Nature's necrosis factor when associated with erythrocytes may not only explain the surprises in lung cancer metastases but also suggest target therapy.

Lung cancer is so strategically situated as regards the heart and aorta that it ought to scatter its metastasizing cells far and wide. However, at careful autopsy, instead of giant opportunities, only dwarf deposition may be detected. Indeed, up to seven patterns of its metastases demonstrate surprises. What explains these surprises? Consider the thoracic duct. When this 45 cm long duct was obtained in its entirety, coiled in the Swiss-roll manner, processed in the usual way, and examined on a single microscope slide, necrosis of some transported lung cancer cells was found to be very intimately associated with the erythrocytes. Therefore, let this underlying natural mechanism be named as the "erythrocyte associated necrosis factor", i.e., EANF. It is argued that this Factor operates differently from the suspected roles of both anoikis and stem cells. Accordingly, it is hypothesized that, if intravital video microscopy is used to obtain subsets of both necrotic and lively cancer cells from the thoracic duct of consenting lung cancer patients, the underlying EANF will definitely materialize. It is predicted that the manipulative replication of this Factor in leading centers will ensure progress. In sum, EANF would not only aid in our understanding of the outlined highly inefficient metastatic processes but also effect a breakthrough in the realms of target therapy.