Chemo/med therapy and RCC

When you look at other types of cancer that they prescribe chemotherapy for, the drug is given and it affects every cell in your body, but works to shrink or kill the cancer cells.  That's why people end up with hair loss, skin rash, and other side effects.  As of yet they haven't been able to develop a traditional chemo drug for Kidney Cancer.

The drugs they do have go by more refined names: immunotherapy-boosting your own immune system to fight of the cancer; targeted therapy(ies)-which shrink or interfere with the blood supply to the tumor and starve it to death; or interrupt the replication of cell growth-which stops the tumor at that point.  But none of these actually kill the kidney cancer cells.

Radiation, again does not kill the kidney cancer; but it can stop cell growth and even make tumors shrink.  That's why it can be effective when the enlarging tumor is causing pain in the bone, pressure against other organs, or is interfering with body functions.

Don't we wish they had a magic pill...but alas, not yet.  I don't know how many people have assumed I've had "chemo" who are shocked to find I haven't.  Thus far, the original discovery and the two recurrences were surgically removed, and that is considered palliative care. But I'll take it, because I'm still here nearly 9 years later.

Keep reading, keep searching.  Progress is being made.

Donna

APny said:

Thanks Donna. I’m still

 

Thanks Donna. I’m still confused, lol. I do understand how the meds work, I just don’t understand why it doesn’t work right after kidney cancer but it does work on mets from the kidney cancer. In other words, the cells in the mets are RCC cells. The same cells as in your kidney tumor. So how come chemo works on shrinking the RCC cells in your lungs when they say there are no chemo drugs for kidney cancer? Those cells in your lungs are kidney cancer cells. That’s where I’m lost.

 

They give people chemo after surgery for other cancers, whether they found mets or not. So why not give it to people after kidney cancer surgery? Why wait until they find a met? If it works on the met that contains the same cells as your kidney tumor then why wouldn't it work on kidney cancer? I wish I could explain this better.

 

And yes, I wish there was a magic pill!

 

Basically, you want to know why the renal cancer cells that have crossed the barriers into the bloodstream (e.g., renal sinus invasion, renal vein invasion, vena cave intrustion, etc) cannot be eradicated with a treatment while they are waiting around in the bloodstream.

If they can be eradicated with treatment as tumors of renal cancer cells, why is it that they can't be treated until they decide to "make homes elsewhere" and show up growing as tumors (i.e., METS). 

I've never heard an explanation for "Why" and it is possible that nobody knows. 

I think, techinically speaking, you are using the word "Chemo" in your post to mean "treatments" am I correct? 

APny said:

Sblairc, yes, that's exactly

Sblairc, yes, that's exactly what I meant. For instance, after breast cancer (or any other, really) even if they think they "got it all" you still receive some form of chemo and/or radiation therapy under the assumption that some rogue cells may be left behind and are just waiting for the opportunity to take up residence elsewhere. But after kidney cancer surgery you don't get that, under the assumption that it's ineffective against kidney cancer cells. Yet those very kidney cancer cells are then treated with "chemo/med therapy" when they show up elsewhere as mets. So why would it work then but not after surgery? Why wait until they find mets?

And yes you are also right about my use of the term "chemo" to include drug therapy and that's why I used the slash as in chemo/meds therapy. I'm using the term "chemo" losely.

Anyone here know wy? 

foroughsh said:

Target Therapy

This is what I know, They never use Chemo in RCC(pre/post recurrences ) because RCC cells are resistant to chemo and, so there is more possibility that this evil comes back compared to those treated cancer types which follow normal treatment(surgery/chemo/radiation) but when it recurrences they use target therapy (Sutent,Nivolumab,IL-2,...) with works differently than chemotherapy. in target therapy, the drug works directly with existed RCC cells where ever they are found in the patient's body, so they can't use it unless there is a sign of rcc mets in patient's body. I'm sure Nano second could explain better if he read this post

Forough

I'm here.  Targeted therapies (Sutent; Votrient; Inlyta; Torisel; etc.) work by inhibiting the signals (in the form of chemicals) that tumors excrete to cause the formation of "private" blood vessels that feed them nutrients and remove their waste products.  As such, the tumors have to get to certain size before these drugs become effective.  They cannot target individual or small clumps of cancer cells because the potential tumors are too small to be "starved" for nutrients yet.

Regardless, numerous clinical trials have been attempted to see if they might work as adjuvant (preventative) therapies but, so far, none of them have been effective when it comes to mRCC.

After so many years of trying I think it is safe to say they just don't work.  However, that may not be the case for the new immune therapies (i.e. Nivolumab - Optiva; Pembrolizumab - Keytruda; etc.)

APny said:

So in other words, drugs used

So in other words, drugs used in chemo are totally different from targeted therapies and the drugs used in targeted therapies won’t work unless the tumor is a certain size? Also, are immune therapies different from targeted therapies?

Yes, "traditional" chemo drugs actually directly kill tumor (and, unfortunately) normal cells.  Targeted drugs do not.  They only "starve" the tumors which is why they generally do not shrink the tumors very much (but stability is an excellent response). 

Immune therapies are differnent than either traditional chemo and/or targeted therapies.  They do not kill tumor cells directly.  They rely on our own immune system (generally, activated T-cells) to do the killing.

Targeted therapies don't seem to work until the tumor reaches a certain minimum size.