Questions re: Counts and more

bdean said:

I reconnected with a childhood friend of mine when I was dx. with cancer. Her Mother had it many years ago, and I knew she would want to talk. She just asked me straight out if I would mind all her questions because so much had changed and she wanted to be as aware of what was going on with me as she possibly could. I didn't mind at all answering all of her questions, and there were a lot. Your friend will probably feel the same. I will try to answer some of these as best as I can.
The brighter spots on her spine could be an indicator of bone mets--not absolutely, but could be. My onco. refers to bright spots as 'hot' spots. My doctor does not use tumor markers so I am not familiar enough with counts to advise you. I know when they go up it means cancer is not responding, maybe getting more aggressive. Going back to spine--the doctors probably will not do anything aggressive about them; maybe Aredia if it turns out to be cancer; if she is in pain--maybe radiation to those spots.
Once cancer has mestastasized, surgery is a last ditch effort to give relief and stop unusual growth, so it is rare for them to do so. All tumors can be different and doctors view treatments in different ways--her doctors may do things very differently from mine. Her doctor probably made her quit working because of low white blood counts.(White cells fight infections in one's system). You are very vunerable to infections when on chemo and have low counts. She needs to save her energy.
As far as being in remission- it depends on how you interpret the word. I do as-- symptom free. It doesn't mean cancer is completely gone - because there is no test that can prove this 100% - but that there is no longer any activity. Cure should mean that doctors believe that body is totally clean and clear of any more cancer cells. As I said I do not know how they can make that promise without a much better and more accurate blood test.
According to a scientist on a NOVA program I was watching, one malignant tumor, no more than 1 centimeter in size, can express millions of cancer cells--the immune system and cancer drugs hopefully kills all of them; but sometimes a few stubborn cells can go dormant for several years, hiding somewhere that doesn't show up--then for some reason they will reactivate months or years later.
Sometimes, a person with cancer does want to talk about her treatments and problems, but is afraid to do so in case, their friend doesn't want to hear about it. Do let her know that you are only asking questions so you will know what she is going through since you are not familiar with chemos, markers; scans, etc.
May God be with you and your friend.
Brenda

pamtriggs said:

The counts referred to are protein marker counts. They are much the same as PSA counts in men with prostate cancer. In breast cancer the protein marker is CA15-3. The normal count in a non cancer patient is less than 20. They rise as the amount of cancer present increases. Mine were 190 on diagnosis of metastatic disease last year. They dropped to 60 but started rising again at Xmas when hormone medication failed. They have since risen to 170 but since being on chemo they are starting to drop a little. Not all doctors use marker tests but realisation is coming that in some women they are a very good indicator of the state of her disease. In mine they are spot on everytime & as they rise a new tumor pops up. The bright spots are probably what my oncologist calls hot spots and are signs of metastatic disease in the bones. A full bone scan shows these up. but an MRI or CAT scan is needed to determine the size. Metastatic diseas is not operable as the sites are often too numerous & once in the bones new ones pop up all the time. Chemo is the best attack. I am stage 4 and know that I have a big battle on hand to slow the course of the disease but I'm trying everything there is out there. Hope this has answered some of your questions.

Love Pam