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Tedi15
Tedi15 Member Posts: 6

Just had first visit with onc last week. Some news good...but then she said "we never know if one cell

Made it into blood stream" even tho sentinel nodes were good. That of course set me into yet another panic stage.  Waiting for onco results, hormonal therapy a definite (I am 59), to see if chemo will also be beneficial. My question is this...if cell did make it into blood steam and lands somewhere like bone, liver etc. will the hormonal therapy lock the door? Or does hormonal therapy (she mentioned letrozole) just treat

Breast and gyn type tissue?  Not sure if I am making myself clear. 

Also when hormone therapy is over won't these cells start growing again?

At this point my head is spinning to the point I will probably be hit by a bus due to lack of concentration. How do you stop thinking about it whole waiting for all these tests results?

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2014

    Hormonal therapy works two ways - Tamoxifen is usually given to pre-menopausal women (and some post-meno) and it works by allowing circulating estrogen to continue, since it does positive things like protect heart and bones in younger women, but it blocks the receptors on breast cells.  Aromatase inhibitors, like Letrozole suppress the conversion of androgen to estrogen by inhibiting the enzyme aromatase that assists in this conversion.  This mechanism suppresses any remaining estrogen that would fuel the estrogen receptors on breast cells.  It is breast cells that travel in the body and set up shop to form a metastasis distantly.  If you take hormonal therapy for a number of years it provides protection for some period following the cessation of the therapy.  Recent studies are now pointing toward taking hormonal therapy for a longer time period, these studies for Tamoxifen have been put into practice, still being studied for AI drugs.  Some post-meno women are starting on Tamoxifen and switching to AI to stretch out this time, and some are doing the reverse.

  • angelia50
    angelia50 Member Posts: 381
    edited September 2014

    I have the same question.  I actually never thought about it until the other day when I read a new post about a person with stage 1, grade 1 and her doctor saying grade 1 does not respond well to chemo, which is what mine told me too. She asked the question of, does that just make the cancer in a sense dormant, which is now, what scares me too.  So, what started out as seeming to be good news, the grade 1, now, I'm worried, was it good news?  Is there no way to kill grade 1?

  • Lily55
    Lily55 Member Posts: 3,534
    edited September 2014

    i am sorry to be the voice of doom, but no treatment kills cancer stem cells and it is these that can create cancer elsewhere. However our own immune systems can inactivate them if given enough resources and known fuel for these cells, such as oestrogen, are blocked from reaching them so the growth triggers for metastases are starved.  I am being very untechnical deliberately, if you go on Youtube you can see cancer cells being destroyed by our own natural killer cells.  Exercise, good diet, good breathing, joy in life are all things that help boost our resources to destroy cancer cells, we are more powerful than any one treatment. But standard treatments can reduce tumour load allowing our immune systems to work

  • vlnrph
    vlnrph Member Posts: 1,632
    edited September 2014

    I very much agree with Lily - mutations are forming all the time (probably in many different places around the body) but our wonderful immune system has the ability to knock them out. Investing in a healthy lifestyle should be of prime importance to everyone!

    For Angelia, I think of grade 1 tumors as being slower growing, not actually dormant. Since chemotherapy acts against rapidly dividing cells, those are the ones that make attractive targets and respond better by taking up the 'poison' and letting it go to work. That is also why two or more drugs are usually given, designed to hit various parts of the life cycle and maximize the numbers killed. 

    Tedi, Special K gives a good description of mechanisms of action of the oral medications. Try to distract yourself with fun activities this weekend. Waiting to sort out the information so you can understand the rationale and have confidence in your treatment plan is a test of patience, to say the least.

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