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Lani · 11-03-2007, 12:54 AM

Breast cancer itself, especially her2+ breast cancer has multiple effects on the immune system which result in the immune system not being able to effectively recognize the breast cancer and fight it, whether utilizing the humoral or the cellular parts of the immune reaction. Some of these methods are physical (secreting a greasy coating so the antigen cannot be recognized by the antibody), some are chemical eg, secreting substances which keep certain subsets of cells like dendritic cells from maturing and learning to fulfill their function, and many have not yet been worked out.

The radiation therapy given for breast cancer affects the thymus gland(which produces cells required for the immune system) and papers from the early 1970s and 80s showed that many subsets of cells involved in the immune system stopped being produced and were not produced even 8 years after the radiation therapy typically given for breast cancer

The chemotherapy given for breast cancer is toxic to cells which divide quickly, notably the cells which become subsets of the white blood cells, red blood cells and platelets and these interact with tumors, other immune cells with complicated feedback mechanisms. Occasionally they are so toxic that the cells which become these cells die, resulting in aplastic anemia or myelodysplastic syndrome (I have posted on this and one of our members has had this)

This is why it would be optimal for her2 to be included in the Adjuvant online estimation of risk of recurrence--so informed decisions can be made regarding the ABSOLUTE not relative risks of recurrence of breast cancer vs the small but present risks of developing second cancers, leukemias, etc.

I will shortly post a recent article on the risk of recurrence of T1a or 1b, NoMo breast cancer (not taking her2 into account) it cited a Breast cancer related 10 year death rate of 4% with a nonbreast cancer related death rate of over 20% as I recall. Some of those nonbreast cancer related deaths may have been due to complications from the breast cancer treatment, both from the radiation therapy, the chemo and the antihormonals, and a few from cardiotoxicity from herceptin(as it has not been used in the adjuvant setting that long).

We don't understand the normal immune system that well, let alone the suppressed one. I have proposed to several researchers that they look at the difference in the immune system between those treated without radiation therapy, those treated with whole breast radiation therapy, and those treated with APBI (just the lumpectomy cavity and in many fewer treatments over a much shorter period). New technology at Stanford will make such studies possible. I share your amazement that this hasn't really been studied before, but it seems the technology and knowledge just weren't there. The new head of the Stanford division starting to study the immune system cells this way says they first have to study a lot of normal people, as they really don't know what is normal yet!

Another example of how much we don't know--reminding us to keep asking questions!

11-03-2007, 12:54 AM	#17
Lani Senior Member Join Date: Mar 2006 Posts: 4,783	breast cancer and immune supression Breast cancer itself, especially her2+ breast cancer has multiple effects on the immune system which result in the immune system not being able to effectively recognize the breast cancer and fight it, whether utilizing the humoral or the cellular parts of the immune reaction. Some of these methods are physical (secreting a greasy coating so the antigen cannot be recognized by the antibody), some are chemical eg, secreting substances which keep certain subsets of cells like dendritic cells from maturing and learning to fulfill their function, and many have not yet been worked out. The radiation therapy given for breast cancer affects the thymus gland(which produces cells required for the immune system) and papers from the early 1970s and 80s showed that many subsets of cells involved in the immune system stopped being produced and were not produced even 8 years after the radiation therapy typically given for breast cancer The chemotherapy given for breast cancer is toxic to cells which divide quickly, notably the cells which become subsets of the white blood cells, red blood cells and platelets and these interact with tumors, other immune cells with complicated feedback mechanisms. Occasionally they are so toxic that the cells which become these cells die, resulting in aplastic anemia or myelodysplastic syndrome (I have posted on this and one of our members has had this) This is why it would be optimal for her2 to be included in the Adjuvant online estimation of risk of recurrence--so informed decisions can be made regarding the ABSOLUTE not relative risks of recurrence of breast cancer vs the small but present risks of developing second cancers, leukemias, etc. I will shortly post a recent article on the risk of recurrence of T1a or 1b, NoMo breast cancer (not taking her2 into account) it cited a Breast cancer related 10 year death rate of 4% with a nonbreast cancer related death rate of over 20% as I recall. Some of those nonbreast cancer related deaths may have been due to complications from the breast cancer treatment, both from the radiation therapy, the chemo and the antihormonals, and a few from cardiotoxicity from herceptin(as it has not been used in the adjuvant setting that long). We don't understand the normal immune system that well, let alone the suppressed one. I have proposed to several researchers that they look at the difference in the immune system between those treated without radiation therapy, those treated with whole breast radiation therapy, and those treated with APBI (just the lumpectomy cavity and in many fewer treatments over a much shorter period). New technology at Stanford will make such studies possible. I share your amazement that this hasn't really been studied before, but it seems the technology and knowledge just weren't there. The new head of the Stanford division starting to study the immune system cells this way says they first have to study a lot of normal people, as they really don't know what is normal yet! Another example of how much we don't know--reminding us to keep asking questions!