A question about recurrence..

[SleepyGuy]

The size of my tumor was a big factor in me getting adjuvent radiation. So, I was curious if the size of my tumor also plays a role in my chances of recurrence after radiation?

My last treatment is tomorrow and I see the Onc right afterwards, but I'm still kinda curious if anyone knew anything on that matter.

Thanks.

[djmac]

The size of my tumor was a big factor in me getting adjuvent radiation. So, I was curious if the size of my tumor also plays a role in my chances of recurrence after radiation?

My last treatment is tomorrow and I see the Onc right afterwards, but I'm still kinda curious if anyone knew anything on that matter.

Thanks.

Hi Sleep...

You had a pretty large mass. I'm at a cancer meeting right now. In many cancer models, tumor size has little to do with chance of metastasis (tumor growth and metastasis being distinct biological processes). To wit, primary lesions of pure choriocarcinoma, which mestasizes early, tend to be fairly small tumors. This is not so true with seminoma, where tumor size has some influence on chance of metastasis.

One thing that I've learned from this meeting, which I did not know, is that most of the science suggests that tumors are ALWAYS shedding cells into the bloodstream, but two things protect you from metastasis and imminent death. The first is the fact that only a small percentage of 'shed' cells have the capacity to form a met, and that the site of metastasis has to be 'receptive' to the attachment of that cell (or cancer stem cellm, as we are currently referring them as).

What does this mean? Well, you didn't present with mets, and the odds are in your favor that you don't have them. Given the size of your tumor you were probably shedding cancer cells into your bloodstream for a really long time, but the fact that you have no detectable mets probably means that your body was doing a pretty good job of protecting you. Apparently, lymphatic growth is fairly easy for seminoma, so its probably a good idea that you did the rad. I'd say your chances of additional mets are probably not significantly higher than anyone else. Remember, at stage I, only ~3% recur after radiotherapy. Still, you must be diligent for your follow-ups and you should be fine...99% cure rate no matter what your original path! Focus on that number and also know that a large majority of that 1% that weren't cured were not good with their followups.

Good luck sleep!

djm

[Fed]

I'm at a cancer meeting right now.

djm,
Out of curiosity, are you at the Keystone meeting? My soon-to-be former postdoc boss is giving a talk today on "drugging the undruggable". Best,

[SleepyGuy]

Remember, at stage I, only ~3% recur after radiotherapy. Still, you must be diligent for your follow-ups and you should be fine...99% cure rate no matter what your original path! Focus on that number and also know that a large majority of that 1% that weren't cured were not good with their followups.

I asked the doctor today, well I only saw the resident, and she said that the radiation will bring you back down to the baseline. So the size doesnt seem to have an affect on recurrence post-RT.

So now I'm just on surveillance. See the Onc every 3 months. The resident said I would be getting CT scans every 3 months, but I think I remember the Onc saying it would be every other visit. I see him in a month, I'll just ask then.

[djmac]

djm,
Out of curiosity, are you at the Keystone meeting? My soon-to-be former postdoc boss is giving a talk today on "drugging the undruggable". Best,

Yes Fed!

I just saw his talk. Fantastic! Actually one of the better talks at this meeting, and completely new to me. Are you involved in any of that work?

Regards,

djm

[Fed]

Yes Fed!

I just saw his talk. Fantastic! Actually one of the better talks at this meeting, and completely new to me. Are you involved in any of that work?

Regards,

djm

I actually am . When I started my postdoc several years ago, I helped optimize the synthetic chemistry work for the "stapled peptide" methodology. Shortly after that, I morphed into a cancer biologist and have been working on its application towards the p53/hDM2 system. Our paper on stapled p53 peptides came out last week in JACS (I can send you a PDF, if you're interested). I believe Greg (my boss) spoke about "Notch", which will likely be the third application of the methodology to be published by our lab.

Enjoy the rest of the meeting,