Oligometastatic disease is when a primary cancer has spread to one to five places in the body, where all the areas of spread can be treated. Oligometastatic cancer is more common in prostate, kidney, colon, breast and lung cancer.

The primary cancer is the type of cells where the cancer started. For example, cancer that begins in the breast is breast cancer. The metastases are the places where the cancer has spread. In the example given here, breast metastases in the liver are still breast cancer.

Although oligometastatic disease is a type of metastatic (stage 4) cancer, it can be more treatable than widespread stage 4 cancer. Because it involves just a few focused areas of metastasis, these can be targeted with newer treatments. This can extend life significantly, and in some cases, may offer a cure.

Symptoms of oligometastatic disease depend on where the cancer started (the primary cancer), and where it’s spread to. Common places for metastases to grow include the lymph nodes, bones, spine, lungs, liver and brain.

Depending on where the metastases are, they may cause symptoms:

• Lymph nodes – a swollen or hard lymph node
• Liver  – losing weight or your appetite, feeling sick, tired, or achy
• Bone – a new, noticeable pain in the bone, joint, or muscle
• Lung – coughing up blood, chest pain, shortness of breath
• Spine – back or neck pain, tingling, weakness
• Brain – headaches, seizures, weakness, numbness, memory loss

A diagnosis will be described in terms of where the cancer started before spreading (the primary cancer). 

This differs from polymetastatic (widespread) cancer, where the cancer has spread to more than five sites.

In oligometastatic cancer, treatment is based on the type of primary cancer. It combines a standard systemic treatment, such as chemotherapy, for the cancer type with a localised treatment like radiotherapy to target the metastases.

Oligometastatic cancer is also categorised depending on when the metastases occurred. This can affect the outlook and treatment plans.

• Synchronous (de novo) oligometastases – metastases found at the same time as the primary cancer or within 6 months
• Oligorecurrence – metastases found more than 6 months after the primary cancer was diagnosed and treatment is finished
• Oligoprogression – where metastases develop more than 6 months after diagnosis of primary cancer but while you’re still having active treatment
• Induced oligometastases – where new, growing or residual metastases are found more than 6 months after treatment for previous polymetastatic cancer

Oligometastatic cancer is identified during the cancer staging process, either at initial diagnosis or if an earlier stage progresses.

The staging criteria differs depending on the type of cancer, but metastasis is usually defined as a cancerous growth in a different organ than where it started. The number, size, and treatability of metastases may be used to determine whether the cancer is oligometastatic or polymetastatic. 

To diagnose oligometastatic disease, consultants use imaging technologies like PET-CT scan and an MRI scans to detect and evaluate metastases. If results show five or fewer areas of cancer spread, you may be diagnosed with oligometastatic cancer.

The treatment approach for oligometastatic cancer usually combines localised treatment with systemic therapy:

• Localised treatment targets individual areas of cancer growth, aiming to destroy the metastases that showed on your scans
  
• Systemic treatment spreads through the body, aiming to eradicate any other small non-visible areas of metastatic spread, which may not yet be detectable on scans

The main radiotherapy treatment for oligometastatic cancer is stereotactic ablative radiotherapy (SABR). It uses powerful beams of radiation that are highly accurate, intending to destroy all cancer cells in the target area.

Depending on the cancer type, systemic treatments may include chemotherapy, targeted therapy, hormone therapy, or immunotherapy. 

We are the UKs leading provider of private cancer care, specialising in the treatment of complex cancers. By choosing us, you can be reassured your treatment is managed by a team of specialists working together with you to design the best plan for your diagnosis.

Our approach to world-class care for oligometastatic cancer includes:

• A personalised plan built around you
• Treatment starting within days if needed
• 14 dedicated cancer centres across the UK
• State-of-the-art facilities specialising in advanced radiotherapy
• Compassionate chemotherapy nurses available 24/7 by telephone
• Integrative cancer care including wellbeing therapies and exercise medicine
• Recognised by all leading private medical insurers and self-pay options available 
• Transport provided, depending on location and treatment

We’re proud so many patients rate our care as excellent as we help them through their cancer journey. Hear the unique experiences of people who have had their cancer diagnosis or treatment at GenesisCare in our patient stories section.

We provide the most comprehensive stereotactic service in the UK, offering world-class expertise and state-of-the-art facilities that specialise in advanced radiotherapy techniques. Our renowned oncologists, radiotherapists and dietitians work together to ensure that you receive the best possible care.

Stereotactic ablative radiotherapy (SABR) is a treatment innovation that allows individual metastases to be treated in oligometastatic cancer. At GenesisCare, we’re equipped with the UK’s first MRIdian MR Linac machines, which deliver a high-precision form of SABR radiotherapy and automatically pauses treatment if the tumour moves even a fraction out of the target area.

Learn more about MRIdian radiotherapy at GenesisCare. 

Alongside radiotherapy to treat individual metastases, oligometastatic cancer usually also requires systemic therapy. Depending on the standard of care, this may be chemotherapy, hormone therapy, targeted therapy or immunotherapy.

We offer all types of drug therapies used to treat and manage cancer with oligometastases, including many of the newest treatments and private chemotherapy suites, staffed by our specialist nurses.

Our compassionate nursing teams are available 24/7 on a dedicated on-call telephone service and can answer any queries during your treatment. They’ll be able to provide advice about side effects or symptoms and arrange any care you need throughout.

Our centres have all received the Macmillan Quality Environment Mark to reflect the quality of care we provide for people living with cancer.

Every patient is supported through their journey with consultant-led integrative cancer care, which combines medical treatment with life-changing approaches including exercise medicine, wellbeing therapies and psychological support.

We offer optional access to a wellbeing expert to guide you through holistic therapies of your choice, such as counselling, acupuncture, massage and reflexology, through our unique partnership with the Penny Brohn UK charity.

Exercise medicine includes a 12-week personalised programme provided by a specialist physiotherapist, available at selected centres, with techniques shown to improve outcomes for cancer patients and reduce the impact of cancer by enhancing quality of life, reducing fatigue and improving strength.