Adjvnt Therapy: Destroys or delays growth of stray BC cells?
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Left my comfort zone years ago.
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Me too...
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I don't know if any of you are old Star Trek fans but I love the scenes in the 4th movie 'The Voyage Home' where Bones et al goes to a modern hospital to rescue Chekov who has a brain injury. His comments on the state of medicine are great.
I often think of cancer cells as retrograde cells, cells that have taken a step back in time to their primordial roots and want to live as single cells again and not play nice in a tissue anymore.
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So does anyone know that if a person gets chemo, and the tumor disappears, is there any need for surgery?
elimar and I wonder if any of you have heard of this? There was a post on the last page of a gal getting chemo, and her tumor disappeard... So we wonder if surgery was performed AFTER this.
It was hillck that posted this.... So hillck, did you have to have surgery anyway? And what if any treatment after? thanks....
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Chevyboy, you were asking about hillck's info after the chemo you will find what she told me under:
Better clinical trials are needed.
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Thanks Cindy... You have the same process as my older Daughter, ha! When I told her I had a small spot in one breast, & that the ultra-sound gave all indications that it was malignant, she told me to have both my breasts removed. Man, I really was shocked! But her thinking was, she would rather have them both off, and have a Mom, than take any chances....
I was so afraid ANYway, even though the Radiologist that read the test said, "Oh, it looks like breast cancer, but we will take care of it with a Lumpectomy and Radiation"... But of course, I started re-searching, talking to my "team" and I didn't listen to my Daughter....Thank God, ha!
My Daughter is going to be 54, and she has already been close to breast cancer & knows what can happen.....Her friends and their Mothers. So as soon as she figured out I wasn't going to mind her, she did come from Orlando for my surgery, and with her Sister & my Husband, they kept me happy and laughing about everything! I am so thankful for that.
Even "our daughter from another Mother" was there, so all those guys went shopping & eating while I was having the surgery. The Surgeon had to call her to ask where they were, because I was ready to go home! So we all got a lot of laughs out of that one.... Here I was groggy, peeing purple, my hair was a mess, and I was "ready to go HOME?"
We even stopped for more food on the way home! Went shopping the next day....I even set off the door alarm in the store, just by walking through it, because of the radioactive dye sloshing around in there.
So with MY surgery, I only think about the Fam out fooling around, having a blast, while I snoozed....Ha, ha! Sorry, I got off track...But hillck, I'll bet you are about the same age as my Daughter? So Women of your era just think differently than us older gals.... And I'm proud of her, for the way she thinks about the future...... Me? I do too, but I'm more aware of just "being" here..... and taking each day as it thankfully comes.
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So Happy Birthday Hillck, ha! I MEANT you have the same thought process as my Daughter.
Yes, I'm happy with everything I did, and didn't do... But I have the advantage, (I think) of being older, so if it ever happens again, that will make a big difference....
And yes I DID set off the alarm as we were leaving.... I kind of just cringed, looking back to see if we were being tailed, but no-one seemed to notice, Ha! My breast surgeon had told me DON'T go to the airport and try & get through security, because of that nuclear dye.... and I really WAS afraid because I couldn't put 2 & 2 together about the purple-pee thing.... until my mind cleared up a little....that afternoon....
Sorry gals, if I got off track....
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Voracious and Chevyboy - I find the Article you both mention really interesting because I have wondered if two injuries I had to my left breast resulted in creating an environment for cancer to grow and spread. When my first son was 6 months old he bit my left breast so hard while nursing that I bled, so he was weened very quickly and onto a bottle. With my second son (only have two), I ended up getting a breast infection (mastitis) while nursing him in my left breast. Fast forward about 11 years, I have 4 areas biopsied in my left breast, all benign. Now jump another 5-6 years I am diagnosed with DCIS (near my nipple) and IDC in my left breast. Kind of makes me wonder if those injury/infection played any role in creating an enviroment for cancer to grow and spread. Can't do anything about it now, but just thought it was interesting.0
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I had mastitis also, and it was on my lumpectomy side. (But to be fair, I thought that I might have gotten the mastitis because of scar tissue in that breast from a previous excisional biopsy not allowing the milk to channel properly.)
[Edited to add: The biopsy itself would have caused plenty of trauma and tissue damage. One of the "risk factors" for B/C is whether you have had previous B9 conditions. I had one of the B9 conditions least associated with B/C (fibroadenoma) but perhaps the removal itself created the cell damage leading to my future B/C.]
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Hmmm...interesting theory about injuries to the breast prediagnosis. I nursed my twins for a year and I had mastitis in the left breast 5 times in the first 5 months.
Fast forward 7 years - BC in the left breast.
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One of the questions my onc and BS asked initially was if I ever had injured that breast. And I did. I was hit so hard at that spot 12 years ago that I developed mastitis even though I was not pregnant and/or breastfeeding. I was put on antibiotics. 5 years later I developed mastitis at the same spot while breastfeeding. I was on antibiotics for 10 days. 6 years later I got cancer at the same spot.
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I also had mastitis while breastfeeding. I can't remember where though.
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Wow, you gals! It kind of makes sense, that it IS possible that an injury to that breast could cause trouble later.... Just like maybe taking Estrogen or the Pill, or even Breast Cancer running in our family.....
The woman that I was talking about, "Winnie" had been hit in her breast with a rod, like I said....and I was so young but remembered how afraid my Mom was when that happened..... Her Doctor had told her that the cancer was probably caused by that injury... So they thought this even like 60 years ago..... I don't ever remember an injury....but I DO know that I have a "divided" nipple on that side... I thought I was some sort of freak, but I nursed my two Daughters, with no problems....
I'm not familiar with Mastitis...but I'll look it up....Sure are a lot of things to think about now.....
I went nuts trying to figure out how one morning I could hear, then the next morning I lost my hearing! So research really helps....not that you can do anything with the information....
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I wonder if an accident I had caused my cancer to spread more, or whether it moved a tumour I could not feel to a place where I could feel it and saved my life. I was pushing a huge dolly and, because of the weight, the dolly half fell on my chest. I felt no pain. About a day later, I discovered my lump. I am sure the incident did not cause cancer, but could it have forced it out more quickly?
I always think that when the day comes that they find a cure for BC, they will realize that the etiology and the manner of spread is faily simple.
You wonder about Elizabeth Edwards. She said that when she felt pain in her rib at first she thought it was because her husband had hugged her too tightly - she felt the pain just after it happened. I wonder if the cad helped her cancer to spread on top of everything else he did to her?
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Athena...you crack me up buddy...i am so smad we did not hook up while in DC...we will:) It would be a delight
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Next time! :-)
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Wow, the 'previous injury' stuff really got me thinking. I had a benign lump removed from the same breast 15 yrs earlier, and then 8 years ago had an accident on a 4 wheeler where I crushed my chest against the handlebar and badly bruised the same breast. Kind of makes sense I had damaged cells in there. ..Then add to that all the mammograms over the years.
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Maybe damaged cells are more suseptible to cancer? As in, they can't fight them off as well?
If it is true that every person, every day has cancer cells roaming in their body - well, it would make sense that taking over the "weak" cells would be the easiest place to start.
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Not everyone agrees that a blow to the breast can cause cancer, but---when I was fifteen I was jostled in my school hall between classes and got an elbow in my right breast. It was agonizingly painful, but of course I couldn't very well grab my breast amongst all those boys!!
Anyway 30 years later I got breast cancer in that very area. And I've heard it takes about that long for the cancer to show up. Just like skin cancer. Too much sun exposure and you get skin cancer as an adult. I've had skin cancers on and off since age 35; no doubt from all the sunbathing I did as a teenager on California beaches.
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i do remember my 'learner driver' oncologist pricking up his ears when i said i had severe mastitis while breastfeeding 12 yrs ago, he asked where the mastitis was. i remember it was so painful tears would flow from my eyes without me crying so to speak..i had ultrasound treatment to the affected areas to break up the congestion.
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I saw an endicrinologist several years ago trying to find out what was going on with me in terms of thyroid, etc...anyway, one of the tests showed I had a high prolactin count...and he leaned over and grabbed my breast and squeezed really really hard...so liquid came out ...he said SEE that is proof...i about slugged the esteemed *sshole and said that friggin hurt....same breast where my BC evolved....
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I was diagnosed about 5 weeks ago and this has been a really tough time. I worry most about the recurrence and asked my doctor the same question. I was told that 80% of BCs are cured. I was also read that even in stage 1, 20-30% of people with stage 1 have circulating cells that could cause a recurrence later. I did a little research and found that surgery (and radiation or mastectomy only) could cure people, but not always. In those 20-30% of people with circulating BC cells, these cells could find a niche in the body and hide, remaining dormant even during chemo. Years later, they could become active triggering a recurrence. Chemo will kill most or all of the active cells, but possibly not the dormant ones. But tamoxifen could change the environment and neighborhood to prevent growth of that cell later. The BC cell may die if the evironment is not favorable for growth and this is how cancer can be cured even when cells are not entirely caught with surgery. If the neighborhood is changed permanently, the cell will never grow, even long after tamoxifen is stopped. So yes, a cure is possible with chemo and Tamoxifen.
I have a question-my doctor said that the oncotype dx test revealed that I would only benefit 1-2% from chemo treatments (TC). I am conflicted on whether I should go forward with chemo, given the toxicity risk. Any advice???
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Liane - thanks for that info. Makes complete sense to me!
A 1-2% benefit wouldn't convince me to do chemo. Can you post your diagnosis? What does your onc recommend?
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To answer the question regarding neoadjunctive chemo and why surgery would still be required - of course scans can't see microscopic cells. The area would have to be removed and examined in a pathology lab to know if there was anything left.
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Liane...request a second opinion. That question, regarding chemo is probably the most common question asked here on breastcancer.org's website. There are women with low oncotypedx scores who choose chemo and those who don't. Some women may want to see a greater percentage value before they do chemo, while others will take the risk of future side effects to get that one or two percent advantage that chemo offers. Age matters, your psyche matters, your general health matters....Good luck!
Also, while you're waiting...check out the NCCN 2011 breast cancer treatment guidelines....
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Liane I agree with voraciousreader. I hope your onc at least made a recommendation. I really hate when I hear the doctor doesn't make a recommendation. I mean they are the ones with all the experience and medical degree in oncology no?
You can find the NCCN guidelines for patients here (scroll to see breast cancer pdf): http://nccn.com/cancer-guidelines.html
NCCN professional guidelines here: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp
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Annette...you know what I WOULD HAVE DONE, RIGHT? What's WRONG with that guy? I think if ANY of our breasts were squeezed really hard, SOMEthing would come out! And maybe HE caused problems!........
Maybe some day they/we will know that previous trauma to our breasts can be taken seriously, and we can try and stop any further problems before they even start....
Liane, we've talked about Tamoxifen on some of the earlier pages here.... And yes, maybe it does benefit a lot of women, but does anyone KNOW just how much? I mean IF you take this for 5 years, and have no evidence of recurrence, does that mean that the Tamoxifen did this, or could we also assume that even without, your body would not have developed any more cancer? And what about the women who do NOT take Tamoxifen, with early stage BC...and they have NED after 5 years....??? There really is no proof, right?
With chemo, it IS a more aggressive way to make sure your cancer never comes back... But then even with chemo, and the type of chemo, so many women are questioning if their early stage BC is even worth the SE's.
And it IS up to you.... And your age! See, when you are as old as me, chemo would not make a lot of sense, unless I had a high oncotype score... But I would most surely do the Radiation, and maybe even Tamoxifen..... But in my case, Tamoxifen didn't work out.
I would only HOPE that the combination of all that would "cure" that cancer....but I am not convinced that I couldn't get it anywhere else.... A new one. If your margins were clear, with a lumpectomy, AND your nodes were clear, then I would like to assume the cancer was gone, & had not spread anywhere else.
So why then do we opt for further treatment? I guess it is for re-assurance that it will prevent another occurance.
Thanks gals for the links to interesting articles! The more information we have, just helps us question the path we are taking.
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Annette - What a jerk doctor. He should NOT have done that. When I was in the hospital after my daughter was born I asked the nurse about whether there was any milk yet. She reached over and squeezed my nipple and said there, see it? I still rememeber that! Wish I had a picture of my face at that moment (or my husbands!).0
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This is probably going to show up out of order as I'm catching up on several days of reading this thread. I too had mastistis when I was breast feeding 30 years ago. It was in the same breast where the cancer developed.
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Chevyboy, regarding Tamoxifen, you say:
"Maybe it does benefit a lot of women, but does anyone KNOW just how much? I mean IF you take this for 5 years, and have no evidence of recurrence, does that mean that the Tamoxifen did this, or could we also assume that even without, your body would not have developed any more cancer? And what about the women who do NOT take Tamoxifen, with early stage BC...and they have NED after 5 years....??? There really is no proof, right?"
We absolutely have proof that Tamoxifen prevents recurrence in some women. Studies have looked at groups of women with similar ages/stages of cancer and compared those who took Tamoxifen with those who did not. Fewer women who took Tamoxifen had recurrences (local AND distant).
Since doctors are not able to look inside our bodies at the cellular level to see who has cancer cells growing, and which of those cancer cells respond to Tamoxifen, we don't know in advance, or even after the fact, who Tamoxifen has worked for. But they know that it does work for some.
The question really becomes: which group of women do you want to be part of? The group that takes Tamoxifen and some will have a recurrence prevented because of it? Or those who don't take Tamoxifen, and therefore don't have that extra recurrence-preventing tool.
It is a gamble, but one that can be quantified to make the decision easier. With no nodes and a small cancer, you probably don't have a high recurrence risk to begin with, so Tamoxifen would only save a few percent who would have had a recurrence. But for someone like me, Tamoxifen would prevent recurrence in about 12 out of 100 women who take it (55 would be cured with surgery alone; chemotherapy would help another 21.) A percentage will not be helped by either chemo or anti-hormonals.
Again Tamox might only help a small percentage of very-early-stagers, but if I were among those who did end up with distant metastasis, I would regret my decision to skip a recurrence-preventing tool. Tamoxifen side effects may be annoying*, but distant recurrence is essentially always fatal. But everyone has to make that decision for herself.
* Note: those with serious/unacceptable side effects from Tamox should obviously try something different.
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