Remembering Jim Valvano and Understanding Metastatic Cancer

What the record says

Jim Valvano — "Jimmy V," who coached North Carolina State to the 1983 NCAA men's basketball championship — was diagnosed with cancer in 1992. The North Carolina Department of Natural and Cultural Resources describes it as terminal.

In March 1993 he accepted the Arthur Ashe Award for Courage at the ESPY awards, and in the final months of his life he helped establish what became The V Foundation for Cancer Research. Its motto came from that period: "Don't Give Up... Don't Ever Give Up!" The foundation says it was founded in 1993 by ESPN and Valvano, and has since awarded nearly $458 million in research funding.

He died on April 28, 1993, at age 47. UPI reported the death that day.

One thing needs saying carefully. UPI reported that he was first diagnosed in June 1992, that doctors gave him about a year, and that the disease was metastatic adenocarcinoma, which his physicians described as incurable. Adenocarcinoma is cancer that begins in gland tissue. What the reporting we can verify does not settle is where in the body it began. Pages that name a specific organ of origin are going beyond the record, and we are not going to do that.

What he said about it himself, quoted by UPI from a February 1993 appearance, was this: "Cancer has taken away a lot of my physical abilities. What cancer cannot touch is my mind, my heart and my soul."

What metastatic cancer actually means

Metastatic cancer is cancer that has spread from where it started to a distant part of the body. For most cancer types this is also called stage 4. The spreading process itself is called metastasis.

NCI describes it as a series of steps. Cancer cells invade nearby normal tissue. They push through the wall of a lymph node or a blood vessel. They travel through the bloodstream or the lymphatic system. They stop somewhere distant, move out of the vessel into the surrounding tissue, and begin to grow. Then they prompt new blood vessels to form, which supplies the new tumor.

Most cells that attempt this die along the way. Only when conditions are right at every step does a new tumor form. NCI also notes that cancer cells can sit inactive at a distant site for years before growing — if they ever do.

Why the name does not change

This trips up almost everyone. Breast cancer that spreads to the lung is metastatic breast cancer, not lung cancer, and it is treated as stage 4 breast cancer.

The reason is biological. Under a microscope those cells still look and behave like breast cells. They respond to breast cancer drugs, not lung cancer drugs. The name follows the origin because the origin predicts the treatment.

Sometimes doctors cannot determine where a cancer began. NCI calls that cancer of unknown primary origin. It is a recognized diagnosis, not a failure of testing, and it has its own approach to treatment. Our page on cancer staging explains how stage is assigned and what the numbers mean.

Where cancers tend to go, and what that feels like

Different cancers spread to characteristic places. NCI lists bone, liver, and lung as the most common destinations overall. Breast cancer tends toward bone, brain, liver, and lung. Colon and stomach cancers tend toward liver, lung, and the peritoneum, the lining of the abdomen. Prostate cancer tends toward bone.

Metastatic cancer does not always cause symptoms. When it does, they follow the location:

• Bone: pain, and sometimes a fracture from minor force.
• Brain: headache, seizures, or dizziness.
• Lung: shortness of breath.
• Liver: jaundice, or swelling in the belly.

When symptoms deserve a call

If you have been treated for cancer before, these are worth reporting rather than watching:

• Bone pain that wakes you at night or does not shift with position, especially in the spine, hip, or ribs, lasting more than two weeks.
• A new headache pattern, particularly one worst in the morning, or any seizure.
• Breathlessness on tasks you managed easily a month ago.
• Yellowing of the eyes or skin, or a belly that is swelling.
• Unexplained weight loss over 10% of your body weight in six months.

New symptoms after cancer treatment often turn out to have ordinary causes. Reporting them early is still the right instinct, because treatment for metastatic disease works better when it starts before organs are under strain.

Treatment, and living alongside it

NCI states that treatments exist for most types of metastatic cancer. The usual goal shifts from cure to control: slowing the cancer, easing symptoms, and protecting how well someone lives. Some people live for years with metastatic cancer that is being managed.

Palliative care belongs in that picture from the start, not at the end. It is care aimed at symptoms and quality of life, and it can run alongside treatment intended to control the cancer.

What this story cannot tell you

• We know from UPI only that Valvano's cancer was a metastatic adenocarcinoma. Any page naming the organ it started in is filling a gap in the public record.
• One person's course predicts nothing about another's. Cancer behavior, treatment response, and personal choices all differ.
• Metastatic cancer is not one disease with one outlook. A stage 4 diagnosis covers situations that range enormously.
• Metastatic cancer has no screening test of its own. Screening looks for individual cancers early, before they spread. Our screening check-up tool shows which screenings may apply to you.
• Nothing here is medical advice.

A diagnosis like this lands on a family as much as a person. Our page on emotions and cancer covers that ground.

Sources

• UPI Archives, "Valvano dead from cancer," April 28, 1993: https://www.upi.com/Archives/1993/04/28/Valvano-dead-from-cancer/8198735969600/
• North Carolina Department of Natural and Cultural Resources, "'Jimmy V.' Died of Cancer": https://www.dncr.nc.gov/blog/2016/04/28/jimmy-v-died-cancer
• The V Foundation for Cancer Research, About Us: https://www.v.org/about/
• National Cancer Institute, Metastatic Cancer: When Cancer Spreads: https://www.cancer.gov/types/metastatic-cancer
• National Cancer Institute, Palliative Care in Cancer: https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet

How this page was made

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. It is not a diagnostic service, does not recommend treatments, and is not for emergencies.

See an error, old source, or unclear wording? Tell us.