Chris’ Caveat: Chris (the author of this document) is not a doctor nor does he play one on TV. Despite his months of intensive study of cancer and months of real-world experience as a caregiver the explanations given here are not scientific or diagnostic in nature. If you have questions, go see your doctor!
Maggie has colon cancer – not liver cancer. Yes, her liver is consumed with tumors but the tumors are colon cancer tumors, specifically, invasive adenocarcinoma originating in the sigmoid and descending junction of the colon. Basically that’s doc-talk for aggressive cancer that started in the glandular tissue of the poop-chute. And since the name of the cancer is derived from the point of origin, Maggie’s cancer is, no matter where it appears in her body, colon cancer.
Colon cancer, as do other types of cancer, spreads throughout the body via the blood stream or the lymphatic system. As Dr. Loukas put it, the cancer spits out “seeds” that spread throughout the body which eventually take root to blossom into another tumor somewhere else. Same cancer, different spot. Thus, the tumors in Maggie’s liver are still colon cancer tumors. They just have a new home. It’s like accidentally getting a jalapeno plant growing in your tomato garden. It’s still a jalapeno and if you try to use it as the base for a tomato paste you’re likely to be unhappy… twice.
Other places that cancer is likely to pop up are fun places like the lungs or the brain. One of the first things they did in the hospital even before they operated on Maggie was to scan her for both lung and brain tumors. They found the crazy in her brain but no tumors. The only thing they found in her lungs was the breath of life… and talking.
These renegade tumors that have popped up like little bastard weeds are properly called “metastases.” They are cancer that has spread from its primary site to another place in the body, in Maggie’s case, her liver.
Cancer diagnoses are given grades that denote the degree of crappiness. These grades are called stages and range from I to IV (1 to 4, for those of us non-Romans), with Stage IV being the worst case. When the cancer has spread to anywhere else in the body from its primary site, called metastasized, a patient automatically wins the prize and gets classified as Stage IV. That’s not a prize you want to win. Maggie is Stage IV.
These codes were created for cancer patients who use them as a quantification of bragging rights or a numerical measure of the cancer pecking order. All of the specific details are laid out in the Official Code of Conduct for Cancer Patients (“The Code”) which are designed to bring some sense of order to a typically unruly group. Essentially, the higher the stage, the higher up the food chain the patient is. Lower staged patients must show deference to patients with higher stages. For example, Stage I patients are required by The Code to avert their eyes and lower their voice if a patient with a higher stage enters the room. Stage IV patients always trump and all other stages must respect their authority. Cancer patients are known to be quite ornery so a deterrent to breaking The Code has been established: doctors and nurses are required to withhold chemo treatments of any cancer patient not following The Code.
Another type of grading the medical industry uses, because just using one type of grading would be too easy to understand, is called the TNM Classification of Malignant Tumors. Using this scale Maggie’s cancer is a T3, N2, M1. As you might imagine, she gets a lot of deference.