31.   Doctors found the cancer had spread and started Ms. LaMott on chemotherapy.

32.   Doctors had discovered a malignancy in his bile ducts and the cancer had spread.

33.   Doctors found the cancer had spread to her bones and she underwent a mastectomy and bone marrow transplant at Shands Hospital at the University of Florida in Gainesville.

34.   Doctors routinely remove the lymph nodes around the armpit in case breast cancer has spread to them.

35.   Doctors said there was no visible evidence during surgery that the cancer had spread beyond the area of the bowel.

36.   Doctors then learned that the cancer had spread to his abdomen and brain, and Armstrong spent the next months having brain surgery and chemotherapy.

37.   Doctors, he said, operate and remove the prostate only when they find no evidence that cancer has spread.

38.   Early indications are that the cancer did not spread.

39.   Even so, the cancer spread to her liver.

40.   Fortunately for Spehr, the cancer had not spread beyond the tumor.