Are metastasis and recurrence different?

foroughsh
foroughsh Member Posts: 779 Member
edited October 2014 in Kidney Cancer #1

I was diagnosed with RCC (T2B) with no metastasis and had a radical nephrectomy two months ago, now my questions are:

 1) Is there a difference between metastasis and recurrence or are they the same?

 2) With your own experience in my case (10 cm, confined to the kidney, cystic Eosinophilic rcc, grade II, no metastasis) how possible it is to have metastasis/recurrence in the future?

 3) How does Rcc's metastasis respond to treatments such as chemotherapy, Immunotherapy?

 4) How possible is to have a normal life for patients like me? I mean is it possible for RCC to cure?

 Thanks a million

 

Comments

  • icemantoo
    icemantoo Member Posts: 3,361 Member
    my thoughts

    These are my thoughts and should NOT be substituted for your doctor's opinion.

     

    1. Mets are where your Cancer spreads which depends in large part on your tumor pathology and size. Recurrancce is where you develop Cancer in the other Kidney which according to my doctor occurs in about 2 % of the cases. A small risk, but higher than the general population's chances of getting Kidney Cancer in the first place.

    2. The reason you have scans is to nip any mets or recurrance in the bud while they are easier to deal with. As far as chances for mets ask your doctor or others may chime in as my experience (no mets or recurrance) is with a smaller tumor. From my experience cysts on your kidney and nodules on your lung are monitored by the use of scans and are in most cases  normal and nothing to worry about  as long as they remain small.

    3. I have no personal knowlege, but from others there are many sucess stories on this board.

     

    4. Very possible. Others will chime in with there experiences.

     

    Icemantoo

  • NanoSecond
    NanoSecond Member Posts: 653
    Some answers

    1.  It is my understanding that metastases and "recurrance" usually refer to the same thing.

    2. It is possible to have mets because there are always microscopic cells that are being (or have been) shed from your primary tumor.  These cells can take up residence anywhere in the body and can stay quiescent for years before developing into mets.  The larger the tumor - and the more differentiated its cells makeup - the more likely the risk of mets of developing at some point.

    3. Most mRCC does not respond to "traditional" (cytotoxic) chemotherapy.  The exception to that rule is if the mRCC has turned very aggressive. The only version of mRCC that has been consistantly shown to respond to HD IL2 immune therapy is clear-cell (but only 5-9% of clear-cell patients get a complete response to it). To date about 20% of the patients who have been given anti-PD1 (Nivolumab or Pembrolizumab) have responded to it but, again, only 5-8% have gotten a complete response.  However, if you combine either one of these anti-PD1's with an anti-CTLA4 (i.e. Ipilumumab) the response rate goes up to about 48%.  All these numbers remain preliminary and probably deceptive.  These drugs have not been around long enough to be tested on any large population of patients as yet.

    4. Normal life is certainly possible.  That is the goal - to turn what was formerly a "terminal" disease into only a chronic one.  However, there is no such thing as a "cure" for mRCC. At least not yet.

  • danbren2
    danbren2 Member Posts: 311
    Try to Just Live!

    foroughsh,

         Everything is possible and nothing is impossible! Try to just live everyday and be thankful for everything and everyone in your life.  Here wishing you no mets and no reoccurence!

                                                                Prayers for good health!

                                                                 Brenda

  • donna_lee
    donna_lee Member Posts: 1,041 Member
    danbren2 said:

    Try to Just Live!

    foroughsh,

         Everything is possible and nothing is impossible! Try to just live everyday and be thankful for everything and everyone in your life.  Here wishing you no mets and no reoccurence!

                                                                Prayers for good health!

                                                                 Brenda

    Your question gets a Yes and a No.

    Any time the cancer from the original site has spread to another or adjacent organ, bone, etc., it is considered Metastasized.

    At the time of diagnosis, mine had already gone to the liver and they weren't sure where else.  Upon surgery, the RCC was the blob they saw in the left half of the liver, but the little spots in the right half were just cysts.  But the RCC had invaded the set of lymph nodes behind the cancerous kidney that was removed.  The set of nodes was removed.

    The surgeons said, "We got it all."  but what that means is they removed everything that was suspected to be cancerous on visual or biopsy inspection..

    Now jump ahead one year after CT's every 3 months.  There was a node that had enlarged between the 9 and 12 mo. exams. Removed-RCC.  A year later, the same story.  Another node enlarging.  Removed-RCC.  Obviously, there was Mets.  But they were slow growing and didn't show visibly on any of the earlier tests.  But was it a Recurrence?  Not likely; because it was probably there all the time.

    So in 2014, I have been 5 years with NED (no evidence of disease) {You'll learn the acronyms quickly}.  And I don't want any recurrences in my Trick or treat bag, this year or any year.

    We go get our tests, find out the results, have the surgery or take the drugs (which they now have for kidney cancer) and get on with living.

    And Be a Survivor.  That's an order.

    Donna

  • sblairc
    sblairc Member Posts: 585 Member
    In the interest of clarity on this topic. . .

    It sees logical that if the original tumor from a partial neprectomy re-grew back in the same remaining kidney, that would be considered a "recurrence" without necessarily being "metastatic" disease. A full neprectomy might then be necessary. I don't know if I've ever heard of that here, but it seems plausible. Comments welcome! 

  • icemantoo
    icemantoo Member Posts: 3,361 Member
    sblairc said:

    In the interest of clarity on this topic. . .

    It sees logical that if the original tumor from a partial neprectomy re-grew back in the same remaining kidney, that would be considered a "recurrence" without necessarily being "metastatic" disease. A full neprectomy might then be necessary. I don't know if I've ever heard of that here, but it seems plausible. Comments welcome! 

    I googled recurrance which is defined as the return of Cancer after a period of remission which fits in the middle of the above discussions. It also appears that the words mets and recurrace are used interchangably. Either way we want nothing to do with either.

     

    Icemantoo

  • Ree_Maryland
    Ree_Maryland Member Posts: 161 Member

    Some answers

    1.  It is my understanding that metastases and "recurrance" usually refer to the same thing.

    2. It is possible to have mets because there are always microscopic cells that are being (or have been) shed from your primary tumor.  These cells can take up residence anywhere in the body and can stay quiescent for years before developing into mets.  The larger the tumor - and the more differentiated its cells makeup - the more likely the risk of mets of developing at some point.

    3. Most mRCC does not respond to "traditional" (cytotoxic) chemotherapy.  The exception to that rule is if the mRCC has turned very aggressive. The only version of mRCC that has been consistantly shown to respond to HD IL2 immune therapy is clear-cell (but only 5-9% of clear-cell patients get a complete response to it). To date about 20% of the patients who have been given anti-PD1 (Nivolumab or Pembrolizumab) have responded to it but, again, only 5-8% have gotten a complete response.  However, if you combine either one of these anti-PD1's with an anti-CTLA4 (i.e. Ipilumumab) the response rate goes up to about 48%.  All these numbers remain preliminary and probably deceptive.  These drugs have not been around long enough to be tested on any large population of patients as yet.

    4. Normal life is certainly possible.  That is the goal - to turn what was formerly a "terminal" disease into only a chronic one.  However, there is no such thing as a "cure" for mRCC. At least not yet.

    t1b and 2b

    what is the diffeernce beside the numbers. why 1b and 2b does the b have to do with the size or the stage? 

  • foroughsh
    foroughsh Member Posts: 779 Member

    t1b and 2b

    what is the diffeernce beside the numbers. why 1b and 2b does the b have to do with the size or the stage? 

    It's called TNM System

    Hi Ree_Meryland

    It's called TNM System which is based on the size of tumor (T), the possibility of distant metastasis (M), the possibility of the spread to regional lymph nodes (N). The stage of kidney cancer is calculated based of this system.

    http://www.cancer.org/cancer/kidneycancer/detailedguide/kidney-cancer-adult-staging