Metastatic Dormancy and What May be Happening During the Years We Call NED

In this article, Janet Maendel DO discusses metastatic dormancy divided into two parts. Part I looks at what may be happening during those clinically silent years: dissemination, the different forms of dormancy, dormancy as a survival program, the metastatic niche, and the role of the immune system in keeping residual disease under control. Part II will take up the question that naturally follows: if a malignant cell can remain dormant for years—or even decades—what changes enough for it to begin growing again?

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