This post has some very interesting factual information taken from cancerhelp.org and I hope that it will be useful to many of you out there who is as frustrated as I am with the 'not knowing.
First, I would just like to go over my initial tumour removal which took place in
October 2010.
OK...........
A lump was discovered and removed.
It was generally assumed to be a cyst, as I have been known to have many.
When the lump was removed, it did not look like a cancer, smell like a cancer, and there was no reason to believe that it was a cancer.
The consequence of this was that only the lump was removed.
If this lump had been identified as a cancer, more of the surrounding area would have been removed to reduce the risk of 'spread'.
A biopsy was done as a precaution, but with no sense of urgency.
I would like to say at this point, that I am not apportioning any blame, I believe that it is no ones fault, and I have no concerns about my treatment in any way..it has been excellent from the beginning.
These things happen. I am just stating facts so that you (and I), can understand the situation as it stands, and why we may never know if the cancer is still in my body or not.
The only way that we may know is by experiencing further symptoms.
Here is the information.........
This was taken from cancerhelp.org
It has helped me to understand why we may not know if cancer is still present in my body, (or anyone’s elses), even after a scan.
· Primary and secondary cancer
The main reason cancer can be difficult to cure is that it can spread to a different part of the body from where it started. The cancer that grows where it first started in the body is called the 'primary cancer'. The place a cancer spreads to and then starts growing is called the 'secondary cancer' or 'metastasis'.
· How a cancer spreads
In order to spread, some cells from the primary cancer must break away, travel to another part of the body and start growing there. Cancer cells do not stick together as well as normal cells. They also may produce substances that stimulate them to move. But how do cancer cells travel through the body? There are three main ways a cancer spreads
· Local spread
The cancer grows directly into nearby body tissues. There is more about this in the page on how a cancer grows.
· Through the blood circulation
In order to spread, the cancer cell must first become detached from the primary tumour. It must then slip through the wall of a blood vessel to get into the bloodstream.
When it is in the bloodstream, it is swept along by the circulating blood until it gets stuck somewhere, usually in a very small blood vessel called a capillary.
Then it must slip through the wall of the capillary and into the tissue of the organ close by. There it must start to multiply to grow a new tumour.
As you can see, this is a complicated journey. Most cancer cells do not survive it. Probably, out of many thousands of cancer cells that reach the blood circulation only one will survive to form a secondary cancer or metastasis.
Some cancer cells are probably killed off by the white blood cells in our immune system. Others cancer cells may die because they are battered around by the fast flowing blood.
Cancer cells in the circulation may try to stick to platelets to form clumps to give themselves some protection. This may also help them to be filtered out in the next capillary network they come across so they can then move into the tissues to start a secondary tumour
· Through the lymphatic system
The way a cancer spreads through the lymphatic system is very similar to the way it spreads through the bloodstream. The cancer cell must become detached from the primary tumour. Then it travels in the circulating lymph fluid until it gets stuck in the small channels inside a lymph node. There it begins to grow into a secondary cancer.
· Why cancers spread where they do
Whether it is in the blood or the lymph, the spreading cancer cell stops at the first place it gets stuck. In the bloodstream, this is often the first capillary network it comes across. The blood flow from most body organs goes next through the capillaries in the lungs. So not surprisingly, the lungs are a very common place for cancer to spread to.
The blood from the organs of the digestive system goes through the capillaries of the liver before going back to the heart and then to the lungs. So it is common for digestive system cancers to spread to the liver. In fact, the liver is the second most common area of cancer spread.
Some cancers show unexpected patterns of spread. For example, prostate cancer often spreads to the bones. Scientists are still investigating why this happens.
Cancer cells often get trapped in the group of lymph nodes closest to the tumour. During cancer surgery, the surgeon may remove the main lymph nodes close to the area of the cancer. For example, the surgeon operating to remove a breast cancer will remove one or more of the lymph nodes from under the arm. These are the first lymph nodes through which lymph draining from the breast flows. The surgeon removes the lymph nodes to remove the cancer cells. Finding out whether the cancer has spread into the nodes gives the doctor some information about whether further treatment with cancer drugs or radiotherapy is needed.
· Micrometastases
Micrometastases are areas of cancer spread (metastases) that are too small to see. If there are individual cells, or even small areas of growing cells elsewhere in the body, no scan is detailed enough to show them.
For a few types of cancer, blood tests can detect certain proteins released by the cancer cells. These may give a sign that there are metastases too small to show up on a scan. But for most cancers, there is no blood test that can say whether a cancer has spread or not.
For most cancers the doctor can only say whether it is likely or not that a patient has micrometastases. This 'best guess' may be based on the following factors.
· Previous experience of many other patients treated in the same way. Doctors naturally collect and publish this information to help each other.
· Whether cancer cells are found in the blood vessels in the tumour removed during surgery (for example in testicular cancer). If they are found then cancer cells are more likely to have reached the bloodstream and spread to somewhere else in the body.
· The grade of the cancer - the higher the grade, the more aggressive the cancer and the more likely that cells have spread. · Whether lymph nodes removed during an operation contained cancer cells (for example in breast cancer or bowel cancer). If the lymph nodes contained cancer cells this shows that cancer cells have broken away from the original cancer. But there is no way of knowing whether any have spread to other areas of the body.
This information is important. If the doctor thinks it is likely that there are micrometastases, they may offer further treatment with chemotherapy, radiotherapy or hormone therapy. This is called 'adjuvant treatment'. The aim is to kill the areas of cancer cells before they grow big enough to be seen on a scan.
Some doctors call this 'belt and braces' treatment. In other words, the treatment is to try to make sure the cancer does not come back. No one can know for sure if all the cancer cells have been destroyed when someone has finished treatment. It is this uncertainty that can make cancer difficult to cope with for many people, even if they seem to have been successfully treated.
Now..............
Another of my poems...............
Where am I now?
6th and final chemo cycle,
This will take all day,
Like all the other chemo,
Later on, I'll pay.
The patients here
All look so well.
We all have cancer,
But you can't tell.
Along with chemo in your veins
Some other stuff goes in.
This all stops you from being sick,
And stops you from being slim!
The drugs give you an appetite,
So....you eat a lot,
And you 'bang' the weight on!
Your diets are forgot!
The Doctors and the Nurses
Say you must loose NO weight!
So, if you do, they say to you,
"Go home, and fill your plate!"
So now I have neuropathay,
Phlebitis and feel numb,
And all I have to show for it
I a whacking great big bum!
The next thing that I need to do,
Is go and have a scan.
This will be the 'benchmark',
And shows cancer, if it can.
So for now, I will tell myself
That after all this 'hell',
Carol Hubbard is now 'cancer free!'
And 'feeling, Oh, so well!'
Now I have to go to work,
And pick up where I left,
And hope that I can still do it,
Despite some side effects.
I know I can,
I'm sure I can,
I'm made of some tough stuff.
That, and some support from work
I know will be enough!
Carol Hubbard 31st May 2011
