Some patients will have metastatic disease on initial presentation. Others may present with symptoms of recurrent disease after a previous cancer diagnosis. Access to the best available therapies, including clinical trials, as well as treatment overseen by a multidisciplinary team, are crucial to achieving the best outcomes for anyone with metastatic disease.

Signs and symptoms will depend on the type of cancer initially diagnosed and the location of metastatic disease. They may be discovered by the patient or by surveillance in the post-treatment period. New symptoms or changes in symptoms may include (Cancer.Net 2019):

• increase in facial flushing
• increased diarrhoea
• wheezing
• heart problems such as palpitations, difficulty breathing, becoming easily tired
• increased abdominal pain
• bloating
• bone pain.