Cancer? Again?

catwins

I just received the call that my lymph node biopsy was positive...again. It has been 5 years-almost to the day-since I was diagnosed Stage IV breast cancer with bone mets. They told me I was looking at 11 months.

My question is how do they know it is new cancer....couldn't it be "old" cancer cells? All my tests are like they were originally. No tumor markers in bloodwork, no tumor anywhere, body scans clean and now bone mets in spine "appear to be healed or arthritis." If it was originally in one lymph node, why would they expect it to not still have cancer cells. I have great respect for my doctors...they are the best in the country. I think I just present a scenario that is not text book. If anyone has had similar experiences or can direct me to resources that can help answer my questions, please let me know.

young_one

No one has an answer to
No one has an answer to this? Really?

chenheart

I was thinking the same
I was thinking the same thing, but this is not my experience, so I don't have "advice" to offer~ just empathy, a HUGE Cyber-hug, and of course I hope that you will find the resources you need to help you make your way through this leg of your journey.

Please keep us posted~

Hugs,
Claudia

CrystalW

New Cancer?
I am certainly no expert but from what I understood from my doc's was that if the cancer was to come back in a different location it is still considered to have orginated in the breast. I could be totally wrong. I am sorry that you have to go thru this again. CANCER SUCKS
Take care and hugs from Oregon.
Crystal

gemsa

Second opinion
Hi Cattwins,

I don't know much about how they come up with a positive diagnosis for cancer cells, but I imagine they look at the cells taken from your lymph nodes under a microscope and see if they are living cancer cells. They would be able to tell the difference between old (dead) cancer cells from before and living ones. However, if you don't trust what the doctors are telling you, you should get a second opinion. I think you should always get a second opinion even if you do trust them because other institutions may have different ways of approaching the diagnosis and treatment.

Congrats on your bone mets healing, that's wonderful. Now it's time to approach this new challenge and find out what is really going on. Keep asking questions until you get the answers you need.

catwins

young_one said:

No one has an answer to
No one has an answer to this? Really?

Thank You
Thanks for your replies. I get the same silent response from most people including the doctors. I think if I had a tumor...now or back in 2003...the doctors would be able to fit me in a slot. As it is, I just don't fit into any category. I have an appointment with a multidisciplinary breast clinic on the 17th. Hopefully, they will be able to give me some answers. I just want to be sure I have enough information and my own questions ready so that I don't get pressured into unnecessary treatment.

phoenixrising

Hi Cat
Do they normally biopsy lymph nodes when everything else is clear? I didn't know that.
I thought if all the blood work and scans were clean then you'd be good to go.

I've often had the same question if cancer recurs. Was it a stray cell that got away or is it a new one. What I've often got was a shrug of the shoulders. I think they can tell if they were to investigate the tumour more and I think they don't because it wouldn't change the treatment. Cost effectiveness I guess.

Sorry I can't answer your question but I do want to congratulate you on your 5 yrs....it's a long way from 11 months. May you have many more. I know it's discouraging when it comes back but I think you're going to conquer this one too.

If you get any good answers please let us know.

jan

jan

catwins

phoenixrising said:

Hi Cat
Do they normally biopsy lymph nodes when everything else is clear? I didn't know that.
I thought if all the blood work and scans were clean then you'd be good to go.

I've often had the same question if cancer recurs. Was it a stray cell that got away or is it a new one. What I've often got was a shrug of the shoulders. I think they can tell if they were to investigate the tumour more and I think they don't because it wouldn't change the treatment. Cost effectiveness I guess.

Sorry I can't answer your question but I do want to congratulate you on your 5 yrs....it's a long way from 11 months. May you have many more. I know it's discouraging when it comes back but I think you're going to conquer this one too.

If you get any good answers please let us know.

jan

jan

Thanks Jan
"Do they normally biopsy lymph nodes when everything else is clear?"

In my situation, there was no primary tumor and the BC was found in one swollen lymph node by a biopsy. A CT scan showed spots on my spine that "looked like cancer." This was back in 2003. The biopsy showed HER2 and ER positive so I did chemo for seven months. For the last 4 years I have been getting Herceptin and Zometa every 3 weeks.

Last week my lymph node felt larger so did another biopsy...the first since my original in 2003. It showed BC again just like before. My question has been...is it the original cancer in the original location or new cancer? If it is the original cancer in a diseased node, then I don't want to do another round of chemo. I figure that the Herceptin has contained the growth from other parts of my body since all my bloodwork and scans are clean. (Note: My bloodwork has always been normal. No tumor/cancer markers.) Doctors can't seem to give me an answer and they feel that it is safer to just start the chemo again.

I feel great right now...Herceptin has been my wonder drug. I just want to keep on keeping on. Thanks again for letting me vent.

chenheart

catwins said:

Thanks Jan
"Do they normally biopsy lymph nodes when everything else is clear?"

In my situation, there was no primary tumor and the BC was found in one swollen lymph node by a biopsy. A CT scan showed spots on my spine that "looked like cancer." This was back in 2003. The biopsy showed HER2 and ER positive so I did chemo for seven months. For the last 4 years I have been getting Herceptin and Zometa every 3 weeks.

Last week my lymph node felt larger so did another biopsy...the first since my original in 2003. It showed BC again just like before. My question has been...is it the original cancer in the original location or new cancer? If it is the original cancer in a diseased node, then I don't want to do another round of chemo. I figure that the Herceptin has contained the growth from other parts of my body since all my bloodwork and scans are clean. (Note: My bloodwork has always been normal. No tumor/cancer markers.) Doctors can't seem to give me an answer and they feel that it is safer to just start the chemo again.

I feel great right now...Herceptin has been my wonder drug. I just want to keep on keeping on. Thanks again for letting me vent.

Nodes, etc
Well, thank you for explaining about your unique type!!! Just when I think I know all there is to know, WHAM! I learn something else! :-)

For the most part, it certainly sounds as if you have this Beast kicked to the curb never wanting to be in your presence again! Markers, bloodwork, scans all clean? HOORAY!!! We rejoice in all of your good news!

I am holding my breath waiting until you find out what this node thing is~ please find out right away; I am turning blue and its just NOT my color! See how I have a way of making EVERYTHING all about me??? LOL

Hugs,
Claudia

KathiM

catwins said:

Thanks Jan
"Do they normally biopsy lymph nodes when everything else is clear?"

In my situation, there was no primary tumor and the BC was found in one swollen lymph node by a biopsy. A CT scan showed spots on my spine that "looked like cancer." This was back in 2003. The biopsy showed HER2 and ER positive so I did chemo for seven months. For the last 4 years I have been getting Herceptin and Zometa every 3 weeks.

Last week my lymph node felt larger so did another biopsy...the first since my original in 2003. It showed BC again just like before. My question has been...is it the original cancer in the original location or new cancer? If it is the original cancer in a diseased node, then I don't want to do another round of chemo. I figure that the Herceptin has contained the growth from other parts of my body since all my bloodwork and scans are clean. (Note: My bloodwork has always been normal. No tumor/cancer markers.) Doctors can't seem to give me an answer and they feel that it is safer to just start the chemo again.

I feel great right now...Herceptin has been my wonder drug. I just want to keep on keeping on. Thanks again for letting me vent.

Are they searching for the primary site?
I know, that sounds wierd...breast cancer anywhere other than in the breast....but, it does happen....

Ask about a PET scan. Maybe that will show something.

My BC was never indicated in the tumor markers, either. My rectal cancer didn't show on the CEA tumor marker for colon cancer...

Have they tested for genetic breast cancer? BRCA1 and 2?

Hugs, Kathi

mgm42

BC
I was told that breast cancer cells have a very distinctive look, different from other types of cancer cells. That's why the pathologists can tell if it is breast cancer in the another part of the body or a new cancer. I know I suffer from senior moments, but if my memory is working, then what I'm saying is correct. Good luck kiddo. I wish I had definitive answers for you. All I can do is send you a big "hug" and ask that you hang in there. Marilynn

Joycelouise

I think that every cancer is
I think that every cancer is personalized. Distribution of ES+,P+, Her2+, etc. They can recognize a new cancer because it will look different from the old. An old one that has stuck around will resemble the original cells. I think I heard once that someone had different cancers in each breast (for ex. one was Est+ and one wasn't). But, anytime I give a medical opinion, it is ALWAYS wise to ask someone else, too! Let us know how you are and how things are going. love, Joyce

NorcalJ

Joycelouise said:

I think that every cancer is
I think that every cancer is personalized. Distribution of ES+,P+, Her2+, etc. They can recognize a new cancer because it will look different from the old. An old one that has stuck around will resemble the original cells. I think I heard once that someone had different cancers in each breast (for ex. one was Est+ and one wasn't). But, anytime I give a medical opinion, it is ALWAYS wise to ask someone else, too! Let us know how you are and how things are going. love, Joyce

New BC or Old?
If your chemo actually killed off all the cancer cells, they have been broken down and absorbed by your body. Joyce is right that any new cancers can be different i.e. a diagnosis of DCIS hormone positive originally, and now someone could have an infiltrating lobular that is a triple negative (er/pr- Her2-).

All cancer cells don't look alike tho. Breast cancer cells look different from lung cancer, which looks different from brain cancer, etc. That's how they can tell if it's mets, or a new tumor, (because there shouldn't be breast cancer cells in the lung, or lung cancer cells in the brain).

You're doing the best thing by getting another opinion. Even if they both say the same thing, at least you aren't left wondering. And no two docs will explain something the same way. If you can, ask the same questions to both docs.

I'm glad you came to this site, sorry you had to.

Let us know how it goes,
Jan

mmontero38

mgm42 said:

BC
I was told that breast cancer cells have a very distinctive look, different from other types of cancer cells. That's why the pathologists can tell if it is breast cancer in the another part of the body or a new cancer. I know I suffer from senior moments, but if my memory is working, then what I'm saying is correct. Good luck kiddo. I wish I had definitive answers for you. All I can do is send you a big "hug" and ask that you hang in there. Marilynn

If I'm not mistaken and I
If I'm not mistaken and I remember a post that Cabbott had written correctly, the breast cancer cells are actually pink. That's why the reason for the pink ribbon. Hugs, Lili

RE

CANCER IN LYMPH NODES
Hello Cat,

I have had bc three times, the second time it started in an enlarged lymph much like yours that moved to my chest wall, I too was a stage 4 that was 9 years ago. The last time was a year ago and it was in my right breast. Today I saw onco man and posed your question as to how they determine if it is a new stand alone cancer, he said the following;

If it is located at a different site, it is a different cancer. They also determine this by running pathology tests that will show what the make up of the cancer cells are and that too will tells them if this cancer is new or residual. He also stated if cancer is found in one breast then years later in the other breast the second cancer is new and not residual. He said it may have similarities to the original cancer, but it is not the original cancer.

I hope this has been helpful to you.

RE