4. Why does Hannah's physician think that her cancer has already metastasized?

To determine why Hannah's physician thinks that her cancer has already metastasized, we would need to consider several factors typically associated with cancer metastasis. Here are some common reasons: 1. **Symptoms**: If Hannah is experiencing symptoms that are indicative of metastasis, such as unexplained weight loss, persistent pain, or new lumps in different areas of her body, this could raise suspicion. 2. **Imaging Results**: Imaging studies (like CT scans, MRIs, or PET scans) may show abnormalities in organs or tissues away from the primary tumor site, suggesting that cancer cells have spread. 3. **Biopsy Results**: If a biopsy of a secondary tumor shows the same type of cancer cells as the primary tumor, this would confirm metastasis. 4. **Tumor Markers**: Elevated levels of certain tumor markers in the blood can indicate that cancer has spread. 5. **Stage of Cancer**: If Hannah's cancer is diagnosed at a later stage (e.g., Stage III or IV), it is more likely to have metastasized. 6. **Histological Features**: The characteristics of the cancer cells under a microscope may suggest aggressive behavior, which is often associated with a higher likelihood of metastasis. If you have specific details about Hannah's case, I can provide a more tailored explanation.