Liver Cancer / Report of new therapy
Quote:
>Subject: Re: Liver Cancer / Report of new therapy
>Date: Sun, 15 Jan 1995 05:25:18 GMT
>: The notion that air hitting cancer makes it spread is a new one on me! I
>: doubt very much that there is even the slightest bit of truth to that.
> I've heard that folk-tale from many concerned patients. There is
>no truth to it. I suspect the origin of it is this: Patients do not come
>to surgery until their cancer causes symptoms. The disease, therefore has
>already progressed to point of causing symptoms by the time "the air hits
>it" at surgery. Unless the surgery is curative, it's likely that further
>symptoms will soon follow the initial ones. These symptoms would have
>occurred anyhow, but are attributed to the air.
>: People with primary liver cancer may be interested in an article in this
>: month's Oncology Times (1/95 P. 7). According to this article, a Dr.
>: Zhao-You Tang of the Liver Cancer Inst. at Shanghai Medical University
>: reports that a complex stategy involving flooding the liver with a
>: radioactively labeled monoclonal antibody has resulted in five year
>: survivals of 60-70%. Dr Tang says "This has changed the once dismal
>: prognosis of these patients radically."
> This is an exciting initial report. The unwary reader may not
>carefully note that Steve rightly cites this study concerns "primary liver
>cancer," that is, cancers which begin in the liver, not those that spread
>there from other sites. There is no reason to think that the results of
>this study translate to metastatic tumors in the liver, and there is
>theoretical reason to doubt such applicability.
> ...Eric Chevlen, M.D.
Agreed there appears to be no foundation to the notion that exposure of a
tumor to air can promote growth. But there are some potential disadvantages
to surgical excision of tumors in some situations. There is the risk of
seeding - spreading tumor cells by cutting into the tumor. This could be a
particular risk, say, with a well-encapsulated brain metastasis, which would
be cut out by chipping off a piece at a time. Also, some of Judah Folkman's
current research has shown tumors secrete an antiangiogenesis factor that
may limit the growth of distant metatastases.
If surgery can be curative and chemotherapy is unlikely to be effective,
surgery is still a preferred treatment. And debulking prior to
chemotherapy has been shown to improve prognosis for ovarian cancer, even
when initial response to chemotherapy is usually pronounced. But in other
cases, neodjuvant chemotherapy, leaving the primary tumor in place, may
be preferable. This avoids the risk of seeding, allows the possibility of
the bystander effect to kill neighborhing tumor tissue, and also allows
accurate tracking of response. A tumor that has been shrunk and weakened by
chemotherapy may offer less risks of seeding with subsequent surgical
extraction. -- David Scheim, Ph.D.
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/* --- David E. Scheim, Ph.D. --- */
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