Jan 29, 2013 - 9:43 am
I apologize in advance for my following rant, I am just in a bad mood this morning; I am not trying to scare anyone. I hesitated a lot if I should post this or not, but the urge to vent is too great. I recognize myself that some of my comments are controversial.
That’s a fear I am facing, reoccurrence and residual disease. I am 2 months out of the treatment (concurrent radiation and chemo, then chemo alone) and I will have the follow-up MRI (no PET in my case) in a month, and of course I wonder if the treatment eradicated the disease. What worries me is that not all the cancer cells have been destroyed. Unfortunately, once the cancer cells start to get awry, they start to “be” very different; it’s not a homogenous mass of cells. Some are very radiosensitive or chemo sensitive, but a few, are not. What’s worse, is that the treatment (if not 100% efficient) selects those cells that are resistant (similar with what antibiotics do, when not properly administered). This small set of abnormal cells are those that have a lower multiplication rate at the time of treatment, that’s what makes them so damn resistant (chemo and radio therapy targets cells that have a high multiplication rate, which also affects normal cells that happen to divide during treatment – hence the side effects).
Another thing that they don’t usually tell you is that both radio and chemo therapies are carcinogenic. Both induce mutations in the cell genome. [In addition to the C cells that already survived the ordeal, if that’s the case], A few other cells become then abnormal (most don’t survive or are destroyed), but the time needed to create a visible (with the current imaging technologies) mass varies from a few years to decades (some die of natural or other causes in the meantime). The new C doesn’t have to be in H&N area, cell that have been mutated are free to circulate in the body.
There is no way of telling beforehand what treatment would be more efficient; the treatment is far from being personalized. It’s just the statistics that give a clue of what should be used. Not encouraging, but that’s what it is.
I wish that more money is put in research studying the targeted therapy. This treatment hunts for specific receptors on (or within) the cells. Trouble is, there is no unique receptor that one can find only on C cells. Until they find anything that is specific to C cells, the “targeted therapy is not so on target, it also destroys normal cells that happen to have the same receptors. More research is needed.
Also, I don’t understand (or maybe I do) why immunotherapy is not researched enough. In my case for instance, the tumor is Epstein-Barr positive. There has been success using patients own Natural Killer lymphocytes that were activated and stimulated to kill the cells that bear the virus’ antigen (basically the tumor cells). But I was told that this is highly experimental. Yeah, sure.
Another interesting venue of research is Reolysin (http://www.oncolyticsbiotech.com/reolysin). Quote: “It was found that the reovirus was able to infect and selectively destroy cancer cells. When a normal cell is infected with the reovirus, an antiviral response is activated, which prevents the virus from replicating within the cell. However, inside a cancer cell with one or more mutations on a growth pathway called the Ras pathway, there is an aberrant antiviral response that is unable to prevent the virus from replicating. This abnormality allows the reovirus to multiply to an extent that is fatal to the cancer cell.”
While I am fretting about new C treatments, the bulk of the money goes to studying the classical chemo variants, because the revenues there are huge (although everybody knows that the “gain” for the patient is measured in weeks of extended life (but with what cost!).