This textbook discusses the systemic consequences of cancer, covering a range of topics from tumor-promoting systemic effects to the development of cachexia, as summarized in the introductory chapter 1. Part I of this textbook focuses on tumor-promoting systemic effects and begins with a chapter on how tumor-derived extracellular vesicles and particles lay the foundation for future metastases (Chapter 2). Chapter 3 discusses how metastatic cells that have colonized the bone impact the local bone microenvironment, neighboring muscles, and host physiology. Chapter 4 summarizes the available strategies for targeting metastatic cancer and emphasizes the need to incorporate a systemic view of the disease. Following this overview of the systemic effects of cancer progression, Part II of the textbook discusses cancer-induced cachexia, a debilitating systemic effect of advanced cancer.