HER2 Support Group Forums - View Single Post - IT TURNS OUT not all hi dose chemo/stem cell transplants were in vain-Stanfordresults

Lani · 07-31-2011, 12:21 AM

. It may turn out that it was something else about this treatment that made this small group of patients do better than others receiving similar but different treatment.

I personally am a big fan of Dr Wicha and his work-- I think there are more mysteries to be discovered in the bone marrow niche and wish researchers and oncologists were testing bone marrows more often

When asked why they don't oncologists usually say patients don't like it--but many patients say that the test is really rather easy to go through and I even had an ex-neighbor, a lady in her late 70s early 80s who volunteered for a bone marrow (she didn't tell me the amount she was paid) and said she was just slightly sore for a day or two.

Some oncologists tell me their colleagues are the ones who just don't want to do it (since oncologists trained recently are no longer hematologists as well, they weren't necessarily trained doing a lot of bone marrow tests and may not be so good at doing them, they say.) If that indeed is the case, why don't they refer the patients for the testing, as they refer patients to radiologists for fine needle aspirations, core biopsies, or to orthopaedic surgeons for bone biopsies?

My comment:

patients don't necessarily like chemotherapy but that doesn't keep oncologists from giving it and if, as Dr. Wicha believes, disseminated tumor cells in the bone marrow are cancer stem cells and lay dormant avoiding chemo and radiation, it will only be by testing the marrow, that one determines whether the chemo or other agent has been effective. If that is true, I doubt a couple days of being a bit sore will be deemed "too terrible" to determine if treatment received has done its job or if different treatment is still needed/and to tell what treatments are the most effective in which patients.

Until more patients get their bone marrow tested we will not know.

CTC testing sounds nicer, but so far CTCs have been inferior to bone marrow DTCs in predicting prognosis and we have yet to determine the best technology for isolating and testing ctcs.

Off my soapbox for now.

07-31-2011, 12:21 AM	#4
Lani Senior Member Join Date: Mar 2006 Posts: 4,783	Re: IT TURNS OUT not all hi dose chemo/stem cell transplants were in vain-Stanfordres . It may turn out that it was something else about this treatment that made this small group of patients do better than others receiving similar but different treatment. I personally am a big fan of Dr Wicha and his work-- I think there are more mysteries to be discovered in the bone marrow niche and wish researchers and oncologists were testing bone marrows more often When asked why they don't oncologists usually say patients don't like it--but many patients say that the test is really rather easy to go through and I even had an ex-neighbor, a lady in her late 70s early 80s who volunteered for a bone marrow (she didn't tell me the amount she was paid) and said she was just slightly sore for a day or two. Some oncologists tell me their colleagues are the ones who just don't want to do it (since oncologists trained recently are no longer hematologists as well, they weren't necessarily trained doing a lot of bone marrow tests and may not be so good at doing them, they say.) If that indeed is the case, why don't they refer the patients for the testing, as they refer patients to radiologists for fine needle aspirations, core biopsies, or to orthopaedic surgeons for bone biopsies? My comment: patients don't necessarily like chemotherapy but that doesn't keep oncologists from giving it and if, as Dr. Wicha believes, disseminated tumor cells in the bone marrow are cancer stem cells and lay dormant avoiding chemo and radiation, it will only be by testing the marrow, that one determines whether the chemo or other agent has been effective. If that is true, I doubt a couple days of being a bit sore will be deemed "too terrible" to determine if treatment received has done its job or if different treatment is still needed/and to tell what treatments are the most effective in which patients. Until more patients get their bone marrow tested we will not know. CTC testing sounds nicer, but so far CTCs have been inferior to bone marrow DTCs in predicting prognosis and we have yet to determine the best technology for isolating and testing ctcs. Off my soapbox for now.