an interesting article and thought provoking queston.......

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c palmer - 08 Sep 2005 22:25 GMT

this article is on breast cancer. since breast cancer and prostate
cancer parallel each other. my question is this. is it possible.....
after an RP and the psa starts to rise, to inject or orally take a drug
that would make the lymph nodes visible, so that a doctor would be able
to see them on the screen in order to get biopsy samples of the actual
lymph node. by doing so, maybe the information we get would help
pinpoint the treatment if RT was needed, with more radiation in that
particular area instead of a general wide beam spread.

~ curtis

=================
Researchers Find New Way to Predict Breast Cancer Recurrence

TUESDAY, Sept. 6 (HealthDay News) --

U.S. researchers say they've developed a potentially more accurate way
to assess a woman's risk of breast cancer recurrence.

Currently, doctors predict the chances of breast cancer striking again
by determining whether tumor cells have invaded the lymph nodes near the
breast.
But researchers at Stanford University say looking at the immune cells
in those lymph nodes -- rather than tumor cells -- will yield a more
accurate forecast.
"Immune changes in the lymph node almost perfectly predict clinical
outcome, much better than any other prognostic factor that is available
today," senior author Dr. Peter P. Lee, an assistant professor at the
Stanford University School of Medicine, said in a prepared statement.

Using samples of 77 breast cancer patients' lymph nodes, Lee and his
colleagues identified unique patterns of immune cells in patients who
remained cancer-free after five years.

Reporting in this Sept. 6 online issue of the Public Library of
Science-Medicine, the Stanford team showed that immune changes within
lymph nodes predicted clinical outcome even better than their tumor
invasion status.

"The nice thing about this technique is that it could be applied to all
women with breast cancer," lead researcher Dr. Holbrook Kohrt said in a
prepared statement. "It's a shot in the arm for the field," he added,
noting that "these findings argue that the immune system is more
important in cancer than previously thought."
-- Dennis Thompson
SOURCES: Stanford University, news release, Sept. 5, 2005

knowledge is power - growing old is mandatory - growing wise is optional
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

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Steve Jordan - 08 Sep 2005 23:17 GMT

> this article is on breast cancer. since breast cancer and prostate
> cancer parallel each other. my question is this. is it possible.....
[quoted text clipped - 4 lines]
> pinpoint the treatment if RT was needed, with more radiation in that
> particular area instead of a general wide beam spread.

(snip interesting article)

There is a misunderstanding evident in Curtis's last sentence that should
be put to rest.

Unless the rad onc is old-fashioned or in some backward country, a "general
wide beam spread" is *no part* of modern EBRT using Intensity Modulated
Radiation Therapy (IMRT).

That's what the IM part of IMRT is about.

In my case, not unusual by any means, the total gland dose was 76 Gy.
Pelvic lymph nodes received 45 Gy;
seminal vesicles received 55 Gy. IOW, it is common when using IMRT to dose
other anatomical features separately in addition to the prostate gland.

Regards,

Steve J

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c palmer - 09 Sep 2005 10:59 GMT

From: mycroft@cox.net (Steve Jordan)
On September 8, c palmer wrote:
this article is on breast cancer. since breast cancer and prostate
cancer parallel each other. my question is this. is it possible.....
after an RP and the psa starts to rise, to inject or orally take a drug
that would make the lymph nodes visible, so that a doctor would be able
to see them on the screen in order to get biopsy samples of the actual
lymph node. by doing so, maybe the information we get would help
pinpoint the treatment if RT was needed, with more radiation in that
particular area instead of a general wide beam spread.
(snip interesting article)

There is a misunderstanding evident in Curtis's last sentence that
should be put to rest.
Unless the rad onc is old-fashioned or in some backward country, a
"general wide beam spread" is *no part* of modern EBRT using Intensity
Modulated Radiation Therapy (IMRT).
That's what the IM part of IMRT is about.
In my case, not unusual by any means, the total gland dose was 76 Gy.
Pelvic lymph nodes received 45 Gy;
seminal vesicles received 55 Gy. IOW, it is common when using IMRT to
dose other anatomical features separately in addition to the prostate
gland.
Regards,
Steve J

=======hi steve - i thought i expressed myself, but again, maybe i was thinking
one thing and said another.

the article i posted was about assessing the risk of recurrence of
breast cancer. that by monitoring the lymph nodes, they have found
certain things take place that is always consistent before the cancer
starts growing. this is not the assessment for the original breast
cancer.

since we are talking about recurrence of cancer - not the original
treatment - which for the men, would have been the RP. when the psa
starts to rise and one does not have a prostate, so where's the cancer?

this is why they use a wide beam radiation pattern over the whole
prostate bed in hopes to killing anything there so that it doesn't get a
chance to get out of there and into the body and spread.

so, if the male with the prostate removed but still has his lymph nodes
still in place is where my thinking was.

by making them visible to the person who could do a biopsy, it would be
nice to know what area is showing signs of change before it goes
cancerous. at least that was my thoughts on the subject.

i don't know if this can even be done. i'm not a person who deals in
the biopsy and do not know the limitations of the equipment.

perhaps, cpw could shed some light on this.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

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Steve Jordan - 09 Sep 2005 16:38 GMT

On September 9, Curtis Palmer replied to my last message regarding IMRT:

> hi steve - i thought i expressed myself, but again, maybe i was thinking
> one thing and said another.

(snip)

Well, maybe I misconstrued Curtis's message. I thought he was referring to
the general EBRT procedure, but it appears now that his subject was
confined to the salvage radiation tx, only.

Thanks for the clarification.

Regards,

Steve J

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ross lazarus - 10 Sep 2005 03:49 GMT

> since we are talking about recurrence of cancer - not the original
> treatment - which for the men, would have been the RP. when the psa
[quoted text clipped - 3 lines]
> prostate bed in hopes to killing anything there so that it doesn't get a
> chance to get out of there and into the body and spread.

Here's my 2c worth for whatever it's worth:

1. Breast cancer has a nasty reputation for early metastasis. Often via lymph vessels to axillary
and other chest nodes. Low gleason PCa appears to have less of this behaviour.

2. Local spread from PCa is unlikely if you had clear margins in the RP pathology - it doesn't tend
to jump locally AFAIK.

3. Spraying radiation around has potential adverse consequences like lymphoedema and lymphatic
malignancy so you'd hope for some serious benefits.

4. Bottom lines: AFAIK, for low grade PCa with clear RP margins, if you get a rise in PSA, you've
got metastases somewhere by definition. From memory, the conventional wisdom is that it's most
likely bone spread via blood (rather than lymph spread to lymph nodes typical of BCa). But I'm
remembering from a long time ago and there may be more recent evidence saying other things?

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Clarence Crow - 09 Sep 2005 00:37 GMT

>this article is on breast cancer. since breast cancer and prostate
>cancer parallel each other. my question is this. is it possible.....
[quoted text clipped - 6 lines]
>
>~ curtis

<snip body of text>

My GP (PCP) is of the opinion that my lymph nodes were over-sprayed
during my EBRT sessions, thereby causing lymphodeoma in both legs,
leaving the R one chronically swollen from the shin to the foot. The L
one is only mildly swollen but painful.
The Professor Rad Onc denies all this emphatically and attributes it
all to the fact that I entered the program with vascular problems
caused by Peripheral Neuoropathy in these areas, (an offshoot of
Diabetes type II (NIDDM).)

So there!!

-- Reader to complete...
-- Please reply to this ng as my email adress is fake:

-- Regards

-- CC

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