Metastasis - The Rude Awakening

Jennt28

Metastasis - The Rude Awakening

Jennt28

Very interesting article on the mechanisms of breast cancer mets...



Metastasis: The rude awakening

http://www.nature.com/nature/journal/v485/n7400_supp/full/485S55a.html



Jenn

pupmom

Great article. Thanks for posting!

Anonymous

Dr Paul Goss at Harvard and other BC  Medical Oncologists are considering keeping ER+ patients on Aromatase Inhibitors longer now ,like 10 years instead of 5 years for reasons indicated in this article

http://www.youtube.com/watch?v=PNbIfbMIM94

wallycat

Well this was truly a rude awakening

Since they cannot treat knowing CTCs and such...what is the point of knowing...unless you like knowing you are a ticking time bomb.

Scary that even DCIS can become mets.

Jennt28

There is power in knowing still... It means that we know where there is need for research. It means we know that there is need for close follow up for ALL breast cancer patients.



Jenn

wallycat

Jennt28, you are correct...knowledge is power but I tend to be a pessimist and this totally depressed me.

To me, reading this was like basically telling me it was just a matter of time before my cancer came back.

I realize that there are many survivors (Julia Child died at 93 from something else)...so clearly not all dx are death sentences, but still, that article totally upset me

luv_gardening

Thanks Jenn for posting such an informative article.  I knew a lot of what was said but it's helpful to see it confirmed in one article.  I'm pleased to see researchers are looking at this and not just concentrating on active tumours.

I believe there must be something we can do to keep these cells dormant. The author, Dr Servan Schreiver, is a good example of someone who beat the odds for 19 years before succumbing to his brain cancer.  We need to be able to replicate that.

chrissyb

Jenn, gresat article and answered a lot of questions for me......thanks.

Love n hugs.  Chrissy 

bevin

Thanks for sharing this really interesting article.

Bevin

otter

This was a well-researched and well-written article. Thanks for posting the link.

I earnestly wish I was reading this article from the point-of-view of a cell biology researcher, rather than as someone struggling emotionally with the risk that my BC will recur.  Intellectually, the article was a fascinating summary of the state of knowledge of BC metastasis.  But, wallycat, I tend to side with you:  I would not want to know that I had circulating or disseminated tumor cells, if there was nothing that could be done about it.

To me, that's sort of like having an early test for late-onset Alzheimer's disease. Say you could find out at age 35 or 40 that you would develop Alzheimer's 40 years later.... but there was nothing you could do about it. There was, and would be, nothing available that would stop or reverse the process.  Would you want to know?

I do have to say that, after reading articles like that one, I'm even more relieved that I did chemo.  Now, please, don't anyone post something that says circulating tumor cells are resistant to chemo.  (I've read that, too.)

otter

JoanQuilts

That really WAS a great article.  I'm going to print it out and bring it to my oncologist, asking him to explain the 99% of it that I didn't understand, LOL!

wallycat

Otter, you said beautifully what I was trying to convey.

I was not criticizing the article, but rather that as the patient, there are currently no recourses I have.  If there were, I would be the first to want to know the status.  This is sort of like the PSA test for men now.   They are telling men that they may walk around with cancer but "don't worry about it"...yeah, right.

Obviously the key is to determine why some cells stay dormant and never bother people, or grow so slowly that it is not worth contending with.  Since they don't know, reading this sort of stuff only makes me more anxious that I am walking around like time bomb.  Yes, life has its own risks, and yes, there are more and more treatments should it rear its ugly head...but to know it might be there and currently you sit and wait till it becomes aggressive...well, that is not helpful to me at all.  Yes, if I were a biologist and trained in that type of research, it would be some great opportunity to focus on this; sadly, that is not the case.

Otter, thank you for being so eloquent

Jennt28

I personally don't find this depressing since I see so many women here (including myself) wondering why some women progress to mets and some don't. The word "crapshoot" gets used a lot in threads and I feel this article goes some way towards explaining why it's a "crapshoot".



I think that my having put this in the research, news section was appropriate since some like me find this information interesting.



Jenn

Tazzy

Thanks for sharing Jenn... like you say knowledge is power.

Heidihill

Thanks for this! The article was very informative although there isn't much I can do yet about those DTCs or CTCs that may be dormant in my body at Stage IV.  I really liked the article referenced called Exercise: powering up. That's something I can do.

gpawelski

They talk about targeting the microenvironment (soil) may effectively kill cancer cells (seeds) through a small-molecular weight sequential dual-targeting theragnostic strategy, or dual-targeting approach.

The process of metastasis requires that cancer cells traveling from primary tumor find a hospitable environment in which to implant themselves and grow. Researchers found that circulating tumor cells prepare this environment by bringing along from their original site noncancerous cells that support tumor growth.

It has been known for some time that noncancerous stromal cells, which provide a support structure for tissues and organs, contribute to the growth of primary tumors, providing the "soil" in which tumors can grow. A study showed that this primary "soil" also helps the initial growth of tumor "seeds" in a foreign soil.

This role for these noncancerous cells is both a conceptual advance and offers potential new targets for treating or preventing metastatic disease. To this end, most investigators believe that treatment advances lie in the development of novel interventions that attack not only the "seed" but also the complicated stromal "soil" of this disease.

In regards to drug selection, that's why the functional cytometric profiling platform works so very well in this environment. It doesn't dismiss genetic testing, it uses all the information, measuring the interaction of the entire genome, to design the best treatment for each individual, not some average population.

It doesn't look at trial-and-error clinical literature search (population studies) to try and match therapies to patient-specific biomarker information to generate a treatment approach. It "actually" measures cancer drugs against your actual cancer cells. It's not theoretical but real-time analysis.

cbm

Than you, Jenn; great article. Now I understand why I'll be taking Femara forever. And why I'll be happy about it .



Peace,



Cathy

Anonymous

Mr Pawelski, then maybe they should use TDM 1 like agents to attack the soil as well as the cancer cell?

Jodycat

I wish I could have read this sooner, when I was asked if I'd let them collect bone marrow while I was out for the breast surgery. I had no idea how important it was.



Now at least i'll understand why I may be on pills forever.

badger

Jenn, thanks for posting this article.  I'm not a medical pro so a lot of the technical stuff is past me but I am a gardener so I get the analogy of soil & seeds. 

sam52

I always wonder how relevant the tumor grade is to (late) recurrence; there has been some research hinting that lower grade (specifically grade 1) tumor cells are more likely to remain dormant, and then reappear later on.It is known that high grade tumors are more likely to metastisize within the first few years after diagnosis; if they don't - what are the implications for possible recurrence? Can one assume by analogy that they are then less likely to met later on?

It is also interesting to note that triple negative bc is very unlikely to recur after 8 years; it would be good to know what the biological mechanisms are by which this is achieved.

Anonymous

This could be a good thing , maybe in the future you will check your CTC s just like a diabetic checks his blood sugar and if your CTCs are low and the subtype has not changed then you know your okay and if your CTCs are too high maybe they will change or increase the dose of your meds until your CTC s drop, its still to early to know what all this means.

otter

Jenn, you're absolutely right. I hope you didn't misunderstand my little personal rant. I would not want someone to decline to post a link here to important research news out of fear that others might find the news depressing.  That's too much like censorship -- don't make it available generally, because it might disturb some readers.

I can't speak for wallycat (although we've been through a lot together!); I was just offering a personal perspective.  You are right:  having a good, thorough review article that explains things clearly can help dispell the "crapshoot" myth.

otter

gpawelski

Christine

They'll most likely be able to measure it, if or when there is an approved indication.

T-DM1 Anitbody-drug conjugates (ADCs)

http://cancerfocus.org/forum/showthread.php?t=3768

Greg

Alicethecat

Hi Jen

Great article.

Pleased to see the researchers acknowledge the importance of diet and exercise.

The way I look at things, the tumour appears in a host - our body - and if we can make the host an environment does that does not support growth of the tumour, that can only help.

That's why I follow all the advice on this website and others re a low fat, low sugar, low starch diet with limited dairy and lots of fruit and vegetables.

I appreciate the jury's still out on parabens, according to this website, and pollution but I'm not taking any chances and doing my best to use paraben-free products and reduce my risk of other pollutants.

Who knows if it will work? But in my mind, I am doing everything to reduce my risk of recurrence.

After the Nature article, I may even ask my onc to do a bone biopsy after my second scan for a possible bone met in six months' time.

Fingers crossed for everyone on this website.

Love

Alice the Cat

ali68

I'm 9 stone, keep fit by hill walking 4 days a week, never smoked, eat non fat food but get stage 3 grade 3 breast cancer. My mum who smokes 60 a day, does not look after herself but is 75 and ok. Can anyone tell me what you do not to get Cancer.

wallycat

Until they understand cancer 100%...crapshoot!

Jenn, I hope my comment that the article was depressing was not indicitive of not wanting to have it posted.

This was NOT a reflection of your post but of the information it held.....to me it meant I could do nothing...which is depressing.

Yes, if eating right and "doing the right stuff" meant no cancer, I would never have gotten it.  That does not seem to be the case and answers are not forthcoming (no blame, just facts).  It would be great if I get to be around when and if there is an answer (OR CURE!) for cancer.  We do what we can with what we know....

Jennt28

Geez, you mean all this broccolli I've been eating won't make any difference?



(sorry, couldn't resist!) :-)



Jenn

jenrio

Nature has a companion article on clinical trial too.   I wrote a review for both of them in my blog.

 

 Different clinical trials should be conducted, with different end-point. The ultimate goal is to make the turn-around-time fast. So scientists can try a drug, wait a few days/weeks for results; tweak it to improve it, wait a few days/weeks for results; repeat above.

Currently the scientists must wait years and years for results every single human related iteration of drug design. No wonder effective treatments are few and far in between and very very expensive.

Imagine one day there is a CTC test similar to blood glucose test, where patients can poke their fingers in morning/lunch/dinner time and get 3 data points. Patients/physicians can see in real time how CTC is changing with new treatment/exercise regimen, and this data can be used to forecast patients' real response to medication and used in clinical trials, which takes a few months to run, instead of years and years. Then we can say truly, that MBC is a chronic disease, like diabetes. And its cure would not be far off.

CuterWCurves

Jenn... I can't resist... It really stinks that broccoli won't help.