I say yes, you say no, OR People are Strange
Comments
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I agree. Until they can determine which ones will require tx, it is a mute point to talk about overtreatment. It is still a guessing game for early stage cancers. But, they are making some headway in discovering the details of the anatomy of a cancer cell. Still wish they would put more $ into treatment of mets.
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Blue - he's fabulous!
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Blue - a wonderful baby (he looks like he is thinking hard!) to lift spirits. Congratulations to you and your daughter's family.
The article...it was interesting, and depressing.
“The five-year survival rate for breast cancer when caught early is 98 percent. When it’s not? It decreases to 23 percent.” Woloshin called that willfully deceptive The numbers are accurate, but five-year survival rates are a misleading measure of success, skewed by screening itself. Mammography finds many cancers that never need treating and that are, by definition, survivable. Meanwhile, some women with lethal disease may seem to live longer because their cancer was found earlier, but in truth, it’s only their awareness of themselves as ill that has been extended. “Imagine a group of 100 women who received diagnoses of breast cancer because they felt a breast lump at age 67, all of whom die at age 70,” Woloshin said. “Five-year survival for this group is 0 percent. Now imagine the same women were screened, given their diagnosis three years earlier, at age 64, but treatment doesn’t work and they still die at age 70. Five-year survival is now 100 percent, even though no one lived a second longer.”
I feel like I may have found my cancer "early," but it will could possibly make little difference to my survival had I done nothing. Hormonals work 30-40% of the time with Luminal B's. Chemo, by Oncotype standards, only gives me another 9% of the 27% recurrence rate I was given. If I'm in the 50% category (hokey stats I did on the fly) of neither treatment helping, then I'll live exactly the same amount of time, treatment or not. Maybe less, since chemo is destructive, not to mention QOL.Scratch above....we do this stuff to make ourselves feel better, to be sure. Frankly, at this point in the game, I feel like nothing is going to cure me of this cancer and I'm Stage 1A. Would I have done anything differently?? No, because the Pink/Medical establishment thinks all of this stuff prolongs or cures and I've been hearing it for years. I honestly think there may be forces beyond anything chemo or hormonals address, including the cell environment. I do believe in eradication of the tumor, though, and with brca, BMX, definitely. << If this sounds confusing it's because I'm conflicted and confused about the the BC thing right now. I don't feel my MO's have been honest with me about MY particular cancer. They just keep giving treatments.
Alexandria - I had a small DCIS component in my IDC, and I've heard of so many women who aggressively treat DCIS and discover a small amount of IDC in pathology. Ofcourse, it takes the argument back to my crap shoot theory above. Does it all really matter. Would those that survive, survive anyway?
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So much going on here, so many hugs needing to be shared. I feel so fortunate to be a part of such a caring community. We didn't get all the boring news we wanted this week and that sucks. Too much pain for E, crap news for Athena, and poor tim, but we will get through this together, one way or another. Oh, damn, there's the optimist in me sneaking out. Sorry, all, it really has been a sucky week. Hang in there! At least winter is over!! Love, glenna
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Oh carp,Bren, E, and Athena.
Congrats Blue and great news suzie. What a bunch of ups and downs.
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It's been a week of good news, not-so-great news, and some totally crappy news for us here. Let's keep fingers crossed for a better week ahead, dear cyber-pals.
As for the Feel-Good War on BC article: I agree with parts of it, and am ambivalent about other parts. I hope Komen is getting the message about throwing the bulk of its donations towards bc research, and especially mets research. Cuz, goshdarnit, we ALL are aware of this sucky (mild word!) disease. And none of us is immune to recurrence, no matter what stats might say. I've just passed my 5-year survival mark, but also recognize that the number of mammos I've had (and will continue to have) on my remaining boob may cause a new primary. Should I stop having them? We all live with the big question mark hovering around our heads like that dark cloud over the Peanuts character (whose name I cannot remember). F**k cancer
.ETA: Oh wait -- maybe I'm thinking of the character in L'il Abner?
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Blue - he's gorgeous!!!
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Blue, what a handsome little man! George will be so happy to have a brother -- and you will have two gorgeous hunks hanging around your house!
Athena, thinking of you and sending comfort vibes your way ....
Sandu & PiP, I must agree. I found the article interesting to a point (hell YES we need to focus on a cure -- we are all plenty aware of breast cancer now, thanks). And I, too, bristle at the suggestion that DCIS is overtreated and some of it can probably not be treated -- and women can go without mammos for a year or two because dx-ing them early doesn't make them live longer. Faugh! Those are aggregates and we are individuals. Yeah, some DCIS might not progress, but until you have an accurate way to figure that out, you'd better treat it all like it would progress. Mine was supposed to be GONE -- less than 5% chance of recurrence -- but it came back. Grade 3 with comedonecrosis was nothing to fart around with.
It IS about saving money, IMO. And it is a cold, hard truth that a few hundred dead women are cheaper than tens of thousands of mammos and a few thousand possible false positives who get treated and take up money from the system. But until you can predict the course of individual disease, you really must treat it all as if it would progess. I have not a scintilla of doubt that mine would have progressed rapidly and killed me. My sister's did when she decided not to have a lump looked at for several years. I'm unwilling to condemn some other woman to die in the name of not overtreating some other women.
L -
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TY ladies. Babies put a whole new perspective on things. Philip's breathing was good today. All the excitement has caught up with me and am very sore. Will post more pics when I'm feeling better.
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L - absolutely, it's about money. And it's not like the so-called overtreatment has life threatening consequences. Those banging the "overtreatment" drum talk about a quality of life thing ferom the overtreatment- oh, women are scared or women have to do without breasts. (My quality of life is just fine without mine, thanks.) But then it comes down to a very cold hard calculation. There are any number of people who have made the decision that it is worth sacrificing the lives of some women to save the money from treating those whose cancer would not have progressed. To me, every woman's life is worth fighting for -and until we can know with certainty which cancers are going to progress and which are not, we need to treat them all.
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"To me, every woman's life is worth fighting for -and until we can know with certainty which cancers are going to progress and which are not, we need to treat them all."
what alexandria said...
wish we'd hear from athena...
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"Where'd ya get those blue suede shoes?" Blue Footed Booby

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I so agree that we all should have every opportunity to SURVIVE! Those who don't want to be screened or have the pre-cancer/cancer removed can choose to forgo those things. Everybody else needs to have the option of doing what it takes to stay alive.
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EXACTLY, Yorkie and Sandy! Everyone should be afforded the opportunity to make their own decision about what treatment is too much -- not be told that your disease "might" not need treatment and "might" not kill you, so they'll just take a wait and see attitude.
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How do we even know if these treatments we currently get do any good? I have a friend who is 11 years out with triple positive, ooddles of positive nodes, but have seen others at Stage 1 and 1cm tumors have a recurrence and are at Stage IV. What do we always say - "it's a crap shoot." How do they really know chemotherapy even works? It certainly doesn't always. Sure, it can shrink tumors, but shrinking is not obliterating. They can't even guarantee if you are ER+ that hormonals will always work. I've lost confidence and realize it is more about cell biology and the cell environment peculiar to the individual. And those two areas of study are in their infancy.
I say throw research money at prevention (vaccines, lifestyle, etc.) and Stage IV, for those of us unlucky enough to have not had the benefit of the former. In the meantime, we can think we're doing some good by discovering our cancers early and treating them, maybe.
I was sure, 45 years ago, when my mother died of cancer, I would live to see a cure by this time. I don't sense we are much closer BUT I will say this. My friend's daughter is in biochemistry at UC Davis, and she (who also had BC), based on her daughter's discussions with professors, think we are very close to "the cure." I wish I knew more than that.
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I have no argument on that. Everyone has a 'life' force within -- it is what carries us through many seemingly hopeless times and what helps so many do the impossible.
Jackie
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Blue, oh my goodness! Philip is so adorable. I just want to nuzzle those cheeks.
Kam, there is a lot of good research coming out on blood cancers which appears to be tying in to solid tumors too. Truly amazing stuff that seems to be moving quickly. What I am seeing in my RSS feed is giving me lots of hope.
E, I hope you're recovering nicely from the hammering - still can't fathom what that would be like.
Athena, I hope you're able to have the surgery and that you soon have a plan with which you're comfortable. I know that there are lots of treatments you don't want to do, but I'm hoping that there are things that could be helpful that you're willing to try.
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I think treatment success is all about understanding the characteristics of individual tumors. Ten years ago I would have gotten chemo automatically, despite the fact that I probably would have only been hurt by it. With the advent of Oncotype testing I was able to avoid that needless, for me, poison. On the other hand, some, with higher scores, who might have not been prescribed chemo, are getting and benefitting from it. Cancer is the most elusive of diseases, because it originates from our own cells. As the book says cancer is the emperor of all maladies. But it can't elude us forever. Kam, I so hope your friend's daughter is correct! I believe she is!
Meanwhile, thinking of you Athena!
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Interesting article showing up at "that" thread comparing President Obama to Adolph Hitler, David Koresh et al - honestly, when does the hating stop - I am heartily sick of these people - I especially hate it when they post on this thread pretending to care....
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Evil is as evil does, Sandy. Nobody is fooled. They have shown themselves too often.
Hugs to you, too, my friend. I think you need some today, too.
XOXO
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RR - I think some blood cancers are genetically very simple. I remember my friends who recently went through ALL (one type of leukemia) with their son, told me leukemia was very simplistic in terms of the number of mutations, so easier to target. << that is a simplistic comment, but I remembered the essence. On the other hand, BC is "very complicated."
http://www.sciencebasedmedicine.org/index.php/personalized-medicine-vs-evolution/
In a study of 100 TN BC tumors, not one genome is identical to another and within each tumor, there was not homogeneity. I think the keyword in this article is "pathways."
There is reason for hope, however. As was discussed at AACR, the vast majority of cancer-causing driver mutations can be divided into 12 key molecular signaling pathways, and, as was found in the NEJM paper, mutations at the “trunk” of the divergent branching evolution tend to remain as divergent evolution occurs, and targeting them is likely to be more effective than targeting mutations further out on the branches. It might be possible to hone in on these different pathways.
My ooph surgeon is studying brca pathways and feels brca BC is more related to ovarian cancer than other breast cancers. In this sense we should be getting personalized treatment based on our tumor biology - not one size fits all! )I did get ovarian chemo, in addition to bc chemo, though it is not protocol yet. I do believe studying a cohort with a known mutation, focusing on one possible solution, such as a vaccine, etc. will help other's without the mutation, for all types of cancer.What we will learn about BRCA 1/2 in terms of risk, prevention, detection, and therapeutics can be applied not only to other forms of breast and ovarian cancers, but to other cancers as well.
—Dr. Susan Domchek -

This applies in many situations we can think of ....
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Sandy - I've had a good laugh at that stuff. I like the "using the Sandy Hook victims" for personal agendas. Maybe those Sandy Hook victims have an agenda too. Have they ever thought of that? If you want to talk about using victims....9/11, invade Iraq for oil. That would be "using." As far as I know, no one is getting rich by having gun purchasers go through background checks.
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All lives do matter....very much. Not caring is what holds us back and solidifies a lot of prejudice which further causes resolvable issues to stay in the way. The lies have to go ( that will take awhile ) but I do think it possible. We have made a lot of strides before, and during the last election.
Jackie
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Yes, Jackie, we did make great strides in the last two elections. And whenever we get disgusted or frustrated by the haters, we need to step back and remember that they are IN THE MINORITY. President Obama won by an absolute majority BOTH times, with more than 50% of the vote. He is the first president of EITHER party to win twice with more than 50% of the vote since Eisenhower, and the first Democrat to do so since Roosevelt. Just think of what that means -- our first black president was elected TWICE with an absolute majority. That should give us hope for the future, regardless of the hatred we see.
L -
I love that our president has such a good sense of humor. Of course, there are those that will say, "See? He admits it!"

He also said, "I thought about building my library in my birthplace, but I decided I'd rather keep it in the United States." Bwahahaha! Awesome!
Mary
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