HER2 Support Group Forums - View Single Post - Revised Guidelines Say Most Women Can Begin Mammograms At Age 50

gdpawel · 11-28-2009, 01:41 PM

Rich

I totally agree. Surgery with clean margins is the largest contributor to survival. Whoever has been cured of cancer, began with an operation. Not only in the early stage, I would recommend it in the later stages also.

Some researchers believe the reason for better survival for patients who could undergo complete resection without any tumor left behind is that these tumors are biologically less aggressive and would do better regardless of the type of treatment they receive, and that the removal of lymph nodes at the time of surgery may additionally contribute to a better outcome.

Surgery is an integral part of the multimodality treatment of many cancers. The line of reasoning frequently used to explain the value of surgery included five points.

First, surgery is thought to remove resistant clones of tumor cells and thus decrease the likelihood of the early onset of drug resistance.

Second, the removal of large masses likely to be associated with poorly vascularized areas of tumor improves the probability of delivering adequate drug doses to the remaining cancer cells.

Third, the higher growth fraction in better vascularized small masses enhanced the effect of chemotherapy.

Fourth, smaller masses required fewer cycles of chemotherapy and thus decreased the likelihood of drug resistance.

Fifth, removal of bulky disease enhances the immune system. Patients who present with a large mass are suffering because of that mass and they need that tumor out to relieve symptoms and to save life due to symptoms. It's important to deal with the bulk.

Sources:
Mayo Clinic
American Board of Surgeons
Society of Surgical Oncology

Don't forget, the signaling pathways in solid tumors are very complex and many. Cancer cells can use any of dozens of biochemical pathways to proliferate and spread. Stop one pathway and the cells can turn on a different. And the more recalcitrant tumors have redundant systems to let them escape from numerous anti-cancer agents.

A goal is the choose therapies so they target the precise proliferation pathways the cancer is using. We have the ability to profile tumors so that oncologists would know not to use one particular drug (or combinations of drugs) because it won't help, but utilized some other particular drug (or combination) because it shows that it is synergistic (cooperative) to the cancer cells (killing them).

11-28-2009, 01:41 PM	#8
gdpawel Senior Member Join Date: Aug 2006 Location: Pennsylvania Posts: 1,080	Re: Revised Guidelines Say Most Women Can Begin Mammograms At Age 50 Rich I totally agree. Surgery with clean margins is the largest contributor to survival. Whoever has been cured of cancer, began with an operation. Not only in the early stage, I would recommend it in the later stages also. Some researchers believe the reason for better survival for patients who could undergo complete resection without any tumor left behind is that these tumors are biologically less aggressive and would do better regardless of the type of treatment they receive, and that the removal of lymph nodes at the time of surgery may additionally contribute to a better outcome. Surgery is an integral part of the multimodality treatment of many cancers. The line of reasoning frequently used to explain the value of surgery included five points. First, surgery is thought to remove resistant clones of tumor cells and thus decrease the likelihood of the early onset of drug resistance. Second, the removal of large masses likely to be associated with poorly vascularized areas of tumor improves the probability of delivering adequate drug doses to the remaining cancer cells. Third, the higher growth fraction in better vascularized small masses enhanced the effect of chemotherapy. Fourth, smaller masses required fewer cycles of chemotherapy and thus decreased the likelihood of drug resistance. Fifth, removal of bulky disease enhances the immune system. Patients who present with a large mass are suffering because of that mass and they need that tumor out to relieve symptoms and to save life due to symptoms. It's important to deal with the bulk. Sources: Mayo Clinic American Board of Surgeons Society of Surgical Oncology Don't forget, the signaling pathways in solid tumors are very complex and many. Cancer cells can use any of dozens of biochemical pathways to proliferate and spread. Stop one pathway and the cells can turn on a different. And the more recalcitrant tumors have redundant systems to let them escape from numerous anti-cancer agents. A goal is the choose therapies so they target the precise proliferation pathways the cancer is using. We have the ability to profile tumors so that oncologists would know not to use one particular drug (or combinations of drugs) because it won't help, but utilized some other particular drug (or combination) because it shows that it is synergistic (cooperative) to the cancer cells (killing them).