Metastasis, the spread of cancer from the primary tumor to distant organs, is the direct cause of most cancer related deaths. Until recently, however, the mechanism by which cancer metastasized was a mystery. Circulating tumor cells (CTCs), cells that detach from the primary tumor and circulate in the bloodstream, are now thought to be one of the key players, but their rarity makes them hard to study. For every one billion normal blood cells circulating in patients with advanced cancer, there is likely only one CTC. Now, new detection approaches and equipment allow researchers to identify CTCs in the bloodstream and use their relative concentrations to predict the odds of metastasis before it occurs.
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