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A way to Stop Mets?


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Whew, wow this is quite a discussion! I'm a clinician, not a researcher, but I'll give my (imperfect) understanding on some of these topics.

First of all, the question about blood thinners preventing metastases from occuring is a fairly hot topic right now that is being looked at. There was a study looking at use of low molecular weight heparin in patients with metastatic cancer (can't remember if it was just lung or a grab bag of malignancies) and while it did reduce risk of blood clots, there was no difference in survival. Of course, would really need to do a study in pts with earlier stage cancer to answer this question. I've heard a study is in the works but have not seen it opened yet. I highly doubt that aspirin alone would prevent metastases although there is some evidence it may reduce the risk of lung cancer in the first place so usually do recommend it for my patients unless there is a contraindication.

As far as the doubling time/growth business, keep in mind that cancers do not grow by these nice mathematical models in living beings. As the tumor grows, its aggregate growth may actually decrease as it outstrips its blood supply. Also some "soils" allow for more rapid growth than others which is why sometimes the metastatic sites are much larger than the primary sites. Also, these tumors are heterogeneous and genetically unstable. What starts as a fairly slow growing tumor may mutate into a very aggressive rapidly growing cancer. As cancers recur after chemotherapy treatments, they may act more aggressively because you have essentially selected out the resistant and often times faster growing clone.

Cancers can definitely grow/spread while receiving chemotherapy if the tumor is resistant so it is not true that cancer cannot metastasize while on chemotherapy.

Finally, while it is true that chemotherapy tends to be more effective in more aggressive cancers, some of the most aggressive cancers tend to be the least responsive to chemotherapy (pancreas cancer and anaplastic thyroid cancer come to mind).

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John Elaine:

Sorry it took so long to respond, busy busy weekend

The tumor is in cm

There were no follow up scans done between 2002 and 2004 because we DID NOT KNOW there was a tumor there, until 2004. Believe it or not its all over moms medical records from 3 scans 11.02 and 12.02 and 2.03, her pulmonary doc never told her, and she was never able to get another appointment to follow up after hospital visit, tried many times. we had already changed drs before we found this out. we had just chg'ed to another dr within same practice, but after learning this about 1 month ago when i got copies of her medical records, we have another new pulmonary dr. we actually go see him this morning. her onc and rad docs saw this on her records, and were rather shicked when they realized we didnt know anything about it. Her onc doc told me when i asked her about it, that she knew from talking to me, that it would not be long before i discovered this and started dealing with it. Unexcusable medical practice in her mind...anyway outcome would have still been the same as she had copd back then also.

Thanks all


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