tag:blogger.com,1999:blog-30499448.post4303365520502447282..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: Tony Snow. And a story.Sid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-30499448.post-46904759524292870522007-06-21T18:54:00.000-07:002007-06-21T18:54:00.000-07:00In regards to Orac's comment about anti-blood-vess...In regards to Orac's comment about anti-blood-vessel-forming therapy, there is a "functional profiling" Microvascular Viability Assay for anti-angiogenesis-related drugs.<BR/><BR/>A major modification of the DISC (cell death) assay allows for the study of anti-microvascular drug effects of standard and targeted agents. The assay is based upon the principle that microvascular (endothelial and associated) cells are present in tumor cell microclusters obtained from solid tumor specimens. The assay, which has a morphological endpoint, allows for visualization of both tumor and microvascular cells and direct assessment of both anti-tumor and anti-microvascular drug effect. CD31 cytoplasmic staining confirms morphological identification of microcapillary cells in a tumor microcluster.<BR/><BR/>The principles and methods used in the Microvascularity Viability Assay include: 1. Obtaining a tissue, blood, bone marrow or malignant fluid specimen from an individual cancer patient. 2. Exposing viable tumor cells to anti-neoplastic drugs. 3. Measuring absolute in vitro drug effect. 4. Finding a statistical comparision of in vitro drug effect to an index standard, yielding an individualized pattern of relative drug activity. 5. Information obtained is used to aid in selecting from among otherwise qualified candidate drugs.<BR/><BR/>This kind of technique exists today and might be very valuable, especially when active chemoagents are limited in a particular disease, giving more credence to testing the tumor first. After all, cutting-edge techniques can often provide superior results over tried-and true methods that have been around for many years.Greg Pawelskihttps://www.blogger.com/profile/13881517358316630729noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-50673969207719360022007-03-30T18:01:00.000-07:002007-03-30T18:01:00.000-07:00Great point. I saw a patient this week with a mass...Great point. I saw a patient this week with a mass just above the left clavicle which is a metastasis from her breast cancer treated with surgery and chemotherapy 22 years ago. It is apparently the only site of disease. She was stunned to think that her cancer has been present but dormant for so long. Ah, Biology!!!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-79115977764427519332007-03-28T14:30:00.000-07:002007-03-28T14:30:00.000-07:00Lynn: you're correct.. In the case of recurrance a...Lynn: you're correct.. In the case of recurrance after being told no tumor can be found, there are not tests able to detect very tiny amounts. Assuming cells spread singly from a primary tumor, it can take years for the cells to multiply (there's the notion of "doubling time," ie the time it takes for the number of cells in a tumor to double, which can vary by months to years) enough to become detectable. In the case of apparent cure, it's probably both: complete eradication in many, or developing some sort of "steady-state" in others. The fact is that some tumors (notably breast and melanoma) may recur furiously as much as twenty or more years after treatment. That's pretty uncommon, by the way; people who've gone that long really don't have much to worry about, statistically speaking. But it suggests that some "cures" don't require complete eradication.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-24373198437259731712007-03-28T08:50:00.000-07:002007-03-28T08:50:00.000-07:00"I object slightly to the notion that her cancer h..."I object slightly to the notion that her cancer has "returned." It never left."<BR/><BR/>I know this was from your Edwards thread, but it's germane to Tony Snow as well. I'm confused about this concept because I've heard docs say they can't find any trace of a cancer, leading to the idea that it has, in fact, cease to exist. Are you saying that there are simply too few cells to show up in a blood test, and that the cancer is still there?<BR/><BR/>Also, what about those whose cancer never returns? Have the cells been eradicated or simply never grew?<BR/><BR/>Thanks in advance for the education.Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-81876824441016657642007-03-27T20:45:00.000-07:002007-03-27T20:45:00.000-07:00When I heard the news about Tony Snow today - I th...When I heard the news about Tony Snow today - I thought of you Dr. S. because of what you said the other day about Cancer. You said that when people say it came back (as they said about Tony today)that it really never left. He seems like such a good man and I truly wish him well.<BR/><BR/>We found out today that our aunt who has been responding well to the chemo/radiation is going to be able to have her breast removed on April 10th. geez - that sounded weird. Just that she was so bad before they couldn't do the surgery and now they can and that is where the CA originated from.<BR/><BR/>I am glad your patient did so well. it must be awesome to have a job that you get to help save someone's life.SeaSprayhttps://www.blogger.com/profile/07906503090688697222noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-53607193015047945592007-03-27T12:20:00.000-07:002007-03-27T12:20:00.000-07:00It is very tuff balancing realistic odds with opto...It is very tuff balancing realistic odds with optomistic hope. Nice piece!<BR/>BTW: I read and enjoyed your book, especially the afterword. You are a very good writer.Richard A Schoor MD FACShttps://www.blogger.com/profile/11520184749583009935noreply@blogger.com