Wednesday, November 3, 2010
The riddle of the cancer relapse
Cancer relapse or the 'Cancer Sleeper Cell' are oh-so-reassuring (NOT!). I read this article and paid attention to it - through all five pages. So they are now trying to figure out if cancer has its own stem cells. But they haven't quite figured it out yet. They are trying. They have been working in this area since at least 1974 - so in 36+ years they still aren't sure.
On one level its quite interesting and almost exciting that they are looking at cancer down at the cell level to see which ones are stem cells - capable of regenerating themselves. They are this deep into cancer biology that they are looking at it cell by cell, detail by detail. They can define different kinds of cells and know which ones they should treat differently.
On the other hand, its been more than 36 years so this must be quite a conundrum if it is yet to be resolved. Why is it so complicated? I don't know. They, meaning the researchers, don't know. Yet. Even going back to the ancient Greeks, they aren't sure. Is cancer what the Greeks called 'black bile'? Or is its secret hidden in the idea of a cancer stem cell?
All of this adds up to the cancer relapse riddle. Why do some relapse or recur and others not? Did the combination of surgery, chemotherapy, radiation, and hormone therapy get rid of every cancer cell in my body? They aren't sure. Just because a tumor has disappeared visually, that we can detect, we don't know if it had stem cells that could lead to recurrence. And there is no time limit on recurrence. What if they go dormant for years and then return.
Thyroid cancer is a relatively slow growing cancer. So if there are thyroid cancer stem cells, and they grow slowly, how long will it take them to be detectable. It is my understanding that current medical technology such as a CT, MRI, ultrasound, or Xray can only detect down to approximately half a centimeter. In a pathology lab, after that something is removed from your body - whether by biopsy or surgery, they can see into the cell but they have to have found it before they can take it out.
How fast do things grow? I had a breast MRI and they indicated a 'suspicious area' that they wanted another look at in six months. At the six month mark, it was a 0.7 cm tumor (benign that time).
Well, we can't run off for tests monthly and have to assume the best - if necessary, go read Candide and learn about the 'best of all possible worlds' and get some optimism. The cancer relapse is still a riddle and we have to live with it.