tag:blogger.com,1999:blog-30499448.post9021014516595537799..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: Beating The SpreadSid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger27125tag:blogger.com,1999:blog-30499448.post-48078827203847810372016-11-03T09:38:04.139-07:002016-11-03T09:38:04.139-07:00I don't know how I could have made it any clea...I don't know how I could have made it any clearer that I already did in this post. The answer is no. Absolutely, no. Re-read what I wrote, and, hopefully, be reassured.<br /><br />I certainly understand how frightening it is to be told you have cancer, and I know very well that there's both very helpful and good information to be found on the internet, as well as simply awful stuff; and that it's impossible for most people to tell the difference. Trust your doctors; or if you can't, find ones you can. The choice between open and other forms of surgery is not about spread, or about cure rates. It's just about technical issues.<br /><br />If it makes you feel better, my mother-in-law just celebrated her 89th birthday, years after being treated for uterine cancer. (She had the open version.) Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-2921002399409001952016-11-03T07:47:04.045-07:002016-11-03T07:47:04.045-07:00Dear Sir, I was diagnosed just yesterday of uteran...Dear Sir, I was diagnosed just yesterday of uteran cancer..my new doctor...oncologist who I was sent to... read my lab from a previous biopsy last month..... She said the cancer was Grade 3..but now she has ordered chest and abdomen cat scans which I am sure will be on monday or tuesday upcoming week..She discussed with me treatment options and also whether we will do the robotic hysterectomy or the stomach open surgery..I am very very scared and also heard of this years ago about the spreading of cancer after the exposure to air..We lost mother in 1987 of Pancreatic cancer..she was only 42 yrs of age. I am 49 and feel very scared about this whole thing..I have never ever been in the hospital or I don't even catch colds or the flu.. This is totally shocking to me..I am overall a pretty healthy person...My oncologist said that we have to do the scans then we will know more...I am hearing a lot of contradictions to the open stomach surgical procedure...Does it os does it not spread??? straight answer please...thanks so much for your guidance in this matter..Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-43970384672343635542011-10-06T20:07:53.232-07:002011-10-06T20:07:53.232-07:00I continue to be pleased that my aging blog is sti...I continue to be pleased that my aging blog is still helpful.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-63881257149073481062011-10-06T19:39:01.907-07:002011-10-06T19:39:01.907-07:00A good friend sent me this site and I am so very g...A good friend sent me this site and I am so very glad she did. I have stage III clear cell ovariancarcinoma with a very large tumor (17x17x10cm)of omental caking, fortunitley there is no invasion in any other organs. As one of Jehovahs Witnesses I do not accept blood products but things as ringers solution, cell salvage et al.....my onc/surgeon (who does perform bloodless surgery) was unable even to attempt this due to the high level of blood loss so he suggested chemo to shrink the tumor and then remove it. The tumor has responded to the extent of "softening" and he has suggested partial removal after a series of EPO treatment for blood building as the chemo has reduced my all around blood numbers. Then more chemo and finally remove the rest of my evil twins! Now this is where you come in....I had heard the "rumors on tumors" and was scared to death...it will spread!!!!! The sky is falling! So here I am reading your blog and feeling my stress diminishing by the moment. Thank you so much, you have given me the freedom to make a choice...sugery!Jonoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-8442626840012429112010-08-11T14:33:56.227-07:002010-08-11T14:33:56.227-07:00I'm glad you found it helpful.I'm glad you found it helpful.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-89574913461089322242010-08-11T13:27:19.146-07:002010-08-11T13:27:19.146-07:00For those of us who worry and who have heard the r...For those of us who worry and who have heard the rumors... thank you very much for this blog topic and follow on comments!Kambojahttps://www.blogger.com/profile/13584621750814078386noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-87140240511138479542008-12-28T12:21:00.000-08:002008-12-28T12:21:00.000-08:00Donna: I re-read my original post and my comments ...Donna: I re-read my original post and my comments and can't find anywhere that I said what you inferred about needle biopsy. Which is good, because it's not something I believe.<BR/><BR/>As I said -- and it was the whole point of the post -- every cancer that was ever cured had some sort of procedure to remove all or part of it for sampling. <BR/><BR/>The type of sampling -- biopsy with needle or knife, removing the whole thing or just a part -- depends on the type of tumor and location, and does not, as far as anyone has been able to determine, affect the success of treatment.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-56263042002953771762008-12-28T12:05:00.000-08:002008-12-28T12:05:00.000-08:00If I understand correctly, you mentioned something...If I understand correctly, you mentioned something about a biopsy of a tumor, possible loosening cells into the bloodstream---that is if not done with a needle biopsy. If someone is having digestive problems and that scope procedure is done and a small tumor is found between the stomach and esophagus---should or do they do needle biopsies in that area because poking at the tumor to test the cells for malignancy will loosen and spread the cells? Thanks, Donna 12-28-08Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-72745862370157235482007-06-21T19:20:00.000-07:002007-06-21T19:20:00.000-07:00Surgeons are the true advocates for the best cance...Surgeons are the true advocates for the best cancer care for patients. Surgery is the most integral part of the multimodality treatment of many cancers. The surgical oncologist is the first specialist a cancer patient should see before any other oncologic specialists. I would not be surprised that if cancer patients don't get to a surgeon first, the patient loses his/her chances at a successful prognosis because of it. When surgeons are first in command, I'm sure many of them brow beat their medical oncologists to look at cell culture assays very carefully in the context of other known prognostic factors and often choose chemo agents based on their profiles.<BR/><BR/>I've been invited by a surgeon, who with several of his colleagues have utilized cell culture assays in their clinical judgements, to support a campaign to encourage surgeons to obtain and analyze fresh tissues for both cell culture assay and genetic testing. To look at the results of these assays very carefully in the context of other known prognostic factors and choose agents based on the patient's profiles. He has been promoting public awareness that can ultimately lead to philanthropy to support a major multi-institutional research effort, spearheaded by surgeons.<BR/><BR/>As increasing numbers and types of anti-cancer drugs are developed, oncologists become increasingly likely to misuse them in their practice. There is seldom a "standard" therapy which has been proven to be superior to any other therapy. When all studies are compared by meta-analysis, there is no difference. What may work for one, may not work for another. Cancer chemotherapy could save more lives if pre-testing were incorporated into clinical medicine.Greg Pawelskihttps://www.blogger.com/profile/13881517358316630729noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-39510018136196926352007-04-06T09:05:00.000-07:002007-04-06T09:05:00.000-07:00It is indeed fascinating: thanks for the link. I h...It is indeed fascinating: thanks for the link. I hope more comes lf it.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-16974056659715532042007-04-06T06:56:00.000-07:002007-04-06T06:56:00.000-07:00I'm in no ways a surgeon...I was actually just acc...I'm in no ways a surgeon...I was actually just accepted to medical school. But I was reading an article this morning about TGF-beta, and how its levels increase following surgery, chemotherapy, and radiation. I'm not sure what this really means for what you were saying, but it is interesting nonetheless:<BR/><BR/>http://www.reuters.com/article/healthNews/idUSN0523151220070406DoctaJayhttps://www.blogger.com/profile/04829191736284199878noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-17664281339055463682007-02-24T06:58:00.000-08:002007-02-24T06:58:00.000-08:00There is an article in the current issue of Scienc...There is an article in the current issue of <I>Science</I> talking about the problem of cell line contamination of various cell cultures around the world, particular some cancer cell cultures -- the most famous being the HeLa cell line from long ago. (Named for Helen Lasker, a cancer patient who died a long time ago, yet her cancer's cells live on today.) It's mainly an issue for laboratories doing research on cancer cell cultures, but it does lend some support to the idea that some cancer cell lines have an enormous ability to survive beginning with a minor contamination. It would seem that biologically and in vivo this must be true as well. <BR/>The problem is, we do not yet have sufficient understanding of why some cancer cells have this property.Greg Phttps://www.blogger.com/profile/18422487877167541900noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-19477984976436181922007-02-23T07:00:00.000-08:002007-02-23T07:00:00.000-08:00On the day of my mastectomy my sister asked my sur...On the day of my mastectomy my sister asked my surgeon "Do you really think you should cut on that: it might cause the thing to spread?" I was in stage III cancer as it was! I was dumbfounded! I started to laugh hysterically and my surgeon looked at me and said "well, at least you see the humor in it." Where does that notion come from?Lisa https://www.blogger.com/profile/09324961653370110887noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-18706037484244240752007-02-22T14:01:00.000-08:002007-02-22T14:01:00.000-08:00The confronted husband in pathology responded thus...The confronted husband in pathology responded thusly:<BR/><BR/><BR/><BR/>"....it was believed that exposing small cell carcinoma to air during surgery caused a rapid dissemination of the tumor throughout the body. <BR/>This was believed because the tumor is so aggressive that after doing lung surgery several weeks later the tumor would be found in the brain, liver, etc so the thought was that the surgery attributed to this, not realizing the aggressive nature of the cancer......"<BR/><BR/>(Edited to protect the guilty)<BR/><BR/>So whadya think: does this let him off the hook? <BR/><BR/>I was worried that I was going to have to choose between him or you!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-36490412424134997202007-02-22T11:58:00.000-08:002007-02-22T11:58:00.000-08:00So all those years of missed birthdays, anniversar...So all those years of missed birthdays, anniversaries, vacations etc was based on a myth? <BR/><BR/>How low can a husband be? using the excuse that he was saving a life.....<BR/><BR/>What category for the divorce papers does this fit into? malpractice or fooling around? I guess I have to do an indepth literature search at this point to find the proof.<BR/><BR/>Here's hoping that your training was missing this characteristic of small cell cancer......Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-18509118567887002602007-02-22T08:20:00.000-08:002007-02-22T08:20:00.000-08:00I only did lung surgery in training, but I know en...I only did lung surgery in training, but I know enough to find it entirely incredible (meaning not credible) that there's an issue of small cell and air. It's the LUNG, which is FULL of air! It's possible that air-drying some cells disrupts them in terms of lab diagnosis (your husband ought to know about that.) I've never heard ANYTHING about fear of exposing small cell tumor to air in terms of cure.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-91905017034287817652007-02-21T16:49:00.000-08:002007-02-21T16:49:00.000-08:00( I meant too - that is one of my pet peeve spelli...( I meant too - that is one of my pet peeve spelling errors so I couldn't let that pass).<BR/><BR/>My husband is here now and he says it is small cell (aka: oatcell, neuroendocrine carcinoma) cancer of the lung is what he works under the impression that it cannot be exposed to air during surgery - they limit fine needle aspirates for this reason.<BR/><BR/>But again, he says maybe new evidence has shown that this does not apply anymore (?)<BR/><BR/>(chemo is usually the therapy of choice? rarely if ever are these malignancies surgically removed in his opinion, but like I said wrongness is in the genes)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-69056163808792253162007-02-21T16:41:00.000-08:002007-02-21T16:41:00.000-08:00my husband works in pathology. And I could be wron...my husband works in pathology. And I could be wrong but I thought there are many times that his pager went off to do an OR lung lavage for suspected malignancy to see if the lung could be successfully resected. I could swear that one of the indicators for non-resecting was a type of cancer that could not be exposed to air.....or is that not considered a curable cancer? <BR/><BR/>Maybe I am one of those people who has heard this in the wrong context. I often misunderstand my husband....and sometimes it is my fault to.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-28773578233947460782007-02-21T10:03:00.000-08:002007-02-21T10:03:00.000-08:00So that's where my car keys are!So that's where my car keys are!Stephenhttps://www.blogger.com/profile/03934169832326108710noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-24995475807318789052007-02-21T09:08:00.000-08:002007-02-21T09:08:00.000-08:00Cutting open the body lets out organ spirits which...Cutting open the body lets out organ spirits which later hide things like your car keys. True fact!beajerryhttps://www.blogger.com/profile/16721586072565803661noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-91994844715261313072007-02-21T08:11:00.000-08:002007-02-21T08:11:00.000-08:00Greg: the specific thought that tumor reduction is...Greg: the specific thought that tumor reduction is harmful is counter-intuitive, in the sense that "debulking" is a supported concept for many tumors: studies have shown (perhaps a bit questionably in some cases) that reduction of the tumor "burden" increases effecacy of certain chemo recipes. The think that bothers me more is the possible seeding of the bloodstream with non-excisional biopsies. There have been studies of that however (specifically in regard to needle biopsies) that haven't shown a risk. I wouldn't be surprised to find that certain combinations of surgery and tumor in specific instances (more likely with palliative surgery) end up doing more harm than good. My point was to address the folklorish fear of any surgery for any cancer, by pointing out that all cures involve surgery of some sort. <BR/><BR/>Graham: I've heard such thoughts, and imagine good data is needed. I've "felt" (being a "feeler") that the longer the anesthetic the worse it is in many ways, which is why I think surgical speed is an issue sometimes. Something that really disturbed me was a study that in colon surgery, patients who had anastomotic leaks had a better cure rate than those who didn't; the implication being that infection turned on an immune response. It made me wonder if I should become a shittier surgeon. I don't recall seeing that study confirmed....Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-89799899352258911252007-02-20T22:15:00.000-08:002007-02-20T22:15:00.000-08:00i guess some people just want somebody to blame wh...i guess some people just want somebody to blame when a surgery does not totally cure cancer. <BR/><BR/>it is jsut unfortunate that you surgeons get the pointing finger, when really, it is the ugly cancer that is the culprit.<BR/><BR/>may<BR/>www.aboutanurse.comAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-46240759284756373202007-02-20T19:13:00.000-08:002007-02-20T19:13:00.000-08:00I am not a cancer expert.While my sense is that wh...I am not a cancer expert.<BR/>While my sense is that what you're saying is true from the perspective you are talking about, it seems to me I have read that there may be some cancers, and I think prostate cancer was one, in which there may be some humoral or other feedback which may cause tumor which has spread already to be rather indolent because of the total mass of tumor present. Then when there is a significant reduction in mass by whatever means tumor previously quiet becomes more aggressive.<BR/>Do you think there is any truth to this? Does it make sense to you?Greg Phttps://www.blogger.com/profile/18422487877167541900noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-51196359842839760952007-02-20T17:55:00.000-08:002007-02-20T17:55:00.000-08:00I encountered that belief myself when taking care ...I encountered that belief myself when taking care of an elderlyish patient this week. It was her daughter who brought it up... her daughter who was wearing nursing scrubs. She and her family had convinced mom for over a year that surgery for a pretty ugly stomach tumor would cause it to spread. They finally agreed when I stated that mom was going to get more frail and have more abdominal discomfort if it wasn't resected. A year. An entire year. I have little hope of her recovery.Juliahttps://www.blogger.com/profile/08175894138510047787noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-33555472756940185662007-02-20T15:45:00.000-08:002007-02-20T15:45:00.000-08:00You remind me of a conversatin that my onc/surgeon...You remind me of a conversatin that my onc/surgeon and I had prior to my surgery. This was when we had been discussing options and I had chosen radical surgery.<BR/><BR/>I asked how long I would be in surgery. He told me he would reserve the OR suite for 4 hours. He then told us that if things were worse in there than he thought then he would just close me up and it would be a quick operation.<BR/><BR/>Time became the most important issue for me with this surgery. I had remembered I went into surgery at about 11:45 AM. When I again woke up, the only thing I thought was "I have to know what time it is"..I kept trying to focus on a clock and couldn't make it out and finally someone figured out what I wanted. When I was told it was then after 6:00PM and I was just getting ready to be transferred out of recovery, I relaxed. It was a wonderful gift.Cathyhttps://www.blogger.com/profile/13540096932312929506noreply@blogger.com