How does cancer spread?

Todd W Franzen

May 16, 2019

diagram of cancer cells entering the blood stream
This is how cancer spreads

How cancer spread is a complicated issue to understand from a biological standpoint. But from a survivor standpoint, you get a little bit more information as you go through the process. But I wanted to share the simple way why and how cancer spreads. Doing this will help give you some insight into how the disease progresses as cancer grows. I will do my best!

I went through lymphoma, so my experience is a little bit different. Normally cancer will start as a tumor and it will slowly grow and get bigger. If not found or treated, it will break off and make its way into the bloodstream.

At this point, it will go wherever it wants to!

This is where Cancer starts to spread. The name for this is metastasizing or metastasis. It can go anywhere in your body. You can say you have lung cancer, it might get into your blood and make its way to your liver, or even your kidneys. It can even make its way to your pancreas, it can go anywhere there’s blood. Or even pancreatic cancer can metastasize and make its way to the lungs.

Cancer is not Prejudiced!

Once that happens is when it becomes much more difficult. As it metastasizes, drugs react differently to different parts of your body in different organs.  It could also get into your lymphatic system and move around your body that way too. Ultimately what happens is it multiplies and spreads by making its way into the bloodstream and it travels throughout your body. That is really the simplest explanation of how it spreads.

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With lymphoma, it gets a little bit more challenging because lymphomas start off in your white blood cells. There are five different types of white blood cells that are created in your body. Neutrophils, lymphocytes, monocytes, eosinophils, and basophils but there’s only one that I’m going to talk about, and it is your lymphocytes.

I had a damaged lymphocyte that created my Hodgkin’s Lymphoma. My team couldn’t kill it with the normal rounds of chemotherapy. I went through 12 rounds of chemo called ABVD to try to kill it. That didn’t quite work and ended up having a reoccurrence. That’s when the decision was made to have an Autologous Stem-Cell Transplant.

A Faulty Lymphocyte

I had a lymph node just above my heart that ended up creating the entire mess. The lymphoma ended up moving throughout my entire lymphatic system.

I had a lymph node removed from my armpit and I had multiple biopsies done. The pet scan showed it was all over my body and it had spread to my liver.

Fortunately, your liver is one of the fastest regenerating organs in your body. Nonetheless, it did go there and I was at risk of having liver damage because of the chemotherapy.

As the cancer progressed, it spread through my lymphatic system. And over time, it just got worse and worse and it grew all over.

That’s why my staging was so advanced. Staged 4B reoccurring Hodgkin’s Lymphoma. And that’s how that whole thing spread. And that’s actually how cancer spreads. Once it gets into your bloodstream, the game changes.

How Cancer Spread

Your circulatory system and lymphatic system are essentially highways of transportation for everything that goes on in your body. Even cancer. So that’s how cancer spreads.

Yes, there’s a lot more that I don’t understand. I believe what’s most important is you understand the basics of how this disease spreads.  Now you can have a bit of an educated discussion with your oncologist and your doctor and choose the next steps in your treatment.

Click Here to learn more about the meaning of cancer survivorship.

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Todd W Franzen


I am a two-time Hodgkin's lymphoma survivor with 17 years of documented cancer survivorship experience that spans multiple treatment eras. My journey began in November 2009 with a Stage 4B diagnosis at age 33, and continued through recurrence and treatment in 2019-2021. This rare longitudinal perspective—living through two complete treatment cycles a decade apart—gives me comparative insight into cancer care evolution that no single medical professional can replicate.

MY TREATMENT EXPERIENCE

First Treatment Cycle (2009-2010)
• 12 infusions of ABVD Chemotherapy over 6 months
• 2 infusions of ICE Chemotherapy (4-day infusions)
• 1 infusion of BEAM Chemotherapy
• 1 Autologous Stem-Cell Transplant
• 8 PET Scans
• 6 CT Scans

Second Treatment Cycle (2019-2021)
• 2 infusions of Brentuximab and Bendamustine
(Severe allergic reaction to Brentuximab — hives)
• 25 rounds of Radiation to Mediastinum (46RAD combined)
• 4 infusions of Keytruda Immunotherapy
• 2 infusions of IGEV Chemotherapy (5-day infusions)
• 1 Total Body Radiation (2RAD)
• 1 Sibling Allogeneic Stem-Cell Transplant
• 6 PET Scans
• 6 CT Scans

COMPARATIVE EXPERTISE

Surviving two stem-cell transplants—one autologous, one sibling allogeneic—across different decades of cancer treatment has given me firsthand experience with nearly every major modality in lymphoma care: combination chemotherapy, salvage chemotherapy, immunotherapy, radiation protocols, and both types of stem-cell transplantation. I've experienced treatment side effects from the "standard" ABVD era through the modern immunotherapy period.

This comparative expertise matters for survivors. Treatment protocols in 2009 looked very different from 2019, and the long-term survivorship implications are still emerging. Doctors treat; survivors live with the aftermath. I've done both—twice.

CREDENTIALS & PROJECTS

• Founder: Strap In For Life 501(c)(3) nonprofit
• Author: Internal Architect: A Cancer Survivor's Memoir
• Licensed Insurance Agent (practical healthcare system navigation)
• 17-year cancer survivor documenting the journey since 2008

WHAT I WRITE ABOUT

Cancer survivorship doesn't end when treatment stops—it's when the real reconstruction begins. My blog covers:
• Practical survivorship (relationships, careers, identity)
• Treatment experience insights (what they don't tell you)
• Long-term effects and secondary health considerations
• Mental health and emotional reconstruction
• Healthcare system navigation

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