When bone cancer tumor reactivates?

[Greta]

Hi,
I'm Stage IV - one bone lesion has been pretty much the same since 2004 -
Femara and monthly Zometa (Aredia recent change) since Oct. 2004.
Radiologist found bone scan showed reactivation at the same site.
What have any of you with this occurrence found treatment changes to be? I
assume that Femara has lost it's effectiveness.
Thanks
Greta

[Tim Jackson]

Greta wrote:
> Hi,
> I'm Stage IV - one bone lesion has been pretty much the same since 2004 -
> Femara and monthly Zometa (Aredia recent change) since Oct. 2004.
> Radiologist found bone scan showed reactivation at the same site.
> What have any of you with this occurrence found treatment changes to be? I
> assume that Femara has lost it's effectiveness.
> Thanks
> Greta
>
>
Was the bone tumour radiated in 2004? If so, it's probably just taken
that long to recover from the treatment, radiation generally can't kill
the tumour completely, but it sets it back by several years' development.

I don't think it necessarily implies a more general progression. Sounds
like the sort of situation where blood tests for one of the 'tumour
marker' compounds would be useful - if you had any taken back then for a
baseline. That would be more indicative of how effective the Femara was
being.

Does the radiologist consider that more radiation to the same area is an
option?


Tim Jackson

[R. Fizek]

Tim,

In an earlier post - everyone agrees to "not scare people" and then you come
out with this???
................. If so, it's probably just taken
> that long to recover from the treatment, radiation generally can't kill
> the tumour completely, but it sets it back by several years' development.
>
Yikes! Is that true for breast irradiation too?

Tammy

[Tim Jackson]

R. Fizek wrote:
> Tim,
>
> In an earlier post - everyone agrees to "not scare people" and then you come
> out with this???
> ................ If so, it's probably just taken
>> that long to recover from the treatment, radiation generally can't kill
>> the tumour completely, but it sets it back by several years' development.
>>
> Yikes! Is that true for breast irradiation too?
>
> Tammy
>
>
Yes and no. Yes, radiation does not kill all the cells. No, that
doesn't mean that the primary tumour is always going to come back. It's
a question of scale.

I was talking about targeted radiation of a known tumour. Adjuvant
radiation is rather different in principle: there is no tumour to treat.
In the first we are talking about volumes, in the second we are talking
about risks.

Consider that a particular radiation dose might kill 95% of the cancer
cells. Now if you give that to a large (i.e. detectable) tumour then
each cell will have to divide four or 5 times to get back to the
original size, which will probably take a couple of years.

Now the post-operative situation. There is no known tumour to target,
but there are probably a few cells and small clusters of cells,
basically tiny tumours below the detectable threshold. Now the immune
system can deal with odd cells and very small clusters, but when they
get to a certain size, they grow faster (at a rate determined by volume)
than the immune system can pick them off (at a rate determined by
exposed surface area). So consider that there might be a 50% chance of
that happening. Now if with radiation we can kill off say only 80% of
these cells, then those few rare large clusters will get reduced well
into the range for immune attack, and the probability of there being any
at all left is reduced dramatically.


Tim

[R. Fizek]

Not sure that makes me feel better.

"Tim Jackson" <[email protected]> wrote in message
news:461604a4$0$8752$[email protected]..
> R. Fizek wrote:
>> Tim,
>>
>> In an earlier post - everyone agrees to "not scare people" and then you
>> come out with this???
>> ................ If so, it's probably just taken
>>> that long to recover from the treatment, radiation generally can't kill
>>> the tumour completely, but it sets it back by several years'
>>> development.
>>>
>> Yikes! Is that true for breast irradiation too?
>>
>> Tammy
> Yes and no. Yes, radiation does not kill all the cells. No, that doesn't
> mean that the primary tumour is always going to come back. It's a
> question of scale.
>
> I was talking about targeted radiation of a known tumour. Adjuvant
> radiation is rather different in principle: there is no tumour to treat.
> In the first we are talking about volumes, in the second we are talking
> about risks.
>
> Consider that a particular radiation dose might kill 95% of the cancer
> cells. Now if you give that to a large (i.e. detectable) tumour then each
> cell will have to divide four or 5 times to get back to the original size,
> which will probably take a couple of years.
>
> Now the post-operative situation. There is no known tumour to target, but
> there are probably a few cells and small clusters of cells, basically tiny
> tumours below the detectable threshold. Now the immune system can deal
> with odd cells and very small clusters, but when they get to a certain
> size, they grow faster (at a rate determined by volume) than the immune
> system can pick them off (at a rate determined by exposed surface area).
> So consider that there might be a 50% chance of that happening. Now if
> with radiation we can kill off say only 80% of these cells, then those few
> rare large clusters will get reduced well into the range for immune
> attack, and the probability of there being any at all left is reduced
> dramatically.
>
>
> Tim

[Greta]

If it's me you are referring to - I am sorry if I upset anyone - I never had
radiation on the bone which my post addressed.
Greta

[R. Fizek]

Hi Greta,

No, not you. I was referring to what Tim wrote about radiation.


"Greta" <[email protected]> wrote in message
newsnyRh.256025$[email protected]..
> If it's me you are referring to - I am sorry if I upset anyone - I never
> had radiation on the bone which my post addressed.
> Greta
>

[Tim Jackson]

Greta wrote:
> If it's me you are referring to - I am sorry if I upset anyone - I never had
> radiation on the bone which my post addressed.
> Greta
>
>
So then, what was the original deactivation attributed to? If it was
just the Femara then I guess there isn't much else to blame. Maybe the
cancer has developed another strategy besides ER. If there was chemo,
then perhaps it is recovering from that, although chemo tends not to
affect bone mets very strongly.

You say you changed from Zometa to Aredia? Could that have influenced
it do you think? As I recall Aredia isn't quite as strong.


Tim

[MMH]

On Apr 6, 4:28 am, Tim Jackson <t...@tim-jackson.co.uk> wrote:
> R. Fizek wrote:
> > Tim,
>
> > In an earlier post - everyone agrees to "not scare people" and then you come
> > out with this???
> > ................ If so, it's probably just taken
> >> that long to recover from the treatment, radiation generally can't kill
> >> the tumour completely, but it sets it back by several years' development.
>
> > Yikes! Is that true for breast irradiation too?
>
> > Tammy
>
> Yes and no. Yes, radiation does not kill all the cells. No, that
> doesn't mean that the primary tumour is always going to come back. It's
> a question of scale.
>
> I was talking about targeted radiation of a known tumour. Adjuvant
> radiation is rather different in principle: there is no tumour to treat.
> In the first we are talking about volumes, in the second we are talking
> about risks.
>
> Consider that a particular radiation dose might kill 95% of the cancer
> cells. Now if you give that to a large (i.e. detectable) tumour then
> each cell will have to divide four or 5 times to get back to the
> original size, which will probably take a couple of years.
>
> Now the post-operative situation. There is no known tumour to target,
> but there are probably a few cells and small clusters of cells,
> basically tiny tumours below the detectable threshold. Now the immune
> system can deal with odd cells and very small clusters, but when they
> get to a certain size, they grow faster (at a rate determined by volume)
> than the immune system can pick them off (at a rate determined by
> exposed surface area). So consider that there might be a 50% chance of
> that happening. Now if with radiation we can kill off say only 80% of
> these cells, then those few rare large clusters will get reduced well
> into the range for immune attack, and the probability of there being any
> at all left is reduced dramatically.
>
> Tim

Have you ever thought of collecting your responses to questions in
this newsgroup and placing them on a webpage, in question and answer
format perhaps? Your ability to explain the details of the breast
cancer experience is so valuable and easy to understand. I would
think that even doctors could profit from this.

MH

[Tim Jackson]

MMH wrote:
>
> Have you ever thought of collecting your responses to questions in
> this newsgroup and placing them on a webpage, in question and answer
> format perhaps? Your ability to explain the details of the breast
> cancer experience is so valuable and easy to understand. I would
> think that even doctors could profit from this.
>
> MH
>

See the FAQ at www.cancersupporters.com

Quite a few are there, although it hasn't been updated for a while.


Tim