Molecular targets of growth, differentiation, tissue integrity, and ectopic cell death in cancer cells.

Cancer cells continue to grow, lose their differentiation, and are found beyond their tissue boundaries, where they survive. These phenomena lead to cancer invasion and metastasis and are responsible for the outcome of the disease in cancer patients. Different factors determine where and when the cells will metastasize. The surrounding host cells, such as fibroblasts, macrophages, leukocytes, et cetera, and the extracellular matrix play an important role in the creation of the microenvironment for the cancer cells to invade. Blood and lymph vessels are not only the transporters of nutrients and metabolites for the primary tumor, these vessels also transport cancer cells to distant sites, where they metastasize. Angiogenesis and host cells are targets in cancer treatment. To monitor therapy or to predict cancer relapses, circulating tumor markers are used that reflect the molecular cross-talk between cancer and stromal cells.