Why carcinoma spreads through blood
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Quick answer
Carcinomas can spread through blood, called hematogenous metastasis, when malignant epithelial cells:
- Invade nearby tissue and break through the basement membrane.
- Enter blood vessels (intravasation), often aided by tumor-produced enzymes and new, fragile blood vessels.
- Survive in circulation, sometimes protected by platelet clumps that help them evade immune cells.
- Get trapped in distant capillary beds, then leave the vessel (extravasation).
- Grow at a new site if the local environment supports them.
Blood flow commonly carries tumor cells first to:
- Liver from many gastrointestinal cancers, via portal circulation
- Lungs from many systemic venous tumors
- Bone, brain, liver, and lungs from several carcinomas depending on tumor type
A key nuance: carcinomas more often spread first through lymphatics, whereas sarcomas more characteristically spread through blood. But advanced carcinomas frequently use both routes.
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