Oligometastatic Disease (OMD)

Oligometastatic disease (OMD) is cancer that has spread from its original site, but only to a few places in your body. It’s a subtype of metastatic or stage IV cancer. There are several differences between the two types:

• Metastatic cancer is widespread. With oligometastatic cancer, you have one to five tumors in a few spots in your body.
• Oligometastatic disease is less likely to spread than typical metastatic cancer. It often grows more slowly.
• Healthcare providers use systemic therapy like chemotherapy to treat metastatic cancer. They may combine systemic therapy with radiation therapy to target specific tumors that develop with oligometastatic disease.
• Oligometastatic disease may be more curable than typical metastatic cancer.

OMD types

Common oligometastatic disease types include:

• Breast cancer that has spread to bones, brain, liver or lungs
• Colorectal cancer that has spread to liver and lungs
• Kidney cancer that has spread to brain, lungs and lymph nodes
• Non-small cell lung cancer (NSCLC) that has spread to adrenal glands, bones and brain
• Prostate cancer that has spread to bones or lymph nodes
• Sarcoma that has spread to lungs or bones

Healthcare providers may describe OMD as oligometastatic, oligoprogressive or oligoremnant:

• Oligometastatic disease means tests detect up to five tumors. Providers may call this limited metastasis.
• Oligoprogressive disease means the primary tumor stops growing after treatment, but tumors in other areas continue to grow.
• Oligoremnant disease means treatment removes most, but not all, of the tumors that spread from the primary tumor.

Symptoms of oligometastatic disease

Your symptoms depend on the type of cancer. For example, you may have bone or joint pain if breast cancer spreads to your bones. Breast cancer in your lungs may cause chest pain or a cough that won’t go away.

Oligometastatic disease causes and risk factors

Experts believe genetic changes (mutations) are why OMD differs from typical metastatic cancer. The changes may be why OMD doesn’t cause widespread disease.

How doctors diagnose OMD

Healthcare providers often use imaging tests to diagnose this condition, including:

• CT scans
• PET/CT scans
• MRI
• Bone scans

Providers may do a biopsy to get tumor samples for analysis.

Sometimes, tests detect the primary or initial tumor and OMD at the same time or within six months of diagnosis. Your provider may say you have synchronous oligometastatic disease. They may say you have metachronous OMD if later tests find tumors.

How is oligometastatic disease treated?

Surgery and stereotactic body radiation therapy (SBRT) are common OMD treatments. Your healthcare provider may combine surgery and SBRT with other treatments, including:

• Chemotherapy
• Targeted therapy
• Immunotherapy

These may be used to treat the primary tumor.

Recovery time

There’s no set recovery time. You may recover from SBRT within a few days, while surgery recovery may take weeks. Your cancer care team will explain what you can expect.

When should I see my healthcare provider?

Contact your cancer care team if you have surgery side effects, like:

• Bleeding you can’t control
• Infection symptoms like chills and fever, or pus draining from the surgery site
• Pain that doesn’t ease even after you take recommended or prescribed pain medication

Tell your provider about changes in your body. New or different symptoms may mean oligometastatic disease has come back to the same area or developed in a new area in your body.

What can I expect if I have oligometastatic disease?

Treatments like surgery and highly focused radiation therapy may remove or destroy tumors in different areas of your body. In some cases, treatment may cure OMD or lead to long-term remission.