There are many cases where using therapeutic ways of target or inhibit the experience of hypoxic tumor cells to overcome metastasis will be clinically beneficial. Essentially, the quantification and detection of hypoxic cells in a primary tumour must be used to identify individuals almost certainly to reap the benefits of therapies designed to target or restrict hypoxic tumour cells to take care of metastases. There are many methods used to identify and quantify hypoxia in solid tumours ranging from physical pO2 probes inserted into tumours, to considering the expression levels of hypoxiainduced meats, to using substances that bind in hypoxic tumor cells that are quantifiable by immunohistochemistry or PET. In addition, when considering inhibitors of CAIX, LOX, or CXCR4, selection of patients must certanly be based on evaluation of expression levels of these target genes in cyst biopsies or by PET imaging based on tumor retention of radiolabeled antibodies. Patients presenting with overt metastatic illness might be chosen for hypoxia based treatment based on the level of hypoxia within their primary tumours and/or tumour metastases for direct targeting of hypoxic tumour cells by hypoxia triggered cytotoxins and to affect the process by inhibition of hypoxia induced proteins. In patients without obvious tumour metastases at the time of presentation, the presence of hypoxic cells in their primary tumour would suggest the patient is prone to have unknown disseminated tumour cells in their program and/or might be at greater risk for developing metastatic infection after treatment of these primary tumour. These patients would likely take advantage of the development of standard systemic chemotherapy in to the treatment regime prescribed for their primary tumour in order to target potential subclinical metastatic infection, especially if hypoxia activated cytotoxins are included to target hypoxic cells in the primary tumour.