The hemodynamic destruction of circulating cancer cells

The blood-stream is the major disseminative route for metastasizing cancer cells, and metastases are generated when the cancer "microemboli" are trapped in the microcirculation. However, most circulating cancer cells are rapidly destroyed shortly before and/or after arrest. Traditionally, destruction is attributed to the cellular or humoral response of the host defense systems. A novel, non-exclusive mechanism for cancer cell destruction has been proposed by Weiss and Dimitrov in which friction or adhesion between circulating cancer cells and capillary walls causes local vascular blockage, and the blood-pressure differentials normally existing over the entire length of a capillary are consequently applied over the length of the cancer cell. In a simple model, this pressure differential is expected to cause expansion of the cancer cell membrane, resulting in increases in tension above a critical level, with consequent membrane rupture and cell death. In vivo and in vitro experimental tests of this hypothesis are outlined.