Note: The contents of this blog are for informational purposes only and should not be construed as medical advice or substitute for professional care. For medical emergencies, dial 911!
Cancer is named from the place it originates. This makes a difference on what type of treatments will be effective. Being diagnosed with cancer of the unknown primary (CUP) means that cancer has been found in the body but the place of origin is unknown.
If later, the place of origin is found then the type of cancer diagnosis changes from an unknown primary to the specific organ or body area that the disease first began.
Some cases of cancer of the unknown primary are unfortunately never found. Physicians will then decide on the best course of treatment based on two factors: The way the cells look under the microscope and which organs are currently involved.
Statistics and Prognosis:
The exact number of cases of this disease is not known. It may be about 2% to 5% of all cancers in the United States. It is found more often among men than among women. The average age of people with this cancer is about 60 years.
This is a very dangerous cancer. Only half of patients will live 9 to 12 months after their cancer is found. There are several reasons why this cancer is so serious. First, most of these are fast-spreading cancers. Second, because the exact type is not known, it is harder for doctors to know what treatment is best. Also, the cancer is often widespread, making it harder to cure.
In recent years, microscopic and other diagnostic techniques have improved dramatically. For this reason, doctors can now determine the primary site in about four out of five cases.
Kristina Collins wrote on August 5 about the book Crazy Sexy Cancer. She bought it for a breast cancer survivor friend and called it "a practical (and funny) survival guide with insights of other young women with cancer." There's even a Crazy Sexy Cancerwebsite, she wrote. And a documentary too. Here's some scoop on the documentary:
The upbeat documentary Crazy Sexy Cancer airs on Wednesday, August 29 at 9:00 PM on TLC. It's the story of Kris Carr, actress and photographer -- now author and filmmaker too -- who in 2003 at the age of 31 was diagnosed with a rare and incurable stage 4 cancer. Weeks after her diagnosis, she began documenting her journey. It's a crazy sexy cancer story. So tune in if you're up for a good dose of inspiration and humor. Check out the seven-minute movie trailer here (click on "trailer"). And take a peek at Carr's blog here.
"I just don't want to die," says Carr. "I will do whatever it takes, whatever it takes." Her documentary is proof of that.
Opera singer Beverly Sills is reportedly at a Manhattan hospital, gravely ill with cancer and with her daughter by her side. This comes from the Associated Press and while those who know her best neither confirm nor deny the news, Sills did cite health and family reasons when she resigned as chairwoman of the Metropolitan Opera two years ago.
Cancer first struck Sills in 1974. She underwent successful surgery and went on to make her Met singing debut in 1975.
Sills, 78, first hit the opera circuit in 1947 in Philadelphia. She had a bit role in Carmen and later became a star with the smaller New York City Opera and was acclaimed for performances in Douglas Moore's The Ballad of Baby Doe, Massenet's Manon, and Handel's Guilio Cesare. Known by the nickname Bubbles -- which some say matches her personality perfectly -- the red-haired diva made many appearances on The Tonight Show and The Muppet Show. She also sang often with her friend Carol Burnett.
David Foster was diagnosed with Advanced Renal Cell Carcinoma in April 2005. Translation: stage four kidney cancer and the sixth deadliest form of cancer. Not a great disease to acquire. Also not the end of the world. Just ask David who is busy working as a National Strategic Advisor in Augusta, Georgia, headlining within the independent magazine community, hanging out with dog Gracie, and documenting his journey in a blog he calls David Foster's Kicking Kidney Cancer's Arse.
He's no wimp, this guy. Just read his June 23 post, titled May kill me, but it ain't gonna beat me. He didn't let that hard-nosed kid Jerry whip him when he was eight -- he smacked him so hard in the lunchroom, Jerry was left stumbling and bleeding -- and he won't let cancer bully him either. Still, David admits: he is sick. He explains it all in a post he calls Mr. Foster, are you really sick?
David got an e-mail one day. It read, Mr. Foster, are you really sick? I read your blog and you don't sound sick.
Shorter courses of radiation therapy may be in order for women with early-stage breast cancer. And the largest study to test this suggests the abbreviated treatment time in no way affects risk of recurrence.
Often, the greatest hassle of radiation is getting to and from appointments, every weekday, for many weeks. With less frequent visits, life could get a whole lot easier.
Dr. John Dewar of the University of Dundee in Scotland led a two-part study of nearly 4,500 women in the United Kingdom to test courses of radiation and found five years later that cancer recurrences were low -- about two to five percent -- for women who received both longer and shorter durations of therapy. There were so few recurrences -- 158 -- that doctors believe the treatments are equivalent. They just can't say this with certainty yet.
This is great news for patients traveling great distances to their treatment facilities. Other benefits of shorter radiation timelines are less swelling and shrinkage of breast tissue and less enlargement of blood vessels.
Why are many early-stage pancreatic cancers not treated with life-extending surgery? It seems that one of the reasons might be that physicians in general have pessimistic views toward all patients diagnosed with pancreatic cancer and are subsequently not being offered surgery.
There are instances where surgery is not an option but it seems that many cases, more often patients over the age of 65, African Americans, patients with lower incomes or those who are on Medicare or Medicade are passed over and not given this life-extending surgery and a chance for cure.
A study published this week by the Annals of Surgery said there is an under-use of curative resection for pancreatic cancer. Pancreatectomy is the primary treatment for early-stage disease. Over the years the survival results from this surgery have improved, giving at this time 19 percent of patients a five-year survival rate.
Women with hormone receptor-positive breast cancer who have negative lymph nodes can take advantage of a test known as OncotypeDX. This test is used to estimate the risk of cancer recurrence in women diagnosed with early stage breast cancer. Results presented at the 2007 annual meeting of the American Society of Clinical Oncology said that the test results changed the oncologist's treatment decisions in about 31 percent of cases.
The test is useful in determining which patients are likely to benefit from chemotherapy in addition to hormonal therapy. It can predict the risk of a patient experiencing a recurrence up to ten years following diagnosis. The patient receives a Recurrence Score that ranges from 0 to 100, the higher the score -- the greater risk of recurrence.
This a great way for oncologists to be able to give individualized treatment -- instead of one size fits all. It's important to get chemotherapy if needed but physicians don't want to over-treat and have the unnecessary risk of side effects from chemotherapy treatment if it's not warranted.
Ovarian cancer is hard to detect and is usually found in the advanced stages. It is the most deadly of all gynecological cancers. Transvaginal sonography (TVS) screening has been associated with detecting ovarian cancer at earlier stages of the disease.
TVS is a procedure used to examine the vagina, uterus, fallopian tubes, ovaries, and bladder. An instrument is inserted into the vagina that causes sound waves to bounce off organs inside the pelvis. These sound waves create echoes that are sent to a computer, which creates a picture called a sonogram. The test is also known as a transvaginal ultrasound.
The researchers' findings appear in the May issue of Cancer. In the study, colleagues assessed the value of annual TVS screenings in over 25,000 women. Participants had to be at least 50 years of age with no cancer symptoms or at least 25 years of age with a family history of ovarian cancer.
UK researchers have developed a 3D laboratory model of human breast cancer, specifically ductal carcinoma in situ (DCIS). The model, complete with normal cells and tumor cells, should help experts understand how the disease develops in its early stages, and it could replace the need for experiments in animals.
About one in five breast cancers in the UK start out as DCIS. Researchers wanted to learn more about how the early cancerous changes in cells develop into larger tumors, and they chose to fashion a 3D test tube model because it is more complex than a layer of cells in a Petri dish.
Once this experiment is proved successful, it could reduce and perhaps replace animal studies.
"With breast cancer, there is an urgent need to move away from animal research models because their similarity to human cancer can be so poor," says one expert who explains this model could help revolutionize breast cancer research -- because unreliable research costs time, money, and lives, both animal and human lives.
The final nine episodes of HBO's Sunday night hit The Sopranos feature the stuff of life. You know -- blood, guts, betrayal, angst, and cancer. It's not quite the stuff of my life, well, except for the cancer part.
Actor Vince Curatola, who plays Johnny "Sack" Sacramoni, powerfully weaves cancer into the end of this popular television drama. Diagnosed with lung cancer, his character is given three months to live -- in a prison hospital bed.
Johnny Sack says very little in the last episodes. He does gasp to his wife in episode two, "I'm very, very sick," but he lacks the lung capacity to muster up much more. He disease is considered stage four.
The cancer depictions -- one shows Johnny Sack shuffling down a long corridor in his hospital robe, oxygen tank dragging behind -- are right on, say those who've taken an early peek at the shows. And reportedly, the cancer scenes pretty accurately reflect the concerns of the larger culture -- where cancer has become an epidemic that sadly, won't come to end in nine episodes.
Results of two studies, sponsored by the Adjuvant Breast Cancer (ABC) Trials Collaborative Group, conclude that adding chemotherapy to the estrogen-blocking drug tamoxifen improves survival for those with early-stage breast cancer. The same studies reveal preventing the secretion of estrogen from the ovaries does not offer much benefit for most women.
Researchers studied 1991 patients, ages 28 to 81. All had received five years worth of treatment with tamoxifen therapy with or without standard chemotherapy. Some premenopausal women were also treated with ovarian removal (ablation) or suppression, a technique used to stop the glands from secreting hormones.
While early results, appearing in the Journal of the National Cancer Institute, fell short of statistical significance, chemotherapy still reduced the overall risk of death by 17 percent, mostly for women younger than 50 and especially for premenopausal women not treated with ovarian ablation or suppression.
Ovarian cancer is difficult to detect. There are no great screening tests to pick up on its presence in the body, and by the time symptoms appear, the disease has often progressed into an advanced stage. But a ray of light has recently emerged in the study of ovarian cancer -- and it could help in the prevention and early detection of this deadly disease.
Think about this, from the April 2007 issue of Woman's Day magazine:
Researchers at the University of Washington School of Medicine have identified a simple checklist of six symptoms associated with an increased risk of the disease and three of them -- if they occur at least 12 times per month and are present for less than one year -- were present 57 percent of the time in a study of women with early-stage disease.
And the three symptoms are: abdominal and pelvic pain, bloating and difficulty eating, and feeling full quickly.
If you experience these problems, especially if they are frequent or new, contact your doctor because identifying ovarian cancer quickly is key. In its early stages, the cure rate is 90 percent. But for advanced cancer, it's only 20 percent.
The OncotypeDX test usage to guide treatment decisions among women with node-negative, estrogen receptor-positive breast cancer is resulting in good outcomes according to a study reported in the journal Cancer.
The OncotypeDX test evaluates the activity of twenty one genes from a sample of the patients' cancer to determine their Recurrence Score -- the risk of a patient experiencing a recurrence ten years following diagnosis. This test gives a more individualized treatment for women with early stage breast cancer and would allow women who are unlikely to benefit from chemotherapy to avoid the toxic effects of treatment. The Recurrence Score ranges from 0 to 100, with a higher score indicating a greater risk of recurrence.
Using the Recurrence Score guided approach, low-risk women would be treated with Tamoxifen alone, and intermediate and high-risk women would be treated with Tamoxifen and chemotherapy. The study results suggest that among women with early stage, ER positive breast cancer, use of the OncotypeDX test to individualize treatment decisions appears to produce good outcomes at an acceptable cost.
Presidential candidate John Edwards and his wife Elizabeth will appear tonight on 60 Minutes where they will publicly discuss with Katie Couric Elizabeth's newest cancer diagnosis and their decision to continue on in the presidential race.
Elizabeth, 57 and first diagnosed with breast cancer in November 2004, shared Thursday that her cancer has returned, this time in her bones. Considered stage four and treatable -- but not curable -- her cancer has generated much discussion and awareness about the workings of this life-threatening disease.
To view a clip from tonight's news program, airing at 7:00 PM ET/PT, click here.
Elizabeth Edwards has been told the metastatic cancer found in her bones is considered stage four. And it's treatable. But not curable.
Tricky stuff -- all this cancer terminology -- and a little hard to fully comprehend.
I saw Sheryl Crow talking with Maria Shriver and Dr. Susan Love on Larry's King's CNN program the other night. Crow says her breast cancer was curable -- it was teeny tiny and had not spread and required a lumpectomy and radiation, but not chemotherapy. "I'm the walking poster child for early detection," she said. Her cancer was caught and treated swiftly. She is cured. Theoretically.
Can Crow's cancer still return? Yep.
We just aren't sure at the time of one cancer discovery if these deadly cells have drifted away from the main site and will later show up elsewhere, explained Dr. Love. All predictions would have Crow living a long life free of cancer. But they may have had Edwards in the same boat just two years ago when she was first diagnosed with breast cancer.
So now Edwards' cancer is not curable. It is treatable. And this is a bit easier to understand. Her cancer will never go away. But doctors can keep it at bay. And Love says they can even make it better. But there is no cure for what Edwards has. So she will live with cancer for the rest of her life.
I guess curable means: the cancer is gone and we hope it never comes back. And treatable means: the cancer is not gone and will never be gone but we will treat it for as long as we can.