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Medical Forum / Diseases and Disorders / Prostate Cancer / March 2005

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OT Breast/Brain Cancer

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Steve Kramer - 12 Mar 2005 20:55 GMT
Sorry for the interruption, but still another member of my extended family
(my brother's sister-in-law) has cancer and we're trying to resolve a
mystery.

She was found to have brain cancer, including 17 lesions.  But, they
determined that the brain wasn't the primary site.  They felt it migrated
from breast cancer.  So, they did biopsies and found "immature cells" in her
breasts.  They still believe this is the primary site.

How can this be?

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3bN0M0
Seminal Vesicle involvement, Neg margins
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05
PSA  .07 .05 .06 .05

non Illegitimi carborundum

J - 13 Mar 2005 08:48 GMT
> Sorry for the interruption, but still another member of my extended family
> (my brother's sister-in-law) has cancer and we're trying to resolve a
[quoted text clipped - 6 lines]
>
> How can this be?

Are they doing more investigations?  Did they find it in the lymph nodes nearby?
Family history?
Investigations are mentioned here
<http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_cancer_of_unknown_pr
imary_diagnosed_58.asp
>

Breast cancer can be in the chest wall.
It also seems to me that I read on the breast cancer newsgroup, that it can be
outside the breast (imaging) area, slightly to the side before the arm/underarm.

As to the chest wall, I saw someone 6? years ago (with picture and story) and
the tumor grew out of the top of her shoulder.

Cancer of Unknown Primary http://cis.nci.nih.gov/fact/6_19.htm  Steph usually
says "carries poor prognosis".
And part of the reasons are probably because the toll the investigations take
and:

Early stage germ cell and lymphomas are (I think) curable with chemo. Other
stages usually respond well to chemos
I think chemo is useless for stomach cancer. (I'm not going through the whole
list there)

Breast cancer gets tricky and I'm not an expert.
Most (not all) breast cancers are hormone receptive.
http://www.cancersupporters.com/abbrev.html
http://www.breastcancer.org/tre_sys_hrt_role.html
http://www.breastcancer.org/dia_pict_hormone.html

Seems to me that they have to know which hormone. If they guess wrong, they
could be a) wasting time b) feeding the cancer. OR they have to take both (chemo
and hormone) which can be hard on the body and there's risk factors. I think
Herceptin carries a warning about heart
<http://www.cancer.org/docroot/CRI/content/CRI_2_4_4x_Treatment_for_Cancer_of_Unk
nown_Primary_58.asp?sitearea
=>

I did see 3 threads about "unknown primary", but I don't know what became of
them.
Stephen's wife died of it. Another's mother; it was in the spine and vertebrae
and the third...not enough details.It was in the lymph nodes. Seems she had a
mastectomy, chemo, followed by radiation.

I would only be guessing that being menopausal (the ovaries have shrunk) or
she's had a full hysterectomy might be a factor.
Taking something that counters estrogen or progesterone, might be a factor.
Those who weigh less have less body estrogens.

I suppose she could have radiation therapy to the brain and then wait and see.
You could post to sci.med.diseases.cancer (in case doctors there want to
comment) and crosspost to alt.support.cancer.breast
Maybe wait and see if you get more information first?

I'm not a doctor, so some of my hormone conjectures could be wrong.
Best wishes.
J
PS Please note that some on the breast cancer newsgroup call anything oral or
infusion "chemo" w/o differentiating whether it's hormone or actual chemo, so
you'd have to ask for clarification. Tim's pretty good at the correct wording.
J - 13 Mar 2005 08:56 GMT
> Sorry for the interruption, but still another member of my extended family
> (my brother's sister-in-law) has cancer and we're trying to resolve a
[quoted text clipped - 4 lines]
> from breast cancer.  So, they did biopsies and found "immature cells" in her
> breasts.  They still believe this is the primary site.

Here's more Steve. :(
http://www.medicineau.net.au/clinical/palliativecare/SecondaryMalignancy.html
So they better have a pretty good clue that it's breast (ie lymph nodes) before
I would submit myself to a mastectomy and combinations of treatments...

there's another possible, which I forgot to mention: Previously removed mole or
skin lesion that was pre or melanoma and has now returned but to the brain. My
cousin died of it last summer. But it had been properly diagnosed when the
primary was removed 2 years previous.
J
J - 13 Mar 2005 09:10 GMT
> Sorry for the interruption, but still another member of my extended family
> (my brother's sister-in-law) has cancer and we're trying to resolve a
[quoted text clipped - 4 lines]
> from breast cancer.  So, they did biopsies and found "immature cells" in her
> breasts.  They still believe this is the primary site.

Sorry if I'm being a pest, but this website seems to imply that finding cancer
near the breast, also could be lung cancer.
There's more here to read - investigations, lymph nodes dissections etc
http://www.indiacancer.org/coca/c/cup.html
J
J - 13 Mar 2005 09:19 GMT
> Sorry if I'm being a pest, but this website seems to imply that finding cancer
> near the breast, also could be lung cancer.
> There's more here to read - investigations, lymph nodes dissections etc
> http://www.indiacancer.org/coca/c/cup.html

One more
http://www.sma.org/smj/97june19.htm
Primary breast cancer in aberrant axillary breast tissue is rare

I don't know where the axilla is and maybe is the area that I described earlier
between the breast and the armpit.
Looks like it is identified after surgery...
They also mention sweat gland cancer, which I'd actually never heard of before.
HTH and FWIW
J
Steve Kramer - 13 Mar 2005 15:48 GMT
Thanks for all your replies, J.  You have certainly cleared up potential
treatment for us and given us an idea as what to prepare for.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3bN0M0
Seminal Vesicle involvement, Neg margins
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05
PSA  .07 .05 .06 .05

non Illegitimi carborundum

> > Sorry if I'm being a pest, but this website seems to imply that finding cancer
> > near the breast, also could be lung cancer.
[quoted text clipped - 11 lines]
> HTH and FWIW
> J
J - 13 Mar 2005 18:20 GMT
> Thanks for all your replies, J.  You have certainly cleared up potential
> treatment for us and given us an idea as what to prepare for.

Hi Steve,
I'm not sure if the picture is as grim as painted (on those websites) or not

I would encourage you to search the breast cancer archives with the word Brain
and draw your own conclusions.
http://groups-beta.google.com/advanced_search?q=&

I just did. It took me about 20 minutes to go back to June 2004.
(I ignored Kaye - she's been convinced for years that she has mets everywhere
and none have been found)
I ignored the "chemo brain" posts. I ignored "troll posts" and/or replies to
"crossposted news items" from various other non-regulars of the breast cancer
newsgroup.

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/cd56fd70283364b5

Alan - Herceptin does not cross brain barrier

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/44bca3673e3c255b

Mark - 6 brain lesions in 2001 - still hanging in there...      replying to
jayu - whose mother has brain mets.

There's one by Tim replying to someone who had whole brain radiation and new
brain mets appeared. You would have to read both the original post and Tim's
reply.
<http://groups-beta.google.com/group/alt.support.cancer.breast/browse_frm/thread/
953ecc57ac576c35/0bd762fd238ef0f1?q=%22brain%22+group:alt.support.cancer.breast#
0bd762fd238ef0f1
>

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/918a71acd93564c4

There's one by Natalie (who is a young/inexperienced UK radiologist) explaining
that some brain mets respond to radiation, some don't and why. She also
mentions surgery, which I think may be unthinkable with 17

There's an RN who claims some live for years with brain mets. Although I
believe she also mentioned "older=slower growing".
(you did not mention your relative's age)

Another says "a few months to a few years".

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/a287a1a44f30aecf

David - in Stage IV for five years and IIRC describes brain mets/treatments.
She did have brain surgery though.

There's a few possibles that I hadn't thought of...
1) the/your relative had breast cancer before and it's a recurrence and they
therefore know how to treat it.
2) imaging problem sometimes occurs with breast implants and/or primary will be
found another way.

Having said all that;
there's a poster on s.m.d.c. whose father has undetermined lung cancer who had
brain and other radiation; is flat on his back with fatigue- doctors give him 8
- 12 months. Online doctors are disagreeing; one says a few months, the other
says "don't give up hope yet, he might rally from the radiation therapy
fatique.
Then there's Bob with SCLC (small cell lung cancer - mets to several places,
had brain and other radiation therapy and has recovered quite well)..NED = no
evidence of disease at the mo, doing well. As I recall, he said it took a year
to recover from the fatique from the radiation.

So situations vary, depending on what they find. the location of the brain
mets, how they respond to treatment, her health/age, how well she recovers from
the treatment (or not), where the actual primary is...

I just don't want to paint a negative view if there's hope.
Nor do I want to encourage false hope.
Hope you understand.

If you find out more about the type of cancer, please feel free to post to
sci.med.diseases.cancer (which is troll infested but still watched by doctors)
and/or one of the two cancer newsgroups, depending on the primary.

J
Steve Kramer - 13 Mar 2005 20:26 GMT
Thanks again, J.  You've done me a tremendous service with all the time
you've spent on this.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3bN0M0
Seminal Vesicle involvement, Neg margins
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05
PSA  .07 .05 .06 .05

non Illegitimi carborundum

> > Thanks for all your replies, J.  You have certainly cleared up potential
> > treatment for us and given us an idea as what to prepare for.
[quoted text clipped - 12 lines]
> "crossposted news items" from various other non-regulars of the breast cancer
> newsgroup.

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/cd56fd70283364b5

> Alan - Herceptin does not cross brain barrier

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/44bca3673e3c255b

> Mark - 6 brain lesions in 2001 - still hanging in there...      replying to
> jayu - whose mother has brain mets.
>
> There's one by Tim replying to someone who had whole brain radiation and new
> brain mets appeared. You would have to read both the original post and Tim's
> reply.

<http://groups-beta.google.com/group/alt.support.cancer.breast/browse_frm/th
read/953ecc57ac576c35/0bd762fd238ef0f1?q=%22brain%22+group:alt.support.cance
r.breast#0bd762fd238ef0f1>

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/918a71acd93564c4

> There's one by Natalie (who is a young/inexperienced UK radiologist) explaining
> that some brain mets respond to radiation, some don't and why. She also
[quoted text clipped - 5 lines]
>
> Another says "a few months to a few years".

http://groups-beta.google.com/group/alt.support.cancer.breast/msg/a287a1a44f30aecf

> David - in Stage IV for five years and IIRC describes brain mets/treatments.
> She did have brain surgery though.
[quoted text clipped - 29 lines]
>
> J
 
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