HER2 Support Group Forums - View Single Post - Rads and the myth of chemo wiping out that "last stray cancer cell"

Aussie Girl · 12-14-2013, 04:01 PM

The residual stem cell stuff is very interesting. The data on the value of radiation for early breast cancer dates back to the 1980's or earlier and has been repeatedly refined to try to find the lowest dose/ best method to reduce side effects. However there is not much data related to subtypes. There is evidence that Luminal A does better than everything else regarding local recurrence after surgery and radiation - no surprises there. Some meta- analyses have shown increased survival as well as decreased locoregional recurrence.

The UK NICE guidelines from 2009 give a good overview. They appear to have put off the 2012 update and next guidelines planned for 2015. The guidelines for radiation haven't been much changed since around 2005.
http://www.ncbi.nlm.nih.gov/books/NBK11643/

The St. Gallen International Breast conferences from 2011 and 2013 are focusing on subtypes, not so much as they relate to radiotherapy but they are good summaries of what's new anyway. The radiotherapy changes appear to relate to how the radiotherapy is given.

http://annonc.oxfordjournals.org/con...2/8/1736.short
http://annonc.oxfordjournals.org/content/24/9/2206.full

I don't know much about stem cells. I can see from the net that CD44+/ CD24 -/lo mammary stem cells which express something called Notch and aldehyde dehygrogenase 1 have been increasingly studied as the potential source of recurrences and that they are resistant to radiation and chemotherapy compared to other cancer cells. They are related to some "invasive" genetic signatures.

Looks like there may soon be ways of detecting these cells to help determine risk of recurrence, which will hopefully lead to better therapy.

http://annonc.oxfordjournals.org/con.../10/2515.short
http://onlinelibrary.wiley.com/doi/1...nticated=false
http://www.nejm.org/doi/full/10.1056/NEJMoa063994

Aussie Girl

12-14-2013, 04:01 PM	#9
Aussie Girl Senior Member Join Date: Jul 2013 Posts: 260	Re: Rads and the myth of chemo wiping out that "last stray cancer cell" The residual stem cell stuff is very interesting. The data on the value of radiation for early breast cancer dates back to the 1980's or earlier and has been repeatedly refined to try to find the lowest dose/ best method to reduce side effects. However there is not much data related to subtypes. There is evidence that Luminal A does better than everything else regarding local recurrence after surgery and radiation - no surprises there. Some meta- analyses have shown increased survival as well as decreased locoregional recurrence. The UK NICE guidelines from 2009 give a good overview. They appear to have put off the 2012 update and next guidelines planned for 2015. The guidelines for radiation haven't been much changed since around 2005. http://www.ncbi.nlm.nih.gov/books/NBK11643/ The St. Gallen International Breast conferences from 2011 and 2013 are focusing on subtypes, not so much as they relate to radiotherapy but they are good summaries of what's new anyway. The radiotherapy changes appear to relate to how the radiotherapy is given. http://annonc.oxfordjournals.org/con...2/8/1736.short http://annonc.oxfordjournals.org/content/24/9/2206.full I don't know much about stem cells. I can see from the net that CD44+/ CD24 -/lo mammary stem cells which express something called Notch and aldehyde dehygrogenase 1 have been increasingly studied as the potential source of recurrences and that they are resistant to radiation and chemotherapy compared to other cancer cells. They are related to some "invasive" genetic signatures. Looks like there may soon be ways of detecting these cells to help determine risk of recurrence, which will hopefully lead to better therapy. http://annonc.oxfordjournals.org/con.../10/2515.short http://onlinelibrary.wiley.com/doi/1...nticated=false http://www.nejm.org/doi/full/10.1056/NEJMoa063994 Aussie Girl __________________ 31mm Infiltrating duct carcinoma Grade 3, ER/PR-, HER2+, Neg Sentinel nodes x 5 49mm field of DCIS 17 June '13: Screen detected impalpable mass, Mammogram neg, US. 25 June '13: Diagnosed after multiple biopsies and MRIs 28 June '13: Left lumpectomey 4 July '13: Left Mastectomy 12 August '13: Commenced TCH chemo Mid December '13 : TCH finished. Herceptin continuing three weekly. 4 August 2014- Herceptin infusions finished. END OF THERAPY - YAY!