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What happens with the dead cancer cells after chemotherapy?

dana-mihaela's picture
dana-mihaela
Posts: 39
Joined: Sep 2016

Hi All,

I was wondering what happens with the cancer cells that were killed by chemotherapy? How are they eliminated by the body, is that by the immune system? What is left after chemo from a tumor larger than 6 cm in diameter? Scar tissue? How long it takes to get rid of all this debris of dead cells? I suppose each body is different and it depends of the immune system which is compromised to begin with.

I would really appreciate if you could give any imput, I tried to find with dr. Google but not much comes up. I was thinking to ask my oncologist for my next appointment.

Thank you,

Dana

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3293
Joined: May 2012

Dana,

Most dead cells are filtered via the liver, which is part of why enzymes can get out of range. A specialty blood test, routine when on chemo, is LDH -- it detects dead cell matter in the system. Your lab reports very likely list LDH results.

My oncologist, sort of out of the blue one day, told my wife and I that the larger nodes, after the cancer cells are all killed off, become like empty pecans, and are a sort of scar tissue.  I was recalling that yesterday, which made your question compelling for me to reply to.

No doubt, even in full remission, cancer treatments leave battle scars. But they are a necessary thing, a small price to pay,

max

po18guy
Posts: 994
Joined: Nov 2011

Trillions of normal dead cells are processed and eliminated by our bodies daily. Once dead, tumor cells are processed just like any other dead cell. Having said that, in leukemias and lymphomas, tumor cells are often killed by lysing (basically tearing open) their membranes. This causes their contents to enter into the blood stream, which creates an excess of certain substances. This is known as tumor lysis syndrome. However, that is normally the case when large masses are involved and response to treatment is rapid. In my case, I had 50+ tumors and response was rapid. Doctor watched for tumor lysis syndrome, but it did not occur.

Scar tissue can indeed be left behind, and may cause symptoms by itself. Some nodes never return to their former size.

lindary's picture
lindary
Posts: 650
Joined: Mar 2015

Before my first chemo my oncology nurse told me it was very important to drink a lot of water after the chemo to flush the un-used chemo out of my body as quickly as possible. When I aksed how many days I had to keep drinking a lot of water she told me daily throughout treatments because I also will be flushing out the dead cells. The more water the better it will be for my kidneys & liver. The goal I set for myself was 2 liters every day. I was not a big water drinker then but now it is normal for me to drink water all day. 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3293
Joined: May 2012

Dana,

Linda of course is completely correct regarding the benefit of drinking a lot of water while on chemo, including between cycles.  I have never had much taste for water, and it was difficult for me to drink a lot of it, preferring my black or green teas or coffee, and the breakfast drinks that I later had to depend on.  Since these have a diuretic effect, I guess they were still of value in flushing the system.

Too much water can be toxic and even fatal, when it washes all of the electrolites out of the blood, but this is extrememly rare, and requires obviously excessive amounts of water intake.

A note on the LDH test I mentioned before. My tumor sizes tracked EXACTLY with my LDH levels; it was remarkable. No other lab result was as indicative of the chemo effectiveness as LDH, but I cannot say that this is true for all, or even most, patients.   LDH is a test that used to be administered in ERs to test for heart attack, but it has since been replaced by more accurate blood tests as regards cardiac tissue death.

Labs DIFFER in what tests they include with various "Group" tests, such as "CBC" or "CMP" (Comprehensive Metabolic Panel).  This article says that LDH is usually part of a CMP, but at my lab, it was not: LDH was a separate line item, not included in the CMP, and ordered separately by my oncologist.  Look at whether LDH tests are being run, and if not, ask why not.

max

LDH:  https://labtestsonline.org/understanding/analytes/ldh/tab/test/

Water intoxication:  http://www.webmd.com/fitness-exercise/features/water-intoxication#1

 

.

dana-mihaela's picture
dana-mihaela
Posts: 39
Joined: Sep 2016

Thank you for this information about LD. I looked back on my analyses and indeed my doctor asked for this besides the WBC always. Before I started chemo LD was 215. I see that normal values are lower than 180. After I finished chemo it was 170 and now 3 months later it is 153. So I think this is good.

My question about what happens with the dead cells was because my tumor was big over 6cm diameter localized in the pelvic behind spinal cord and my thinking is that those cells cannot just disappear it takes time for the body to dispose of and is there any scar tissue left that would always be there? How long it takes for the body to dispose of all this dead tissue? Can we do anything to accelerate the healing?

Too many questions I think...

Dana

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3293
Joined: May 2012

Dana,

In my layman's, non-medical understanding, your LDH sounds great.

Your questions are reasonable and understandable. A 6cm tumor is indeed very large. The pressure of the surrounding organs and tissues have no doubt by now collapsed it down to nothing. Chemo kills astronomical numbers of cells very rapidly, and just know that NED/CR means it is time to celebate and stop worrying. 

You will heal gradually, do not push it. Tiredness is a normal reaction of the body healing. Allow yourself to rest as necessary.  I read of people taking on new jobs, new this, new that while on chemo and I wonder: Why would a person do such a thing ?

There are no magic diets: Just eat healthy, with plenty of greens and fiber, and limit red meat.  Teas, coffee, are healthy for everyone. This is as much as a person can do, but it will help you regain strength.

max

tryshz's picture
tryshz
Posts: 14
Joined: Jan 2017

After I read this, I went and checked out my blood tests - and found this was done at every blood draw since March - except this last one in December when I started maintenance Rituxan.  I looked up the link you provided (thank you!!) and read it all - it said the 'normal' range was from 92 - 194 approx. Does that mean that it has to go over the top range to be a bad thing? Mine seem to be up and down in the 145-155 range - and I'm not sure what that means. Numbers went down for last time I got Rituxan, but then went back up even before it was done (once a week for 4 weeks) - and the subsequent PET scan donfirmed that the cancer was not gone, but about half the lesions were bigger.  Thanks for the info - I will be adding this to my questions for the oncologist in February.

Trish

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3293
Joined: May 2012

I'm assuming the question was directed to me Trish, and let me say that I'm glad you've joined and are benefitting from the discussions.

Obviously LDH in the normal range is to be preferred. Not all cancers skew the various blood tests the same way, and while LDH was very predictive of node size for me, it might be less.so for others. During my time before and throughout treatment, my WBC counts were almost never outside normal range, which is quite odd. Go figure. But I did have LDH as high as 600, if I recall correctly, here six years later.

You are correct: ask the oncologist about your specifics.

max

tryshz's picture
tryshz
Posts: 14
Joined: Jan 2017

Yes, the question was directed to you - sorry I wasn't more specific - had to do some looking to find where you had put the link, so I just answered it when I found it! I so appreciate your answer and encouragement. Helps me to find out as much as I can, and to collect the questions for my onc when I see  him. Your experience with the LDH has helped me understand that better, and to know where to look for it on my bloodwork printouts. It is a huge help to me to find out all I can, helps me feel like I'm a little bit more in control of what is going on with me!

You've also helped me get out of my pity-party mode and back into fighting mode - and that is definitely a good thing!

trish

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3293
Joined: May 2012

More Rocky, less Ally McBeal:  a formula for success !

tryshz's picture
tryshz
Posts: 14
Joined: Jan 2017

Oh, yeah!!

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