Ten anomalous patterns of lung cancer spread with a single explanatory hypothesis

Lung cancer is so strategically sited in relation to the pulmonary veins, left heart, and aorta that its disseminating cells have the greatest possible opportunities for being distributed everywhere. Consequently, because scientists need to be ever watchful for the unexpected, this review points out ten topographical patterns of its metastases which are at variance with expectations from blood-borne dispersal. Since a comparative study of disseminated lung cancer cells returning to the lung through the thoracic duct and of those cells carried to the contralateral lung blood vessels revealed that necrotic cancer cells are commoner in blood than in lymph, it is hypothesized that the anomalous patterns occur because of the degree of lethal exposure experienced by these cells during blood-borne transportation. Therefore, in all probability, if the secrets of Nature hitherto hidden in the blood stream are well decoded, a new era will dawn in oncology.