the question (minus not from me) $\endgroup$ – Артур Клочко Apr 15 '20 at 12:49

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