Disseminated Tumour Cells As Culprits For Metastatic Recurrence
Metastatic relapse is attributed to the outgrowth of cancer cells that have escaped from the primary tumour and take up residence in secondary sites. Cancer cells that physically detach from a primary source and seed distant sites are known as disseminated tumour cells . The process whereby DTCs transform a localised cancer into a systemic disease is called the metastatic cascade . In the next few sections, the seven key steps comprising this complex biological process are discussed with the goal to shed light on the when and how of DTC dissemination. Importantly, while depicting the metastatic cascade as an orderly series of sequential eventsstarting from the primary tumour and ending in a distant metastatic siteit should be noted that DTC spread can take place through multiple routes and different directions. Accordingly, clinical evidence of self-seedingwhereby a metastatic cell re-infiltrates its primary tumourand of metastasis-to-metastasis spread, has been documented, with one such study in HR+ breast cancer patients reporting a common origin between lymph node and distant metastases in up to 25% of cases.
Fig. 2: Tumour cell dissemination: the route to metastatic success or failure.
Iodine Research From Mexico India And Japan
India
The Shrivastava group in India reported molecular iodine induces apoptosis in human breast cancer cell cultures. Iodine showed cytotoxic effects in the cultured human breast cancer cells.
Mexico
From Mexico, the Carmen Aceves Velasco Group reported Iodine to be safe, with no harmful effects on thyroid function, and an anti-proliferative effect on human breast cancer cell cultures. Their 2009 paper reported the mechanism by which Iodine works as an anti-cancer agent. Iodine binds to membrane lipids called lactones forming iodo-lactones which regulate apoptosis . Iodine causes apoptosis which makes cancer cells undergo programmed cell death. Dr. Aceves concluded that continuous molecular iodine treatment has a potent antineoplastic effect on the progression of mammary cancer.
Japan
From Japan, Dr Funahashi reported a common seaweed food containing high iodine content is more beneficial than chemotherapy on breast cancer . He found thatadministration of Lugols iodine or iodine-rich Wakame seaweed to rats treated with the carcinogen dimethyl benzanthracene suppressed the development of mammary tumors. The same group demonstrated that seaweed induced apoptosis in human breast cancer cells with greater potency than that of fluorouracil, a chemotherapeutic agent used to treat breast cancer.
Fig 2 from Funahashi 2001. Breast cancer induced in rats with DMBA a carcinogenic chemical.
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Our Advice To Other Women With Metastatic Breast Cancer: Be Nice To Yourself
Give yourself a break! is the advice that Sendelbach offers. Stop negative self-talk about what you should have done but didnt do, she says. If you have MBC, you need to be kind and loving to yourself.
The body has only so much energy to offer per day, and managing metastatic breast cancer requires a lot of it. So it doesnt make sense to try to compare what youre able to do with what your cancer-free friends are accomplishing.
Just getting through the day can be hard, Sendelbach says. Getting rid of those not good enough feelings can lift a huge weight off you.
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What Are The Risk Factors For Breast Cancer
Like many conditions, risk factors for breast cancer fall into the categories of things you can control and things that you cannot control. Risk factors affect your chances of getting a disease, but having a risk factor does not mean that you are guaranteed to get a certain disease.
Controllable risk factors for breast cancer
- Alcohol consumption. The risk of breast cancer increases with the amount of alcohol consumed. For instance, women who consume two or three alcoholic beverages daily have an approximately 20% higher risk of getting breast cancer than women who do not drink at all.
- Body weight. Being obese is a risk factor for breast cancer. It is important to eat a healthy diet and exercise regularly.
- Breast implants. Having silicone breast implants and resulting scar tissue make it harder to distinguish problems on regular mammograms. It is best to have a few more images to improve the examination. There is also a rare cancer called anaplastic large cell lymphoma that is associated with the implants.
- Choosing not to breastfeed. Not breastfeeding can raise the risk.
- Using hormone-based prescriptions. This includes using hormone replacement therapy during menopause for more than five years and taking certain types of birth control pills.
Non-controllable risk factors for breast cancer
Iodine And Companion Nutrients
Vitamins and minerals work together in the body. Iodine has several companion nutrients that must be present in the body to ensure that the full benefit of iodine is experienced. Additionally, without the companion nutrients, a reaction to iodine or lack of success with iodine supplementation is likely.
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What Are The Symptoms Of Breast Cancer
Symptoms of breast cancer can include:
- a lump or area of thickened tissue in the breast
- a change in the size or shape of one or both breasts
- a change in the shape or appearance of the nipple, such as crusting, sores, redness or inversion
- changes to the skin of the breasts, such as dimpling , rash, or redness
- discomfort or swelling in either armpit
Symptoms of breast cancer in men are similar to those that women experience.
If you have any unusual symptoms, such as the above, you should see your doctor to get them checked.
Stage 1b Breast Cancer Means One Of The Following Descriptions Applies:
Lymph nodes have cancer evidence with small clusters of cells between the approximate size of a pinprick to the approximate width of a grain of rice .
AND EITHER No actual tumor is found in the breast.
OR The tumor is smaller than the approximate size of a peanut .
Similar to stage 0, breast cancer at this stage is very treatable and survivable. When breast cancer is detected early, and is in the localized stage , the 5-year relative survival rate is 100%.
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Box 1 How Rapid Autopsy Studies Can Inform On Metastatic Dissemination And Relapse
Definitions
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Rapid autopsy: rapid post-mortem collection, examination and biobanking of tissuesfresh, snap-frozen and fixedfrom deceased patients shortly after death.
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Rapid autopsy cancer programme: coordinated effort among oncologists, pathologists and scientists aimed at collecting specimens from cancer patients within a post-mortem interval of 68h before key biological information within the tissues of interest is lost.
Advantages
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Multiregional biopsies: to conduct extensive, spatial sampling of tissuesprimary and metastatic, cancerous and normalfor in-depth, high-resolution multi-omics analysis.
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Physiological model: to analyse DTCs in their natural metastatic niche.
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to generate novel, ex vivo living patient-derived modelsautopsy-derived xenografts and organoids of metastatic tumours from sites that would otherwise be difficult to sample for functional evaluation .
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Cancer evolution: to study the phylogenetic relationship of each sampled site to each other and infer the complete clonal evolution of a neoplasm.
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Dormancy: to examine why some DTCs lodged in certain organs of the human body become dormant for years to decades.
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Drug resistance: to study why DTC spread across different sites responds differently to therapy, with some developing resistance and others remaining sensitive to treatment.
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Recurrence: to understand why only some DTCs residing in certain sites of the human body give rise to active metastases, ultimately responsible for patients relapse.
Outlook For Breast Cancer In Men
The outlook for breast cancer in men varies depending on how far it has spread by the time it’s diagnosed.
It may be possible to cure breast cancer if it’s found early.
A cure is much less likely if the cancer is found after it has spread beyond the breast. In these cases, treatment can relieve your symptoms and help you live longer.
Speak to your breast care nurse if you’d like to know more about the outlook for your cancer.
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Physical Emotional And Social Effects Of Cancer
In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
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Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.
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Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.
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Meditation and yoga to improve general quality of life.
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Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.
In Vivo Effects Of Topical Application Of Iodine On Expression Of Estrogen
To investigate the in vivo effect and to imitate the clinical observation, we determined the effect of topical application of iodine on the established MCF-7 tumor in ovariectomized athymic nude mice. We first analyzed the effect of topical application of Iodine Tincture on iodine absorption and on estrogen-regulated genes in MCF-7 tumor. Topical application of Iodine Tincture increased urine levels of iodine, suggesting an efficient skin absorption in nude mice . Although pS2 expression on both iodine and estrogen treated groups show no significant difference compared to control levels , expression levels of CyclinD1 and Cat-D was significantly higher in the iodine or estrogen treated nude mouse when compared with the average expression levels of control group . These data suggest that skin-absorbed iodine has an estrogenic effects on MCF-7 tumors grown in athymic nude mice.
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Wait What Men Get Breast Cancer Too
It came as a heavy jolt when Michael Kovarikwas first diagnosed in 2007.
“I remember just like, sitting down and going, wait a minute, wait a minute. Women get breast cancer. Men don’t get breast cancer. So, it was very much a shock,” he told me when we first spoke. “There were people that didn’t quite believe it at first. And so, it was a way of educating people a lot at the beginning. But I think that made it more real to me.”
He had a recurrence in 2010 and was diagnosed with metastatic disease in 2015.
“The fatigue is unreal,” Kovarik said. “I’m struggling right now, but hopefully things will get better.”
He became active in the Male Breast Cancer Coalition and MBC Alliance and, like Jamil Rivers, in Metavivor. Metastatic disease is the primary lethal form of breast cancer, yet only 7% of breast cancer research is devoted to curing it.
“We get answers to stopping this disease,” Kovarik said when we last spoke in August.Michael Kovarik died from MBC on Sept. 22, 2021.He is survived by his long-time partner, Tim Watkins.
What Will Happen After Treatment
Youll be glad when treatment is over. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back.
At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed.
If you still have a breast , youll need to get a mammogram every year. Depending on your treatment, you might need other tests as well, such as yearly pelvic exams or bone density tests.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as well as you can.
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The Types Of Radiotherapy
The type of radiotherapy you have will depend on the type of breast cancer and the type of surgery you have. Some women may not need to have radiotherapy at all.
Types of radiotherapy include:
- breast radiotherapy after breast-conserving surgery, radiation is applied to the whole of the remaining breast tissue
- chest-wall radiotherapy after a mastectomy, radiotherapy is applied to the chest wall
- breast boost some women may be offered a boost of high-dose radiotherapy in the area where the cancer was removed however, this may affect the appearance of your breast, particularly if you have large breasts, and can sometimes have other side effects, including hardening of breast tissue
- radiotherapy to the lymph nodes where radiotherapy is aimed at the armpit and the surrounding area to kill any cancer that may be in the lymph nodes
Can Breast Cancer Be Prevented
Unfortunately, there isnt a way to prevent breast cancer completely. However, lifestyle choices such as maintaining a healthy weight and lowering alcohol consumption can help to reduce your risk of breast cancer.
If you are at high risk of developing breast cancer, your doctor may suggest hormone treatments , or a pre-emptive mastectomy.
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Signs That Dcis Is Likely To Become Invasive Breast Cancer
Bottom Line: New research shows when it may be safe to watch and wait.
Source:
Study titled Predictors of an Invasive Breast Cancer Recurrence after DCIS: A Systematic Review and Meta-Analyses by researchers at the Netherlands Cancer Institute, Amsterdam, published in Cancer Epidemiology, Biomarkers & Prevention.
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Mostductal carcinoma in situ breastcancer will never become life-threatening, even if left untreated. However,there hasnt been a good way to tell when DCIS should be treated and when treatment can be safely skippeduntilnow. A new study has identified six factors that determine when DCIS is mostlikely to become invasive breast cancer.
DCISis cancer that starts in a milk duct and has not spread outside the duct. Oftencalled stage 0, its such an early stage of cancer that some experts believeits actually a precancerous condition rather than actual cancer. DCIS has becomeincreasingly commonpossibly because women are living longer, more women aregetting screening mammograms, and mammograms have become better at findingthese small breast cancers. About 20% of all breast cancers are DCIS.
Mostwomen with DCIS have a lumpectomy, and some also have radiation. The risk forDCIS recurrence after lumpectomy alone is about 25% to 30%adding radiation therapydrops the risk to about 15%. Only half of recurrences are invasive cancertherest are DCIS again.
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Causes Of Cancer And Types Of Cancer
Lung cancer, skin cancer, prostate cancer, leukemia, which is blood cancer, throat cancer, but the most common types of cancers are skin, lung, and breast cancer. Breast cancer is also ranked as one of the commonly diagnosed cancers among women.
Some of the causes of cancer include genes and ones lifestyle. Alcohol or tobacco abuse may increase the chances of cancerous cell growth.
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Below is a detailed analysis of stage two breast cancer
- To better understand the growth and spread of the cells, doctors use T, to denote the size of the tumor in the breast.
- T0 means there is no tumor in the breast T1 implies the size of the tumor is two centimeters in diameter or less.
- T2 means the size of the tumor is between 2 to 5 centimeters.
- T3 means the tumor is over 5 centimeters in diameter.
- N, on the other hand, represents, the number of lymph nodes affected.
- N0 or N-0 means the cancer cells have not affected any lymph nodes N1mi, the cancer is in the lymph nodes but can only be identified under the microscope.
- N1 cancer has spread and can be detected in one lymph node around the tumor.
- N2 cancer has spread to more lymph nodes is further away from the tumor.
- M denotes metastasis. This means cancer has spread to other parts of the body, the liver, bones, or even the brain.
- However, at stage two, the cancer cells have not spread other parts, and the steps are described as M0.
Stage 2B: T3, N0, M0, the tumor is now larger than 5 centimeters,
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How Is Breast Cancer Diagnosed
During your regular physical examination, your doctor will take a thorough personal and family medical history. He or she will also perform and/or order one or more of the following:
- Breast examination: During the breast exam, the doctor will carefully feel the lump and the tissue around it. Breast cancer usually feels different than benign lumps.
- Digital mammography: An X-ray test of the breast can give important information about a breast lump. This is an X-ray image of the breast and is digitally recorded into a computer rather than on a film. This is generally the standard of care .
- Ultrasonography: This test uses sound waves to detect the character of a breast lump whether it is a fluid-filled cyst or a solid mass . This may be performed along with the mammogram.
Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue. Biopsies are performed using surgery or needles.
After the sample is removed, it is sent to a lab for testing. A pathologist a doctor who specializes in diagnosing abnormal tissue changes views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is and whether it has spread beyond the ducts or lobules .