BREAST CANCER RESEARCH RIGHT NOW! #30: Breast Implant “cold spots”?

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today...

Another wrinkle in the changes brought by breast cancer, double mastectomy, chemotherapy, and breast reconstruction. Last night, my wife mentioned that there were cold spots on her skin over the saline implants she has. I checked them myself and they DID feel cooler than the surrounding skin.

Hence today’s subject.

There’s remarkably little written about the way external temperatures affect the saline or silicone gel in standard breast implants, though I did find this:

“Implants placed after mastectomy tend to be a little cooler than the rest of the body, and a complaint or feature that women do appreciate over time, especially in women in colder climates. This is because the implants are filled with saline or silicone and essentially sit outside the chest cavity and just beneath the skin. They probably are, in fact, a degree or a few degrees cooler than the true body temperature.” Kristin Brill, M.D., F.A.C.S.

We are, in fact, in the middle of a cold spell – actually our part of the country is in a cold spell from October through April – and while she hadn’t experienced this exactly before, there IS some evidence that while it’s unusual, it’s not unheard of:

“To answer your question--yes, there are reports of implants being affected by cold weather. This is more likely with saline implants, but also occurs with silicone. People report breast pain, and occasionally a change in feel during the cold months. There is no good data to say how often this occurs--however it is certainly not universal. This appears to lessen with time, however can last years. The likelihood depends on the procedure--where exactly the implant is placed.”

“Many drugs used to treat breast cancer…can damage nerves outside of the brain and spinal cord. This can sometimes lead to symptoms (mainly in the hands and feet) like numbness, pain, burning or tingling sensations, sensitivity to cold or heat, or weakness. In most cases this goes away once treatment is stopped, but it might last a long time in some women…”

Not sure how MUCH of an explanation it is, but without regular contact with the plastic surgeon and the breast cancer expert, there’s not much else we can do but check the internet (using RELIABLE sources) and wait until the next checkup…

Resources: http://www.breastcancer.org/treatment/planning/ask_expert/2008_05/question_39, https://www.zocdoc.com/answers/2987/does-cold-weather-affect-breast-implants, http://www.cancer.org/acs/groups/cid/documents/webcontent/003090-pdf.pdf

Image: http://www.medicalnewstoday.com/images/articles/279/279108/woman-checking-breast.jpg

ENCORE #7! – Metastatic Breast Cancer: Liver Cancer

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in December of 2011.

This is not a cancer you hear about frequently, though it is third worldwide after lung and stomach in the number of deaths each year. It is uncommon in the United States with three fourths of all cases diagnosed in Southeast Asia, Mozambique and South Africa.

It is one of the least common of the metastatic breast cancers with bone cancer being 70% of the metastases and brain cancer being 10%. The remaining 20% are distributed between liver, lung and non-specific systemic diseases.

Metastatic breast cancer-caused liver cancer can show up as a significant weight loss, jaundice (getting yellow skin – this condition is sometimes seen in newborns (our son was jaundiced at birth)), and elevated liver enzymes (Inflamed or injured liver cells leak higher than normal amounts of Alanine transaminase (ALT) [This enzyme causes certain reactions to happen in the body that provide for cell energy and brain signal transmission] and Aspartate transaminase (AST) [which helps in the formation of the amino acids used to make several different body proteins such as hemoglobin], into the bloodstream). Other symptoms of MBC are abdominal pain, loss of appetite, fevers, nausea, sweats and vomiting. In some cases, there are no symptoms.

Tests that may be done to diagnose liver metastases include a CT (Computer Assisted Tomography) scan of the abdomen, liver function tests (to check for the elevated enzymes mentioned above), MRI (Magnetic Resonance Imaging) of the abdomen, PET (Positron Emission Tomography) scans or ultrasound of the liver

Pain from this kind of liver cancer responds to chemotherapy and analgesia. Doctors can also try radiation therapy to relieve pain and shrink the cancers.

How well you do depends on the location of the original cancer and how much it has spread to the liver. As recently as January of 2011, doctors have added a new treatment to the arsenal: Resection (removing parts of the liver affected by the cancer) of breast cancer liver metastases paid off in a survival benefit in patients with chemotherapy-responsive, estrogen receptor (ER)-positive primary tumors, according to data from a retrospective chart review.

“Although the cases were small in number, they are relevant in the context of changing views about cancer that metastasizes to the liver…I think there has been a [dramatic change in thinking] over the past 10 years or so, where it has been realized that this surgery can lead to long-term survival…I don't think that was recognized previously…I think there has been something of a nihilistic attitude toward breast cancer metastasis to other organs in the past…Generally incurable, most liver metastases from breast cancer are treated with chemotherapy or hormonal therapy,” said Daniel E. Abbott, MD, of the University of Texas MD Anderson Cancer Center in Houston. “I think this information is most valuable when people are willing to counsel patients and make the tougher decisions about who should and should not have surgery and then let patients make informed decisions.”

References: http://www.breastcancer.org/treatment/surgery/new_research/20110123.jsp

http://en.wikipedia.org/wiki/Metastatic_breast_cancer

Image: http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg

GUY’S GOTTA TALK ABOUT...#12 – What The Heck Does “Metastasize” MEAN?

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

We got news a few days ago that a friend of mine with skin cancer may have had a site that it had metastasized to.

With a swelling knee, he went to the doctor. Fearfully, he reported that the clinic was afraid that his cancer had spread. He underwent a full day of blood tests, ultrasounds, and had fluid withdrawn from the area as well.

While the upshot is that his skin cancer HAD NOT SPREAD (hallelujah!), it got me to wondering.

I did a series of articles on metastatic breast cancer a few years ago – two of them are the most read on the blog. My own recent brush with skin cancer has made me very aware of the possibility of my own cancer spreading.

So I did some reading. The type of skin cancer that I had has a microscopically small chance of metastasizing. My friends type does in fact spread.

How EXACTLY does breast cancer, skin cancer, and other kinds of cancer spread? “By metastasizing, dummy!"

“Yeah, yeah, yeah,” I would reply. (I’d also make a smart aleck remark about the Beatles.) “But HOW does it spread? How do cancer cells get from the skin to the knee or from the breast to the bones? Do they just pack up their little twisted chromosomes, wave to their family of twisted cells, and head on our into the Wide World of the body they’ve coopted for their evil intent?”

So, I did my research, starting (and I ONLY start here, I use the primary sources shortly afterward!) with Wikipedia.

Wiki defines metastasis as “the spread of a cancer or disease from one organ or part to another not directly connected with it.”

Hmmm…while that’s simple to understand, it doesn’t bring me any closer to WHAT happens. I don’t understand! Turns out, neither does the medical community, exactly: “Metastasis is a complex series of steps in which cancer cells leave the original tumor site and migrate to other parts of the body via the bloodstream, the lymphatic system, or by direct extension.”

When DOCTORS say the steps to metastatic cancers spreading, it often means that they don’t know exactly what’s happening. Great – that should be the next Great Discovery, “How To Stop The Spread Of Cancer Cells”…

So, here goes.

“Cancer occurs after a one single cell in a tissue is progressively genetically damaged to produce cells with uncontrolled proliferation.” The question I have is WHAT is it that does the genetic damage? With over a hundred different cancers, the list is probably just as long. There ARE things we know of that can damage cells on a genetic level – the ultraviolet rays of sunlight can damage cell genes, switching on the cell to grow uncontrollably. This, naturally, leads to skin cancer.

The chemicals in cigarette smoke (which contains 7000 (!!!) DIFFERENT substances) are mostly harmless. But of those several thousand, seventy are known to damage the genetic components of cells – plus the RADIATION that tobacco plants pick up and concentrate in their leaves. The obvious end result here is lung cancer.

Other chemicals in the environment, as well as carrying a family history of different kinds of cancer also damage cells and create the “runaway effect” that characterizes ANY cancer.

So WHAT happens then?

Cells grow out of control resulting forming a tumor. In the case of my own skin cancer, simple removal of the offending (or affected) area stops the cancer. Monitoring over the rest of my life will be a part of every checkup from now until the day I die. In my wife’s case, chemicals specifically targeted to annihilate breast cancer cells were introduced to her body after the source of the cancer cells – breast tissue – was surgically removed in a double mastectomy. She is now cancer-free, as is the wife of a good friend of mine and one of my colleague teachers. Again, monitoring over the rest of my wife’s life will be a part of every checkup and physical.

The effort to first destroy the SOURCE of the cancer and then destroy those cells wherever they may have “landed” using chemicals, radiation, and physical excision of tissue is how doctors stop the spread of cancer.

But there's LOTS more. I've gone on enough. Next time around, I’ll be delving deeper into this whole concept of METASTASIS...

Resource: http://en.wikipedia.org/wiki/Metastasis

Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #6! – Metastatic Breast Cancer: Bone Cancer

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in December of 2011…

We just got news this week that a “cancer friend” of ours had a bone scan, and after an extended time of treatment, she is cancer free!

But just what IS bone cancer and why did she get it?

The cancer, while it can certainly occur by itself, is what is called metastatic breast cancer. It happens when cancer cells from the breast escape into the blood stream or the lymph system and invade MORE new flesh.

While bone cancer is the most common – 70% of metastatic breast cancers are of this ilk – the other 30% is made up of brain cancer (10%) and lymph, lung and liver cancer. Let me emphasize here that these cancers are NOT the peculiar type of cancer cells that initiate these diseases in people who have never had breast cancer. These cancers are BREAST CANCER cells that have invaded other organs and therefore are called metastatic breast cancer. The word “metastatic” was used in the 1570s and comes from the Greek metastasis which means "transference, removal, change.” The roots are meta which means "over, across" plus the word histanai which means "to place, cause to stand.” The medical use for "shift of disease from one part of the body to another" dates from 1660s in English.

Bone cancer caused by the invasion of breast cancer cells into the bones can first show up as back, bone, or joint pain lasting more than two to three weeks that seems to be getting worse; numbness or weakness in a particular part of the body; a change in bowel or bladder activity, such as problems with incontinence or not being able to urinate or have a bowel movement. This may be a sign that the nerves in your backbone are getting pinched by the cancer.

As well, blood tests can reveal a buildup of calcium or tumor markers (special proteins in the blood) like CEA (carcino-embryonic antigen), CA (cancer antigen) 15-3 or CA 27-29 that suggest the cancer might be in the bones. Calcium build up might also show up in a routine bone scan. These tests are NOT usual and are typically ordered only if the symptoms appear.

Metastatic bone disease (MBD) caused by invading breast cancer often behaves in a “mixed osteolytic (destroys bone cells) and osteoblastic (causes abnormal growth of bone cells) manner”. Bone destroying or bone growing MBD occurs because the different cancer cells give off chemicals that interfere with the naturally occurring cells in the bone and cause bone destruction, new bone formation, or both. MBD weakens the affected bones, people with the disease are prone to fractures. Broken bones caused by MBD are termed "pathological fractures."

The most common treatment options for MBD include radiation and medications to control pain and prevent further spread of the disease, and surgery to stabilize bone that is weak or broken. By killing the cancer cells, radiation relieves pain, stops the tumor from growing and can prevent the bone from breaking. Radiation can also be used to control the cancer after surgery to fix a broken bone.

MBD is a systemic (body-wide) problem and radiation therapy may be use just to lessen symptoms and pain in more advanced cases, or to completely destroy disease in the affected bone.

Different cancers respond differently to radiation. Several types of radiation therapy are available. Local field radiation is the most common type of radiation used to treat MBD in which radiation is directed at the metastatic tumor and the immediate adjacent tissue. Entire bone segments or multiple bones can be targeted by local field radiation, depending upon how many areas are affected by the disease. This usually results in complete pain relief in 50% to 60% of cases and partial relief in more than 80% of cases. How well MBD responds to radiation depends on many things, including cancer type (for example, breast cancer typically responds very well to radiation, while kidney cancer does not), and where the tumor is located.

Pain usually begins to subside in the first 1 to 2 weeks, but maximum relief may take several months. Therefore, pain medication is prescribed throughout the radiation treatment course.

For our “cancer friend”, the treatment has been effective and with the pain greatly reduced, we are planning to actually meet for the very first time for dinner over the holiday season!

FEBRUARY 2014 UPDATE: Yesterday, this friend got a CLEAN BILL OF HEALTH!!!

References: http://www.breastcancer.org/symptoms/types/recur_metast/where_recur/local.jsp , http://orthoinfo.aaos.org/topic.cfm?topic=A00093

Image: http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg