Surgery and Recurrance

[Rozebud]

I asked someone to ask this question on my behalf at the YSC conference this weekend (I could not attend), and here is her answer. Hooray!
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Rose and others:

I got a very definitive answer to this question, which came up at two sessions I attended - absolutely not! I attended a session with a pathologist, Dr. Bleiweiss from the Mount Sinai School of Medicine, and it came up in the ask an expert panel. In both cases, the answer was absolutely not, there is no evidence that surgery displaces cancer cells and causes a recurrence. The pathologist was quite definitive and went further saying that if this were the case, women with reconstruction and multiple surgeries would have a worse prognosis than women with a single surgery and that this has been studied and is not the case.

In a way, you got three docs to agree about this, because there was a clinician with the pathologist who agreed with him.

I would be very reassured and go and enjoy your planned reconstruction!

Brin

I read a different scenerio, it is called a SPILL, that is when cells drop from the surgical instruments and attach to another area causing the cancer to grow. This happened with my uncle, he had a melenoma removed from his back and ended up with the cancer in his lungs, he may have died anyway from the melenoma but they said that was cured so he had lung and bone mets. My breast lump didn't show on the mammo but when detected it had attached to the chest wall, so no surgery just pressure for biopsy at that time and I feel it moved to the chest . Now I won't even consider a biopsy without having chemo at the same time, I took Xeloda this time because every other biopsy I have had has enlarged the area within days, this time the appearence hasn't changed since before the biopsy and the skin healed beautifuly. It is all a gamble, and unpredictable. My latest outbreak in the other breast is to be treated with 30 doses of radiation and Xeloda 500mg per day, not surgery opinion from my chemo onc, my rad onc, and yesterday I saw my plastic surgeon, I am still trying to get the other breast reconstructed and now this has turned up, he agrees and says he will review me 12 months after radiation and only then when I am stable. I said that the left breast was severe and this one isn't but still no, they don't want to transfer skin cells that may have BC and infect new area, at least I have another goal, wait 12 months and see. I was willing to take the risk but a bit hard with 3 backed up against me. No doubt I could find a hack to do it, but then what happens when I need more treatment, would I get kicked to the kerb. Then there is the other issue of how they make cancer grow on healthy mice?

Love & Hugs Lyn

Hi Rozebud,
Hope you are doing well. I just wanted to give you another perspective. My husband is a surgical oncologist. He's been doing surgery on cancer patients for many years. He told me that he had a strong idea that there is a strong connection between 'the growth factor' that increases with surgery and tumor growth.
It's a difficult decision and I believe everyone has to weigh alot of factors to choose what's right for themselves. Everything involves risks, but somehow you come up with the right choice for yourself.

I'm choosing not to do reconstruction. I've adapted pretty well to my mastectomy and just see it as part of life, just like the scar and stretch marks I have from two ceasarians for my two beautiful children. I see my mastectomy as part of the life I've lived and it's just my external skin it really has nothing to do with who I really am and how I present myself to the world. I even participated in a yoga video with my yoga teacher with one breast. I felt very proud to be asked to be in the video and I'm very proud of how I looked in the video. I didn't even wear a prosthesis.

Like I said, everyone has to make their own decision with what is right for them, but I'm just really happy not to have to think about going back to a hospital and surgery and doctor visits and healing wounds and all that...
Good luck with whatever you choose.
Take care, Margaret

[Lolly]

Dr. Judah Folkman, who pioneered the theory of anti-angiogenisis, believes that the primary tumor produces a substance which inhibits the growth of secondary tumors, until removal of the primary. Here's an excerpt from an article about this, followed by the link:


"...Curiously, some tumors also secrete substances that inhibit angiogenesis. This explains a clinical phenomenon that has been known for decades:
A patient has a tumor, the so-called primary tumor.
There is no evidence that the primary tumor has metastasized.
A surgeon removes the primary tumor.
Some weeks later metastases of the tumor appear throughout the patient's body
The speed of their appearance indicates that they were present all along but too small to be detected.
This phenomenon caused Dr. Judah Folkman of Children's Hospital and the Harvard Medical School in Boston to hypothesize that a large primary tumor secretes not only stimulators of its own angiogenesis but angiogenesis inhibitors that are released into the circulation and inhibit angiogenesis - and thus further growth - of any metastases of the primary tumor..."

http://users.rcn.com/jkimball.ma.ultranet/...giogenesis.html

I think there's still a lot we don't know about cancer and how it's growth is fueled. BUT, it would stand to reason that if you're diagnosed, have surgery and reconstruction followed by chemo, or some chemo first to shrink the tumor, then surgery, reconstruction and mop-up chemo, any stray cancer will more than likely be eliminated.

[Rozebud]

Thanks to all of you.

Margaret - So your husband believes that when he does surgery to remove cancer that he could be spreading it? What does he think about reconstruction on someone who is currently "NED"?

I understand what you are saying. A lot of people don't understand. My husband is fine with it. I just don't feel sexy. I'm only 34. I can't wear 1/3 of my clothes with lower necklines. I hate taking my kids to the pool because the prosthesis is never "naturally low" like my natural breast. I can't wear anything with straps and I'm tired of only having 2 bras. I hate walking around the house without a bra, because when someone comes to the door I have to run up and put a bra on. I just want to feel sexy and good about myself physically again.

[Lolly]

Hi Rozebud; I know how you feel about the akwardness of the whole business, and what a relief it would be not to have to worry when the doorbell rings. I would have reconstruction if I could but have never felt secure enough with my health to go thru the process. Ever hopeful, though!

Love, Lolly

Hi Rose,
I'm 41 and also NED. My husbands point was that after any type of surgery the body will go into a 'healing mode' and increase cell renewal (growth factors) and he thinks this may have an effect on some 'dormant' cancer cells that 'could' lead to recurrence. I think it's just one perspective and there certainly are many others. There's all kinds of challenges the body is put to so it truly is a personal call. If you are looking forward to the benefits. Go for it and I'm sure everything will be fine. Most women I think do the reconstruction.
I just wanted to let you know, that there is another way to look at it. You can love your body even with it's scars and let your inner radiance and beauty shine through. You can indulge in feeling sexy for exactly what you look like at any moment of your life. The body goes through natural changes and gets older (hopefully, 'cause it sure beats the alternative) but you can still be fully worthy of indulging in feeling beautiful and fully sexual no matter what.
Either way you choose, just love yourself exactly how you are no matter what and fully enjoy life.
Take care, Margaret

Rozebud
I know how you feel, that is why I went for reconstruction....I was stage 1
when I started, 4 months later I was stage iv.....was it from the surgery? l will never know ....I can wear all my clothes now, but I also developed capsular contracture....and being stage iv, they are hesitant to operate.
I wish I had never started ...life was easier with the prosthesis. I thought the surgery would make me feel better. It didn't!

Hugs

Sheila