Why cancers possess a wanderlust, spreading from one site to another, has been one of the most confounding questions in medicine, and now New York scientists have unmasked the role of infinitesimal “scouts,” cells and proteins that coalesce to seek out fertile ground for a tumor’s spread.

The finding turns a corner in the history of cancer research, experts say, demonstrating that a series of ominous events lead these scouts — dispatched by the tumor itself — to find fresh ground and lay a foundation for a new cancer. In some cases, the foundation can be laid years before seeds of the new tumor arrive.

“For many years it was thought that cancer was happening in one way: A tumor developed, a piece of it broke off and traveled through the bloodstream and planted somewhere else. Even though people forever and a day thought that this was the case, we now realize that there is more to it than that,” said Dr. Rosandra Reich Kaplan, a pediatric oncologist who holds joint appointments with Weill Cornell Medical College and Memorial Sloan-Kettering Cancer Center in Manhattan.

She said the finding opens a new window on understanding cancer, and could soon lead to new diagnostic targets and more treatments. “We’re hoping to conduct a very large trial with patients in about a year or two,” Kaplan said.

Dr. Goarav Gupta, a cancer researcher at Memorial Sloan-Kettering, who was not involved in the research, broached a similar possibility earlier this year when he described how his studies eavesdropped on the “crosstalk” between the initial tumor and the spot to which it spread. Kaplan and her colleagues delineated the multiple steps in this network.

BY DELTHIA RICKS
STAFF WRITER
Posted December 22 2005, 9:51 PM EST

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Wednesday was the PET scan and yesterday was the biopsy. THe PET scan was a piece of cake, the biopsy was an all day affair.

I want to know why: a doctors office will send you for an appointment, and they don’t bother telling you any specifics. Like, you ask:

How long will I be at the hospital?
They say: no more than a couple of hours.

Doctors office tells you not to eat or drink anything from midnite on.
You get to the hospital, nurse takes your vitals, etc, you mention you can’t wait for a cup of coffee, and bam! she brings you one.

The nurses and the “medically trained” – for lack of a better description – are wonderful. But the people at the hospital registration desk, while nice and efficient to a point, need a tad more training. The girl who registered us yesterday told us where to go. I specifically made her draw me a map. We go to the designated place – it was the wrong place. This happened two weeks ago as well. Why can’t they pick up a phone and confirm where a patient needs to go? My mom can’t walk very far. If a patient is sick, is there by themselves, whatever, they don’t want to wander hospital corridors.

I know I was worn out from the whole thing. I can imagine how mom felt.

We went to the oncologist today. Mom does have lung cancer. Exactly what kind; I don’t know.

Why does this stuff take so long?

Anyway, the oncologist didn’t say anything that we didn’t already know. He did say that Moms tumor is unusual in that it’s shape is almost perfectly round. He said that this is indicative that the cancer started somewhere else in her body, that lung cancer that started in the lung usually has “strings” or “fingers” – I forget exactly what he said, but it’s usually not in a big ball like moms is.

Part of the cat scan report from last week reads:

5.9 x 4.3 cm soft tissue density mass in the posterior right lower lobe, highly
suggestive of a primary bronchogenic malignancy.
Thickening of the left adrenal gland. This is a non-specific finding, which may
represent hyperplasia or early metastatic disease.

I emailed her xrays and cat scan study files to bro who then showed them to a radiologist out west who said the cancer looks like it has spread.

The oncologist disagrees with this, at least for now.

The next step is a PET Scan – Positron Emission Tomography or Pet Imaging

Most commonly used to detect cancer, Positron Emission Tomography is a diagnostic examination that involves the acquisition of physiologic images based on the detection of radiation from the emission of positrons. Positrons are tiny particles emitted from a radioactive substance administered to the patient. The subsequent images of the human body developed with this technique are used to evaluate a variety of diseases.

The oncologist also said that Mom is not a candidate for surgery, nor is she a candidate (-jeez is she running for office??) for chemotherapy, because the chemo will make her sick and she likely won’t survive it.

So for now, we wait for the Pet scan to be scheduled and more info as to what the doctors see.

Big bro called today.

He talked to Moms doctor a couple of days ago and apparently the doctor thinks her condition isn’t good, and that her prognosis will not be good.

Depending on specifics – which we don’t know, should she have cancer, and depending on what kind it is, if she has to have surgery, whether a biopsy or to remove part of her lung or her whole lung, chances are good that she won’t survive the surgery because of her age and the fact that she’s so frail.

Since there are no other xrays/tests to tell us when this thing in her lung started: last week starts the baseline. The doctor has no idea when it may have started, is it small cell (? – 2 different types were mentioned, but I can’t remember them both right now) or the other one. One is localized, surgery can be used to treat, along with chemo, etc. The other one is the spreadable one, goes into the lymph nodes and other parts of the body. Is it fast moving or slow moving?

I took Mom to the doctor today for her annual checkup.

I think, for the first time ever in the history of my moms life, the doctor may have found something serious.

There is a mass on my mothers lower right lung, about the size of an orange. Her last chest xray, taken 2 years ago, shows no such thing. While Mom doesn’t seem to be upset, hell she seemed almost happy! for Gods sake, her kids are a tad upset. Even her doctor is more upset than she is, and his head nurse was actually visibly shaken at this.

So we are currently waiting her lab results, once they are in (tomorrow) she is to be scheduled for a CAT scan and then I guess we’ll go from there.