Prognosis with mets questions?

[Sherryg683]

Why is prognosis survival so poor for those that develop mets. I understand if it has spread all over the body and the organs that it has spread in, comes into play. But for those that may only have small mets in one area or even those with multiple mets, aren't once the mets cleared and you are declared NED, don't you have just as good a chance as anyone else? I realize that it may come back but then it could come back in someone who was stage I with no mets. Is it always just a constant fight with cancer for those that have mets? I'm just a little confused, does my questions even make sense??? ..sherryg683

[jhandley]

hi

In the "olden days" before herceptin...it was thought that if a metatasis was large enough to show on a scan it was unlikely that treatment could effect a cure. In Dr Love's book she quotes statistics (published in the year 2000) of average survival 2-3.5 years, with 25-35 % surviving 5 years and 10 % surviviing 10 years and 1-2% cured. These are of course pre her 2 statistics and dont take into account new therapies such as herceptin. I dont think anyone knows enough about post-herceptin results to make any definite statements except of course that herceptin has increased survival and has some people in long term remissions.

regards
jackie

[StephN]

Your question is a good one and is the reason so many of us are here on this particular board to share our experiences.
I for one would have been gone probably 3 years ago after first showing of rampaging mets. Fortunately I was the first one through a new clinical trial to show a COMPLETE response, and am the farthest out of the other women who had a good response. They must not be on Herceptin, but I don't know their treatment details.
My med onc has referred to my brain mets as "isolated" and thinks this is all I will have if I stay NED from my ears down. I like that approach!

WE are writing new chapters in the course of cancer care and survival - and it is up to us to show what can be done with the new drugs in the right instances as more becomes known about our pathology and who responds to what drugs. Most of the docs are not up to speed on who we are and what we can accomplish in our battle with BC.

Don't know if this answers, but I think I understood your question ...

[aquinis2000]

Hi Sherry, Part of the reason that the prognosis is different for stage 1 than stage 4 is that the cancer has either 1) entered the bloodstream , or 2) entered the lymphatic system or 3) both, when you are a stage four. Thats how it spread to other parts of the body. And even when you can't see active mets on a ct or pet scan, it is still there microscopically, so you really always have cancer in your body. At stage 1, the cancer has not entered the surrounding tissue , the blood, or the lymph system. So when a stage 4 is NED, that just means the cancer is stable and so small the scans cannot pick it up. When a stage 1 is NED, there is vitually no cancer at all. That doesn't mean that that the person will always stay a stage 1, but it means they don't have circulating cancer in their system. Thats why the prognosis is so much different.But don't let the prognosis stuff scare you, as many many women are hammering the cancer over the head , and winning. At all stages.

[Sherryg683]

I guess it's like what my Oncologist told me..he's sure that he will get me NED, but I will have to be fighting reoccurances all my life. That's wonderful. I just want to get all this cancer out my system. At least now we have some drugs that we can fight with. I am hoping one day that I won't have to worry so much about it...sherryg683

Which brings us back to me being boring on diet and fats.

Which includes fats and particularly omega threes and sixes. Trials have shown than increases in omega six over omega three will alter the expression of very significant number of genes and proteins linked to BC including erbB-2 (Her 2).

Trials have shown women with the highest levels of DHA/EPA (made in body from omega threes and found in fish oil) had a 70% less chance of biopsied lumps being cancerous.

If you can create an environement in the body that is less friendly to cancer it must help. For me 70% cannot be ignored, and changing the fat balance in ones diet is on balance a lot less testing than most of the alternatives, and if it makes no difference in cancer terms it should help your heart veins gums joints brain ...

If you are on the unconvinced list there are lots of posts on this site and hosts of books. It takes a while and quite a lot of reading but I would think that most who take the trouble will be sufficiently convinced to at lest amake some changes.

If you are convinced already please excuse my rant.

RB

[Lolly]

RB, your posts are never boring. Diet and the types of fat we ingest are a very important component of maintaining health and living with cancer. Thanks for your input!

<3 Lolly

[Sherryg683]

Rb, I would love to know more about the diet you are talking about. I would like to do anything that would make me healthier. Could you give me a link or some book reference....tks..sherryg683

I will try and get you a list of book titles I have seen which I found interesting.

I recently spent some time looking at books in the health section of the public library pulling books out and looking for fats, lipids omega, in the index. If they had a significant amount of information I would pull them out and check it out. If the book was particularly interesting I would then read more. Generally the people with knowledge of the omegas also seemed to have similar views on diest in very general terms, but you have got to look at in from a wider perspective, as the omega six message is less well understood, and it is the excess omega three that is more of a problem in a sense that the lack of three as the level of fats the body needs to survive are not reported as being very high. (even some well known clinics dont seem to have yet grasped the possible implications, and still include unsaturated fats high in omega six as a recommend)

Re links try searching on omega three on this site and also readiin the post the importance of omega three and six to breast cancer with the Ben Best link. You wonnt understand all of it, I still dont but hopefully you will get the gist and it will begin to make more sense over time.

I dont know that my own diet is in any sense right, it evolves as I read more, but I will give some ideas on a separate post later.

RB

[CLTann]

Returning to the original question about mets among stage 4 versus stage 1, the key issue is whether the cancer cells have gone outside from the origianl breast area. Even a healthy person would normally have cancer cells in the body. The body is constantly killing these enemy cells all the time.

When the body loses the ability to kill ALL bad cells and allow some of them to secure a landing site and start a new colony, thats when we begin the mets problem. At the onset of this process, the lesion is so small and no test can detect them. By the time one has symptoms and tests confirm the presence of mets, it is established that one has lost a battle (not necessarily a war) in containment of cancer at the local breast area. Since now it has shown the cancer cells are present elsewhere, one is considered to be vulnerable for more mets by the doctor, regardless of the chemo, radiation, disection or any other treatment methods.

Basically, this is the thinking of the treating oncs. This is also the basis of using chemo as the first line of protection in treating most breast cancer cases, since chemo is supposedly to kill all cells that divide quickly. Unfortunately, many chemo agents do not accomplish the assigned task completely.

Those of us who believe that dietary intake would strength body's own defense system to fight cancer cells subscribe to the view that if we can bring ourselves to the fighting strength of a healthy person who routinely kill cancer cells, we should be able to stay cancer free. Indeed, many of us are staying healthy by adhering to a long list of supplements. Although I am one of those who follow this approach, I strong believe that a systemic sweep of stray cancer cells in the body by chemo is useful for high risk patients.

The above is a very simplistic way of interpreting the current view of cancer mets. As to Herceptin, it is just another drug which has shown high degree of efficacy of combating cancer mets among HER2 positive patients. Many of us got benefit from its effectiveness; however, there are many who got no positive response from its use. We don't know whether it is just a crap game or not, scientists are still trying to sought out factors that can make this drug, or any other new drug, more effective to ALL the patients.

Ann

Clarification - and apology

I am not having a very good day - rushing which is generally a bad idea.

Both omega threes and sixes are essential, but as most people have ratios of omega three to six in excess of 1:10, and 1:1 is an often quoted ratio to aim for, and omega six is very much more commonly available, the generality is increase three and cut out six.

I am sorry my last post was not more clear, my threes and sixes got mixed at one point, I have no idea how.

I will post some interesting book titles tomorrow.

RB