• Is microscopic cancer responsive to chemo?

    Asked by catherinemarr on Saturday, April 27, 2013

    Is microscopic cancer responsive to chemo?

    Im intrigued by this question,will probably be starting chemo soon for a metastatic lesion,am wondering,,could this have been prevented by preventative chemo?please weigh in with any knowledge

    2 Answers from the Community

    • carm's Avatar

      Hello, I am an oncology nurse so let me see if I can help you with these questions that have you pondering. First let me state that chemotherapy is not a preventative medicine so I sincerely doubt that would have been an option and it should not be. Colorectal cancer is usually a hereditary disease. It can at times, be an onset that was caused by a mutation on a chromosome instead of a familial trait. It is hard to prevent either as you never know when a gene is going to mutate and chemotherapy targets all cells, not just cancer cells so the damage done by it is best preserved for treatment once a diagnosis is established and not before it. If there is a preventative to cancer of this type, I do not recall that it has been established. I remember a time in my career in Research where I worked on the Celebrex for colorectal cancer prevention and the trial did show promise. I think if I had the possibility of this hereditary trait, I might consider getting a prescription for Celebrex based off of what I saw with the 40 patients I had enrolled in the trial. I think the only prevention is through a colonoscopy or a virtual colonoscopy because there you can pick up precancerous polyps before they become an issue and then monitor the patient with annual colonoscopies if there is a risk determined. If you are wondering if chemotherapy is useful to microscopic metastases that have been established, that is another issue. I would suppose that it could but then, how would one know that enough of the treatment is enough. An average 2.5 cm lesion (about 1 inch) breaks off between 3 to 5 million cells into the bloodstream every 24 hours. The body does a great job of catching them but sometimes unfortunately, one slips by and then travel to distant sites. I think as we move towards the promise of targeted therapies we will see how the new therapies can help to either prevent a disease from spreading or identify a persons response to a treatment. I hope that I have answered your questions. Best of luck to you, Carm RN.

      over 4 years ago
    • Peroll's Avatar

      I think your question is related to this question https://www.whatnext.com/questions/who-to-trust--1/answers/new posted yesterday. The medicallically correct answer to your question is no, chemo can't prevent a metastatic lesion or any other metastisis from occuring, it can only kill cancer that has already developed (metasticised). However, I do not think that is actually what you intended to ask. A 1 mm tumor contains about a billion cancer cells and a tumor has to be 4 to 5 mm to be seen by a CT or PET scan so what you really want to know and what was discussed in the question yesterday is could having chemo before the metastic lesion was found have killed the cancer when it was still "microscopic" thus preventing it from being found and needing treatment. As was noted in the question yesterday, tmclean67 was supposedly told by a Dr form MD Anderson that chemo was not effective against "microscopic" cancer and was advised against prevenative chemo in her case. This contradicted what her Drs at IU had advised her previously and she was rightly confused by the contradiction.

      I answered her question noting that she should request that the Drs talk to each other about her case and then provide her clarification on the advice she was given due to the contradiction. I noted that I have been told that chemo is effective against "microscopic" cancer and have had prevanative chemo in the past and am currently on sort of prevenativbe chemo. I, and a lot of other people here, are very interested in the answer to this question as it has a direct bearing on our treatment. I find it hard to believe that chemo is not effective against "microscopic" cancer as I have been told that chemo works best on smaller tumors as it can have trouble penetrating to the heart of large tumors. I suspect that what the Dr from MD Anderson really meant was that, at least in tmclean67's case, he/she didn't think that prevenative chemo was warranted, not that it is ineffective against "microscopic" cancer. I requested that tmclean67 share anything she learns from this situation as it can impact a lot of us and I am following her so that I will see anything she posts on this subject.

      I hope this helps explain the situation better, I know that not knowing for sure like this is not comforting but hopefully we will all learn something from this situation. Good Luck with your journey.

      over 4 years ago

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