Confusing Oncology terms - secondaries, mets, etc..

[BlondeCookie]

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Secondary tumors, metastatic disease, secondaries and other types of terms are all basically the same thing. Correct? I'm just a bit confused on the terminology of "secondaries" and I'd really like some confirmation/clarification is possible.

OK, here is my understanding based on a couple of examples.

1. A secondary brain tumor is a tumor that originated elsewhere, but has now metastasized to the brain. Correct?
2. A secondary brain cancer is cancer that originated in the brain, but has spread somewhere else. Correct?

 

[mdc848]

Secondary tumors, metastatic disease, secondaries and other types of terms are all basically the same thing. Correct? I'm just a bit confused on the terminology of "secondaries" and I'd really like some confirmation/clarification is possible.

OK, here is my understanding based on a couple of examples.

1. A secondary brain tumor is a tumor that originated elsewhere, but has now metastasized to the brain. Correct?
2. A secondary brain cancer is cancer that originated in the brain, but has spread somewhere else. Correct?

Hmmm. Unless I'm way out in left field, my understanding is cancer is synonymous with tumor. The definitions do not have anything to do with origin. So:

A secondary brain cancer/tumor is a cancer/tumor that originated somewhere else but has now metastasized to the brain.

A brain cancer/tumor that originates in the brain and spreads somewhere else is considered the primary brain cancer/tumor.

Thoughts?

 

[TIMTIM]

I think they mean the SAME thing, Secondary brain tumor/cancer can both just mean mets, IN THE BRAIN...

Primary brain cancers rarely metastasize...it kills the patient before that happens.

Sometimes a secondary CAUSE of primary brain tumor/cancer is low-dose radiation, etc...

Primary is primary...and they should have a name in the question stem, like GBM, etc...

 

[Scaredshizzles]

I think they mean the SAME thing, Secondary brain tumor/cancer can both just mean mets, IN THE BRAIN...

Primary brain cancers rarely metastasize...it kills the patient before that happens.

Sometimes a secondary CAUSE of primary brain tumor/cancer is low-dose radiation, etc...

Primary is primary...and they should have a name in the question stem, like GBM, etc...

Technically, metastatic and secondary should not mean the same thing. Metastatic implies it is a tumor that originated in another body tissue that spread to wherever (i.e. of the same histology as the priginal). Secondary tumor should refer to a tumor that occurred after treatment of another tumor; the classic case is the development of AML about a decade after treatment with topoisomerase inhibitors like etoposide. (I think about ~2% occurrence). Generally, secondary tumors should be of a different histology from the primary. A recurrent tumor refers to a tumor that arises in the same tissue as where the primary was, but after a complete response had occurred in that primary.


But yes, I can see some people referring to metastatic and secondary as being the same thing, even on the USMLE. Lets face it, people who write USMLE questions for the most parts are people who aren't contributing anything else useful to medicine (i.e. not the sharpest tools in the shed.) I particularly despised the inaccuracy of heme-onc questions on step 2.