Breast cancer is very well-studied so there’s probably more information about this type of cancer than others. It’s possible that other (less well-studied) solid tumors act in a similar way.
It’s now known that breast cancer cells can break off and migrate to other parts of the body where they lay dormant for years even after treatment is apparently successful. If something wakes up a dormant cell it can grow into a deadly metastatic cancer.
Prior evidence has suggested that inflammatory processes can awaken disseminated cancer cells (DCCs) – cells that break away from a primary tumor and spread to distant organs.
A new study has found that Covid and the flu can wake up dormant breast cancer cells in the lungs. This is a scary finding for a breast cancer survivor like me.
Just one more good reason to get vaccinated.
Wendy
ER+ breast cancer return has been studied over a period of 20 years. (ER+ accounts for 70% of breast cancers.) The death rate over the 20 years is linear. That is, a woman who survives 5 years after initial treatment isn’t out of danger. Little by little, those dormant cancers wake up. By the end of the 20 year period, 80% of the women were dead.
The average age of breast cancer is 61 so many of those women may have died from other causes. But breast cancer survivors should not be complacent. A woman in my support group had a recurrence 17 years after successful treatment. In a year she was dead.
Wendy
1poorlady also is a cancer survivor. She’s coming up on 5 years. Originally, they said she would have to be on an estrogen blocker for 5 years. Now they are saying 10. She has decided she’s quitting at 5. It causes such joint aches that her quality of life is being seriously affected. Plus, it causes bone loss, and she can only take the Boniva for 5 years. After that, she can’t do much to combat the bone loss. So when she stops Boniva, she stops the blocker, too.
We’ll keep up with the oncologist, though. Very regular checks. She had a PET scan as part of a study, and it showed zero traces of cancer in her system. So that’s good.
Like 1poorlady I was on an estrogen blocker. I stopped at 5 years because the data showed that patients with my exact situation (Stage 1, over 60 years old) had no difference between taking it for 5 years and 10 years. But everyone is different.
It’s also important to understand the difference between absolute risk and relative risk.
As for the PET scan…studies show that there is no survival benefit from PET scans, MRIs, etc. in non-symptomatic survivors.
This is probably because the danger of recurrence is from a tiny, dormant cancer cell hiding in bone marrow or lung tissue that is impossible to detect as long as it’s dormant. It’s also impossible to know when or if it will begin to multiply into a dangerous metastasis. By the time it is symptomatic and detectable it’s already a metastasis.
I haven’t checked in with an oncologist for 9 years. There’s no accurate blood test and the scans are not correlated with survival.
Sorry.
I had a bilateral mastectomy for double breast cancer in 2015 (age 61). This factored into my decision to start Social Security at age 62 instead of age 70. Especially since my mother died of cancer at age 71. But I decided to be hopeful when I decided to have open-heart surgery last year at age 70. Who knows? Maybe the cancer won’t recur after all.
Not quite sure what you mean by that. The scans are crucial for early detection. I’m not as sure about blood work, but our oncologist looks at some very specific blood markers. She gets a scan every fall. We never would have know about the previous cancer until it was too late, because even the doctor couldn’t feel anything with palpation. Only the scan revealed it.
Her onco-score is a bit higher, so the oncologist wants to continue the blocker for 5 more years. She already had in her head 5 years from when they said that 5 years ago. I think it was a goal for her, enduring the side effects while moving closer to the light at the end of the tunnel. Moving that goalpost probably will be a no-go. At least, that’s what she’s saying now.
It’s a panel. She doesn’t look at cholesterol, or thyroid, or anything like that.
I have an order in my hand (she needs to get it done soon). It’s for B12 and Folate, CMP, CBC, PLT, and DIFF. Fasting not required (but we usually do anyway).
Not a medical person. I learned a lot about her cancer, and chemo, during that time. But I’m a physicist, not a medical person. She reviews the blood work, and so far has said “looks good”. If she ever flagged something, I would want to know why.
They also did a genetic panel on her before her surgery, to see if there were any markers there. There were none.
In all probability your wife’s oncologist is aware of this, but genetic testing is something that’s a rapidly developing field. It’s a one time only deal if testing identifies anything specific but not necessarily if it doesn’t. Just think about how rapidly the field has developed so far…by the time you get to the end of my post, someone somewhere will have discovered a whole lot more (@btresist might have a clue or 6.5 on this topic)
Husband, daughter and I are having our various cardiology issues managed by a multidisciplinary unit at the University of Colorado School of Medicine following dh’s discovery of his severe aortopathy. He was tested at follow up shortly after the surgery and nothing idenrified at that time. Regardless, daughter was also evaluated and discovered that she too qualified for membership of the Big Aorta Club. Obviously a congenital issue and future testing advised.
I wouldn’t even begin to speculate on frequency, mind…but it’s something to keep an eye on.
They did a genetic panel on me to see if there were any markers there. There were none. Despite my great-grandmother, three of her daughters (including my grandmother) and three of their daughters (including my mother) and three of my generation all got cancer (all except one breast cancer).
@VeeEnn is right. The field is developing fast and there are new genes discovered as time proceeds.
B12 and Folate, CMP, CBC, PLT, and DIFF. These are general health screens which are not specific to cancer.
The older tumor marker tests (like CA-15) are not used alone to diagnose or detect recurrence because their levels can be elevated due to non-cancerous conditions and sometimes they are not elevated even if cancer is active. The newer “liquid biopsy” blood test, like Circulating Tumor DNA (ctDNA) is still being researched, and it’s not yet a standard part of routine clinical care for all patients. It’s personalized because the test searches for the specific the genetic mutations in a patient’s original tumor.
I was wondering if your wife had the ctDNA blood test but it looks like she didn’t.
Wendy
That’s interesting, my dad’s side has a similar thing. Almost all the women had early breast cancer, most dying in 50s or 60s of it, and he had early colon cancer (age 52). Because of that, I went for regular colonoscopies beginning at age 32. When my sisters refused to go for their colonoscopy, my dad sprung $1500 for a genetic test, and it also showed negative for what is thought to cause breast/colon cancers. My grandmother died at age 64, and nearly all his female first cousins died young of breast cancer, and some of the second cousins as well at this point. Meanwhile, his older sister now well into her 80s is fine.
Add to the discussion that 5-10% of Kidney cancers are ‘heritable’.
When I mention to a Dr that I have close family that had kidney cancer, I get a terse ‘Kidney cancer is not genetic’… a couple times the dr has struggled to not ‘eye roll’.
ChatGPT says:
Heritable vs. Sporadic Kidney Cancer:
Sporadic kidney cancer (non-heritable):
~90–95% of kidney cancers are not inherited and occur randomly, often influenced by factors like smoking, obesity, or hypertension.
Heritable kidney cancer (genetic/familial):
~5–10% of cases are linked to inherited gene mutations. These usually present at a younger age, may involve both kidneys, or have a family history.
That doesn’t sound familiar. The geneticist did whatever analysis was available in 2020, didn’t find anything worrying, but did say that there were a lot of genes they didn’t really know about. She was saying something like “it’s just genetic diversity” (1poorlady is Asian). So it was a hedge that there might be something in one of the genes that they had not (yet) linked to anything worrying.
We’ve heard about liquid biopsy, but the oncologist said something to the effect that it isn’t ready for prime-time yet.
They also grabbed the DNA of her tumor. Hopefully they release the technology that trains a person’s immune system to attack a particular gene sequence (i.e. that of the tumor). I know it’s making great progress, but it isn’t available yet. Until then, all we can do is get regular scans to make sure it isn’t coming back. And her oncologist is insistent that she get regular blood works, so she’s looking for something in them.
