GETTING BREAST CANCER AGAIN AND AGAIN?

cabbott said:

Pathology and Cancer
I am no doctor. That said, I am insatiably curious (though not about spelling, so bear with my spelling). When I got diagnosed with breast cancer 6 years ago,my chief way of handling all the stress was to read like crazy and I was mainly interested in the science of breast cancer. How in the world could they tell it was cancer when I never even felt a lump? My journey to decide what kind of surgery I needed took me to Johns Hopkins University Hospital. At the time, all the doctors who were also professors had pictures of cells up on their doors. Sometimes I had to wait in their offices. I saw pictures and charts of little pictures of cells. Cancer cells. At first, I figured that only doctors and med students could figure out those little pictures. I mean, they all looked a bit like ink blots and strange pink balloons to me. I knew they were cells, but they weren't anything I had in high school. One day I had to sit in the nurse's office. SHE had the little pictures on her wall. She knew what some of them were. I was intrigued. If someone other than a doctor could figure them out, I decided I could too. So I got on the internet and with my son's encouragement (he was about 11 at the time), I kept looking and found a pathology site for med students and interested parties that explained the little pictures with little paragraphs about the size my overstressed mind could handle. Eventually I found that I could also tell by looking at the cell shape and the color of the cell after staining what kind of cancer it was. Breast cancer when prepared on a slide comes up breast cancer pink. Go figure. Our favorite color this month! The cells are not regular in shape and the nucleus in the cells are really crazy in the cancer cells. Regular breast tissue has a regular shape and normal looking nucleii. I was impressed. Different kinds of breast cancer have different kinds of patterns and the chart I saw in a few of the in the breast surgeon's offices were progressions of different kinds of breast cancer. Eventually I figured out a few of the lines of the chart so I could sort of tell what I was looking at. It helped me understand what the pathology report was saying and what doctors meant when they talked about cancer even though I would hate to be tested on the subject. One thing I remember clearly though was that when the primary cancer cells traveled through the body and set up camp elsewhere (like in bone tissue, lung tissue, or brain tissue) they still stained that lovely shade of breast cancer pink. They still had the crazy shape of the original tissue. They didn't look anything like bone cells, lung cells, or brain cells. Once you could recognize a kind of tissue, it was fairly obvious when it showed up elsewhere. That's why breast cancer in the lung is still called breast cancer. It is stage 4 because it is breast cancer that has left the breast and traveled to a distant spot to set up camp. Because it is breast tissue that has moved to, say the lung, it will only respond to breast cancer chemo. Lung cancer cells respond to lung cancer medicines. When they are not sure of what they are looking at (a dilemma my thoracic surgeon had with me two years ago when my lung had an "iffy" spot that when biopsied was obviously adenocarcinoma like my original cancer), the pathologist does micro-genetic testing. I turned out to have adenocarcinoma of the lung rather than adenocarcinoma of the breast that set up in the lung. Are you cross-eyed yet? It meant that I was stage one lung cancer on top of stage one breast cancer. If I had had oatcell carcinoma of the lung, or any of the small cell carcinomas, they would have known right away that I didn't have breast cancer just by looking at it under the microscope in the operating room. But when the cells look similar, they can do genetic testing on the tissues to make sure. That took a week of testing, so I was sewed up, sent home, and then called back for more surgery a week or so later. That would have been more agonizing if I hadn't understood what they were talking about. Again, it was very important to make sure. Surgery to remove part or all of the lung is recommended treatment for stage one lung cancer. Chemo is the recommended treatment for stage 4 breast cancer in the lung. If my hospital hadn't checked, I would have had breast cancer chemo that would have never worked on the lung cancer cells and I would probably be pushing up daisies sooner than necessary. As I'd rather be looking at the daisies, I'm rather glad that science was as far along as it was when my body betrayed me a second time. I am also indebted to my oncologist that understood that the kind of breast cancer I had was not likely to travel to the lung and ordered a surgical biopsy. Some doctors wouldn't have bothered, but jumping to conclusions is not good medicine. Lucky as I have been though, I do wish they would come along with a cure soon!

C. Abbott

cabbott said:

Pathology and Cancer
I am no doctor. That said, I am insatiably curious (though not about spelling, so bear with my spelling). When I got diagnosed with breast cancer 6 years ago,my chief way of handling all the stress was to read like crazy and I was mainly interested in the science of breast cancer. How in the world could they tell it was cancer when I never even felt a lump? My journey to decide what kind of surgery I needed took me to Johns Hopkins University Hospital. At the time, all the doctors who were also professors had pictures of cells up on their doors. Sometimes I had to wait in their offices. I saw pictures and charts of little pictures of cells. Cancer cells. At first, I figured that only doctors and med students could figure out those little pictures. I mean, they all looked a bit like ink blots and strange pink balloons to me. I knew they were cells, but they weren't anything I had in high school. One day I had to sit in the nurse's office. SHE had the little pictures on her wall. She knew what some of them were. I was intrigued. If someone other than a doctor could figure them out, I decided I could too. So I got on the internet and with my son's encouragement (he was about 11 at the time), I kept looking and found a pathology site for med students and interested parties that explained the little pictures with little paragraphs about the size my overstressed mind could handle. Eventually I found that I could also tell by looking at the cell shape and the color of the cell after staining what kind of cancer it was. Breast cancer when prepared on a slide comes up breast cancer pink. Go figure. Our favorite color this month! The cells are not regular in shape and the nucleus in the cells are really crazy in the cancer cells. Regular breast tissue has a regular shape and normal looking nucleii. I was impressed. Different kinds of breast cancer have different kinds of patterns and the chart I saw in a few of the in the breast surgeon's offices were progressions of different kinds of breast cancer. Eventually I figured out a few of the lines of the chart so I could sort of tell what I was looking at. It helped me understand what the pathology report was saying and what doctors meant when they talked about cancer even though I would hate to be tested on the subject. One thing I remember clearly though was that when the primary cancer cells traveled through the body and set up camp elsewhere (like in bone tissue, lung tissue, or brain tissue) they still stained that lovely shade of breast cancer pink. They still had the crazy shape of the original tissue. They didn't look anything like bone cells, lung cells, or brain cells. Once you could recognize a kind of tissue, it was fairly obvious when it showed up elsewhere. That's why breast cancer in the lung is still called breast cancer. It is stage 4 because it is breast cancer that has left the breast and traveled to a distant spot to set up camp. Because it is breast tissue that has moved to, say the lung, it will only respond to breast cancer chemo. Lung cancer cells respond to lung cancer medicines. When they are not sure of what they are looking at (a dilemma my thoracic surgeon had with me two years ago when my lung had an "iffy" spot that when biopsied was obviously adenocarcinoma like my original cancer), the pathologist does micro-genetic testing. I turned out to have adenocarcinoma of the lung rather than adenocarcinoma of the breast that set up in the lung. Are you cross-eyed yet? It meant that I was stage one lung cancer on top of stage one breast cancer. If I had had oatcell carcinoma of the lung, or any of the small cell carcinomas, they would have known right away that I didn't have breast cancer just by looking at it under the microscope in the operating room. But when the cells look similar, they can do genetic testing on the tissues to make sure. That took a week of testing, so I was sewed up, sent home, and then called back for more surgery a week or so later. That would have been more agonizing if I hadn't understood what they were talking about. Again, it was very important to make sure. Surgery to remove part or all of the lung is recommended treatment for stage one lung cancer. Chemo is the recommended treatment for stage 4 breast cancer in the lung. If my hospital hadn't checked, I would have had breast cancer chemo that would have never worked on the lung cancer cells and I would probably be pushing up daisies sooner than necessary. As I'd rather be looking at the daisies, I'm rather glad that science was as far along as it was when my body betrayed me a second time. I am also indebted to my oncologist that understood that the kind of breast cancer I had was not likely to travel to the lung and ordered a surgical biopsy. Some doctors wouldn't have bothered, but jumping to conclusions is not good medicine. Lucky as I have been though, I do wish they would come along with a cure soon!

C. Abbott