Re: Should we remove a left kidney with a tumor if pulmonary lymph nodes are enlarged?
From: Tim Jackson (tim_at_tim-jackson.co.uk)
Date: 11/18/04
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Date: Thu, 18 Nov 2004 08:43:09 +0000
> ----------
> So you're saying there's a definite cutoff point between "recurrence" and
> "second cancer?" Speaking as a patient, now....what difference does it
> make? You had it, now you have it again.
>
> Eva
>
>
There is a massive difference between a recurrence and a new primary cancer.
When a recurrence occurs it is usually a distant metastasis, and as such
represents the tip of a very nasty iceberg. The implication is that the
original cancer has spread much more widely than had been hoped, that
there are cancer cells circulating in your bloodstream, your bone
marrow, and settled in various tissues in various points around the
body. Over the next few years many of these will develop into tumours,
and while it may be possible to treat some of them individually, and to
destroy most of the smaller clusters with chemotherapy, the sheer
quantity of tumour sites will eventually overwhelm your system one way
or another.
On the other hand, if the original tumour was contained and removed, and
there was no cancer left, the original tissue which became cancerous
once retains the propensity to do it again. For normal cells to become
cancerous requires them to get several genetic ducks in a row, and if it
has happened in one location, the chances are that there are other
locations that already have -some- ducks lined up. So the chances of
getting another cancer in that tissue are rather higher than for the
population at large. But should it happen, it is clinically basically
the same as the original, as long as it left enough time for the body to
have recovered from the first round of treatment.
Consequently in the case of breast cancer, getting a second primary is a
good indication for bilateral mastectomies, to get rid of all the
potentially cancerous tissue for the future.
In between the above two there are some local recurrences, where the
original tumour had spread beyond the resected volume, but not beyond
the original organ, and so the metastatic scenario still does not apply.
Tim Jackson
- Next message: Mary Fisher: "Re: Should we remove a left kidney with a tumor if pulmonary lymph nodes are enlarged?"
- Previous message: Steph: "Re: Lymph node biopsy procedural question"
- In reply to: Eva: "Re: Should we remove a left kidney with a tumor if pulmonary lymph nodes are enlarged?"
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