The Ericksons

Category Archives: Cancer Information

These articles are filled with information about general cancer topics such as prevention and resources.


X-Ray

Image courtesy of stockimages at FreeDigitalPhotos.net

An X-ray is the most commonly used imaging scan for most people since it is simple, safe, and low cost. Doctors use x-ray to diagnose injury and lung issues, from bronchitis to lung cancer.

An x-ray uses radiation in small quantities. The radiation (or x-ray) passes through the body, capturing an image. The rays are blocked by dense tissue, bone, and objects in the body. Radiologists look at the x-ray picture and send a report of their findings to the doctor.

CT Scans

CT stands for Computed Tomography. It’s a painless scan that combines the power of x-ray with computers to make images. The images are 360-degreecross-sectionall views of your body.

Doctors often use CT scans when they want to see bone, soft tissue and blood vessels at the same time. It’s also okay for a patient who has metal in their body to have a CT. Because of this capability, it is a common scan for a cancer patient to have.

CT scans often involve oral and/or intravenous contrast. This clear, tasteless liquid helps radiologists see certain things in the scan, such as lymph nodes, better. During the scan, you lay on a scanner table. The table will move you through the scanner, while the technologist will take the images from outside of the room. Depending on what your doctor needs from the scan, it takes from 10 to 30 minutes.

MRI

Your doctor may order an MRI if he or she wants a good picture of soft tissues such as your organs, your brain, or other internal structures. Unlike x-ray and CT scans, MRI doesn’t use radiation. Instead, it uses powerful magnets to take cross-section images, or “slices.” This scan takes from 30 minutes to an hour.

Because a patient must lay on a table in a small tube for a long time, it’s not an ideal scan for people who are claustrophobic.

A Helpful Comment from MRI Test Prep:

“While external metal, such as keys, cellphones, hairpins, etc. are strictly forbidden from entering the MRI exam room most metal implants, including nearly all orthopedic and dental implants are MRI Safe. There is a spectrum of safety with metal implants which includes safe, conditional, and unsafe. Even many implants which were previously deemed “unsafe” for instance cardiac pacemakers, are now being built with MRI Conditional varieties, allowing these patients to undergo MRI. As a patient be sure to inform both your physician and technologist of all metal implants prior to your exam, and if you have any implant info cards be sure to fax them to the MRI center before your exam, and have them on hand the day of your MRI. (I know this may be too much information but I don’t want people with metal implants to feel like they are disqualified from MRI when they otherwise would be a fine MRI candidate.)”

Whether it’s an x-ray, a CT, or MRI, your doctor will know the best imaging scan for your needs. They’re very careful about safety. If your doctor orders a scan, it is because they believe the risk of letting a suspected problem go undiagnosed outweighs any potential risk the scan may have.  Thanks to low dose radiation, and careful precautions, imaging technology has become quite safe.

Our Story

The first scan Dan had was an x-ray. Doctors saw something suspicious but needed to know more in order to make a diagnosis. They performed many more scans and tests to confirm their suspicions. Throughout Dan’s treatment, he has had scans at least once every 3 months. Often they have been 6 weeks apart. At one point, they needed more up to date information, so they gave him an x-ray every 2 weeks for 2 months. All of these images have given us a picture of what was happening in his body. With that knowledge, we could make informed medical decisions.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

Undifferentiated, A Definition (1)

A term used to describe cells or tissues that do not have specialized (“mature”) structures or functions. Undifferentiated cancer cells often grow and spread quickly.

This is a somewhat scientific post. Keep reading because it’s very interesting.

Tumor grade is different than cancer stage.

After the doctor biopsies, suspicious tissue, he or she sends it to a pathologist. The pathologist then determines whether the tissue is malignant. Furthermore, they can tell what kind of cancer it is, as well as what the tumor’s stage is. Your doctor may also ask the pathologist to also check for specific mutations which can be treated using targeted treatments.

When a pathologist looks at the cancerous tissue under a microscope, they assign a tumor grade. This is based on how similar the tumor cells and the tissue are to normal, healthy cells. They call tumor cells that are more like healthy cells, “well differentiated.” They call more abnormal the cells, “undifferentiated.” This is important because, in undifferentiated cancer, the cells are immature. In addition, undifferentiated tumors are likely to grow and spread quickly.

Making the Grade

There are several ways to grade tumors, This is a popular method. Pathologists give tumors a grade of 1, 2, 3, or 4. The lower the number is, the more normal the cells and the organization of the tumor appears. Grade 3 and 4 tumors grow rapidly, dividing and spreading faster than tumors in grades 1 and 2. (2)

  • GX: Grade cannot be assessed (undetermined grade)
  • G1: Well differentiated (low grade)
  • G2: Moderately differentiated (intermediate grade)
  • G3: Poorly differentiated (high grade)
  • G4: Undifferentiated (high grade)

It’s important for doctors to know a patient’s health history, the stage of their cancer, and the tumor grade to determine a patient’s prognosis and put together a treatment plan.

Sinonasal undifferentiated carcinoma – high magnification By Nephron – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=21382293

To Know or Not to Know

Patients sometimes get upset that their doctor has given them a poor prognosis based on the cancer being advanced and their tumor(s) being undifferentiated. You can tell your doctor at the outset, how much information you are comfortable hearing about your cancer. Tell your doctor if you don’t wish to be given certain details about your cancer. They will usually take care to honor that. Doctors base these predictions on statistics as well as their years of experience. Still, they are statistics. A patient is not a statistic. At the same time, a prognosis can be extremely valuable in making treatment decisions as well as end of life planning.

Our Story

Early on, we saw the word, “undifferentiated” on countless reports over the past four and a half years. What did it mean? Undifferentiated almost sounds okay. It sounds like it’s not clear, so maybe it’s not that serious. We found out how wrong we were in November of 2015 when Dan began to have a hard time breathing. He coughed whenever he tried to talk or take a deep breath, due to undifferentiated cancer filling his lungs. Radiologists call this “ground glass,” because it looks like ground glass on scans.

I have a picture of one CT scan that shows the comparison. His cancer was so aggressive that when we wanted a couple of weeks to try one treatment and then change if it wasn’t working, the doctor said, “You don’t have two weeks.” Therefore, we treated aggressively. It saved his life.  Read more HERE.

Undifferentiated cancer
The x-ray on the right shows the rapid increase in cancer in Dan’s lungs.

Everyone has their own way of coping with their cancer. Ours has been to learn as much as possible, trust Dan’s medical team, and pray, pray, pray.

Footnotes:

  1. National Cancer Institute, NCI Dictionary of Terms, Undifferentiated
  2. National Cancer Institute, Diagnosis and Staging, Prognosis, Tumor Grade

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. My husband, Dan has battled stage IV lung cancer since 2012. I help cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com.

The Erickson Family, August 2016. Photo By Jim Bovin

 


Not that long ago, cancer treatments were synonymous with losing your hair and suffering from nausea and vomiting. Now with the advancements in cancer research, it’s not uncommon for patients to go complete a treatment regimen without either of these issues.  One of these advancements is targeted therapy, also called targeted treatments. Targeted treatments “target” specific genes or proteins found in cancer cells These genes and proteins are related to cancer growth.

Many different types of cells make up the tissues in your body, from your bones to your skin. Cancer cells are created when specific genes in healthy cells mutate or change. To learn more about how cancer cells are made, check out my post, C is for Cancer Cells.

What is a Targeted Treatment?Drug Resistant

Your genes tell your cells how to make the proteins that keep your cells working. What happens if your genes change, or mutate? The proteins will change, too. This is when you get cancer cells growing and spreading out of control. Like zombies, they don’t know when to die.

Targeted treatments “target” the mutations like a zombie killer. They try to normalize the cell growth by turning off signals that tell the cancer cell to grow or divide. This keeps the cells from living longer than normal and soon, they die the death they were meant to.

Traditional Chemotherapy Vs. Targeted Treatments

Traditional chemotherapy takes the carpet bomber approach. It blasts all the rapidly dividing cells in a patient. While it’s effective at killing cancer cells (since they are rapid dividers), it also kills healthy, rapidly dividing cells like hair, nails, skin, and mucous membranes. This leads to the classic chemotherapy side effects like nausea and hair loss. Targeted treatments attempt to treat cancer while sparing healthy cells.

Chemotherapy resistance

Small-Molecule Drugs

One type of targeted treatment is small-molecule drugs. These treatments are typically taken orally in the form of a pill. One example of a small molecule drug is angiogenesis inhibitors. This type of treatment prevents the formation of blood vessels around a tumor. This cuts off the supply line of nutrients to the cancer cells, essentially starving them.

Finding a Match

Different types of tumors have their own unique genetic mutations. It’s important to have the biopsy tissue sent to a lab for molecular testing to find out if you are a match for one of the known mutations. Not all cancers have a known match, suitable for targeted treatments. This is still cutting-edge medicine. Researchers continue to isolate new mutations and develop drugs to treat them.

Cancer.Net has a comprehensive guide that you can use to see some of the latest information about a specific cancer and known targeted treatments. Look up the specific cancer, and then click on the link for “Treatment Options.”

changes in cancer treatments

Monoclonal Antibodies

Another type of targeted therapy, called monoclonal antibody therapy, is a form of immunotherapy. It binds to certain cells or proteins outside of the cancer cell. Often the idea is to get the immune system to see the cancer cells that so often elude it. These drugs are usually given intravenously as an infusion. They are also often used in conjunction with traditional chemotherapy or radiation. It has been used in a variety of diseases including rheumatoid arthritis. You can spot this kind of therapy by the “mab” at the end of its name.  For example, nivolumab, also known by the brand name, Opdivo. Researchers are still learning why these therapies work well for some diseases and not for others and why they work well in some patients while having no effect on others.

 

Side Effects

Some people assume that immunotherapy is natural or that targeted treatments don’t have side effects. These treatments are still drugs and they do still have side effects, sometimes even serious ones. If you are a good match for one of these treatments, they can be a valuable weapon in your arsenal against cancer.

Our Story

When Dan’s oncologist first diagnosed him, she sent his biopsy sample to a special lab in California where they checked it for the most likely mutation, EGFR (epidermal growth factor receptor). The results said he was positive for this mutation. He was on and EGFR inhibitor called Tarceva for 18 months before it stopped working. After a time, the mutated cells that the Tarceva was fighting would mutate again in order to avoid getting eradicated. Think of it like the zombies in the video games that keep coming back with new strengths. While it had its own side effects, it greatly improved his quality of life and extended it.

He tried various more traditional treatments with different degrees of success. Each time we learned a treatment wasn’t working, we would try another one. Then he was put on Nivolumab. That treatment wasn’t right for Dan at all.

He was ready for hospice when a drug called Tagrisso was released by the FDA early. Tagrisso was a new generation of targeted treatment that went after the Tarceva resistant mutation. It was amazing how well it worked. Dan has been taking this drug for 15 months, now. It’s been effective, with very little side effects.

Initially, Dan was given a prognosis of 6 months to live. Thankfully, with both traditional and targeted treatments, and a lot of answered prayer, he will reach 5-year survival in October 1017. That’s a miracle for a stage IV lung cancer patient.

About Heather Erickson

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

The Lymphatic System

Lymphatic System
Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work

Your lymphatic system is part of your circulatory system AND your immune system. It’s a network of vessels and lymph nodes that make up your body’s drainage system.

These vessels move excess fluid that’s been collected from all over the body back into your blood stream. Once the fluid enters the lymphatic vessels, it is known as “lymph.”

The word Lymph comes from the Latin word lympha, meaning, water.

As these fluids move through the tiny lymph nodes, Harmful organisms and cancer cells are trapped and destroyed by the lymphocytes. Those lymphocytes are then added to the lymph which flows from the nodes, back into the bloodstream.

Unfortunately, the lymphatic system is also notorious for transporting cancer cells around the body, also known as metastasis.

Doctors call it called lymphoma when cancer begins in the lymphatic tissue. Leukemia is related cancer in the bone marrow and blood.

What’s a lymph node?

A lymph node is a small, kidney bean-shaped organs. They contain B and T cells (lymphocytes) which are part of your adaptive immune system. (see Immune System)

Lymph Node
Diagram of a Lymph Node By Cancer Research UK – Original email from CRUK, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=34332684

Lymphadenopathy

It’s called lymphadenopathy when one, or more, of your lymph nodes, become enlarged. This usually happens when you have an infection, or in response to inflammation. When many the enlarged lymph nodes are in different areas of the body, it can be a symptom of a systemic infection like mononucleosis, or inflammation like rheumatoid arthritis. It can also be a sign of or cancer.

Lymph nodes can trap cancer cells, but if they don’t destroy all of them, the nodes can become secondary tumor sites.

Our Story

My husband felt a string of hardened enlarged lymph nodes along his left clavicle. These are supraclavicular lymph nodes. He usually avoided doctors, always thinking whatever ailed him would go away on its own. This time, though, he called and made an appointment immediately. He had stage IV lung cancer. Because doctors diagnosed and treated him as quickly as possible, Dan is still alive today.

If you discover hard, enlarged lymph nodes, get them checked out.

Lymphedema

Sometimes lymph accumulates in a patient’s face or limbs. This is called lymphedema. This is a common problem for cancer patients who have had their lymph nodes removed. Treatment is usually massage and compression sleeves. Thankfully, it’s usually temporary.

The Spleen

Your spleen is basically a giant lymph node. It filters your blood. As it does, it removes old red blood cells, recycles iron, and plays a big role in your immune system, to the point that if you don’t have a spleen, you are far more likely to get certain infections.

The Thymus

Your thymus is also part of the lymphatic system. This is where the T-cells mature.

By the way, if you’ve ever heard the term, “sweetbread,” referring to a culinary delight, they are specifically talking about a calf’s thymus. I’ve never eaten them, but have heard they are delicious.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com.

 

Speaker


What is your immune system?

The immune system is your first line of defense against infections, both viral and bacterial, as well as other diseases. The immune system, which is made up of special cells, proteins, tissues, and organs.

How does it work?

Your immune system works through a series of actions known as the immune response. This response attacks invaders including organisms and substances that attack and your body’s systems and cause illness and disease.

Three Types of Immunity

Blood Cells
One can see red blood cells, several white blood cells including lymphocytes, a monocyte, a neutrophil, and many small disc-shaped platelets. By Bruce Wetzel (photographer). Harry Schaefer (photographer) (Image and description: National Cancer Institute) , via Wikimedia Commons

Adaptive Immunity

This type of immunity is very active, developing throughout our lives as we are exposed to various germs and diseases, as well as when we are vaccinated. Adaptive immunity involved the parts of our immune system that are in our blood.

Most people know that their blood is made of white and red cells. The white blood cells are part of your immune system. They are also known as leukocytes.

There are two basic types of leukocytes:

Phagocytes

Phagocytes are cells that destroy invading organisms. The most common type of phagocyte is the neutrophil. Neutrophils fight bacterial invaders.

Lymphocytes

Lymphocytes are created in the bone marrow. If they stay in the bone marrow to mature, they become B lymphocytes (think B for bone marrow). B lymphocytes produce antibodies.  Antibodies are special proteins that lock onto specific antigens. Antigens are foreign invaders in the body. These antibodies stay in your body, preventing you from getting sick with the same disease in the future. An example of this is the chickenpox. Once you get chickenpox, you usually won’t get it again.

Immunizations utilize this function to prevent certain diseases. Most immunizations are an inactive virus or disease which doesn’t make you sick but still causes your body to produce antibodies, protecting you from getting sick with that disease/illness in the future.

B lymphocytes are great at finding invaders, but they can’t destroy them on their own. They need the help of another type of lymphocyte.

While the B lymphocytes are maturing in the bone marrow, there is another type of lymphocyte that leaves the bone marrow early and head for the thymus gland, where they mature into T lymphocytes (think T for thymus). T lymphocytes destroy the invaders the B lymphocytes have identified. Sometimes, people call T lymphocytes, “killer cells.” Another thing that T lymphocytes do is signal other cells in the immune system, such as phagocytes, to do their job.

Antibodies can neutralize toxins. They can also activate a group of proteins called a complement, which assists in killing viruses, bacteria, and infected cells.

Innate Immunity

Everyone is born with natural immunity. This is known as innate immunity. This type of immunity protects one species from getting illnesses of another. For example, humans don’t get heartworm and Dogs don’t get HIV.

Some of our innate immunity comes from parts of our immune system that form a barrier between us and potential invaders.

One of these barriers is our skin. If you get a cut, the defensive barrier is broken. As the cut heals, you are vulnerable to infection. Thankfully, immune cells on the skin attack invading germs, protecting us.

Mucous membranes are also part of our innate immune system. These gooey barriers to germs and other invaders line our nose, throat and gastrointestinal tract. As you breathe, the mucus membranes that line your nose trap air pollutants. It’s your first line of defense.

Passive Immunity

In the early years of life, we are most vulnerable to infections and viruses because we haven’t yet developed a strong immune system that recognizes and destroys invaders. Thankfully, babies can get antibodies in their mother’s breast milk. These antibodies protect them against many early childhood illnesses and infection.

What if it doesn’t your immune system doesn’t work right?

There are 4 main things that can go wrong with the immune system:

  • Immunodeficiency is when part of the immune system isn’t working properly.

Primary Immunodeficiency is when you are born with the problem.

Acquired (or secondary) immunodeficiency develops later. They can be the result of malnutrition, disease, or medication such as chemotherapy or steroids.

  • Auto immune disorders are when the body’s own immune system attacks its own tissue as if it were a foreign invader. Examples of autoimmune disorders are rheumatoid arthritis and lupus.
  • Allergies happen when the immune system over-reacts to antigens (allergens), producing excess histamine, causing a variety of symptoms ranging from mild itching to life-threatening anaphylaxis. Associated disorders include eczema, allergies to food, environmental allergies, and asthma.
  • Cancers of the immune system include lymphoma and leukemia. Both are common childhood cancers. Thankfully, most cases of these cancers in kids are curable with current treatments. Leukemia involves out of control growth of leukocytes. Lymphoma involves lymphoid tissues. Both cancers weaken the immune system making it harder for the patient’s body to fight off infection.

How does cancer treatment affect your immune system?

Medications like chemotherapy and radiation destroy cancer cells. Unfortunately, they also destroy healthy cells like those found in bone marrow and other parts of the immune system. Patients lose neutrophils, which fight infection-causing bacteria. Doctors call this “neutropenia.”

Immune System
By Volker Brinkmann – (November 2005). “Neutrophil engulfing Bacillus anthracis”. PLoS Pathogens 1 (3): Cover page. DOI:10.1371. Retrieved on 2009-01-04., CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=2107792

Boosting your Immune system

Doctors sometimes give patients non-specific immunotherapies alongside traditional cancer treatments such as chemotherapy and radiation. This improves their overall immune system function.

An example of this is the Neulasta shot which prevents/treats neutropenia. This is a colony-stimulation factor, a man-made form of a protein which stimulates the growth of white blood cells. There are no common side effects of Neulasta. My husband, Dan, experienced one side effect that occurs in less than 30% of patients. The side effect was bone pain. This is caused by the rapid production of white cells in the bone marrow.  It feels like growing pains, only much worse. Dan was in the worst pain of his life.

When someone is in active cancer treatment, they must be more careful about coming into contact with bacteria and viruses. One person’s minor cold can put a cancer patient in the hospital since they are immunocompromised and can’t fight the illness. Cancer patients often decline to shake hands or attend social functions when their immune system is compromised.

Can your immune system fight cancer?

Immunotherapy is one of the most recent developments in cancer treatment. The goal is to stimulate a patient’s immune system, causing it to be more effective in fighting cancer.

Cancer cells grow and spread because the immune system doesn’t recognize them as foreign, Immunotherapies are inactivated forms of cancer cells or proteins that are unique to cancer cells. These are introduced to the patient’s immune system to try to “teach” it to recognize cancer cells and attack them. These therapies aren’t without side effects, and they only work for certain patients with certain cancers. For those patients, immunotherapy can be a powerful; weapon in their cancer battle.

Immunotherapy is opening doors to new ways of fighting cancer. With every new discovery, researchers gain a greater understanding of the enemy we are up against, and the possibilities for eliminating that enemy.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

One of the things we learned early on in Dan’s cancer journey was that even if a treatment worked, eventually, it wouldn’t. Cancer cells become drug resistant.

Our Story

When doctors first diagnosed Dan with stage IV lung cancer in 2012, they perscribed a targeted treatment called, Tarceva. The treatment worked well for 18 months before the cancer in his body became drug resistant and again progressed.

After that, he volleyed back and forth between targeted treatments, immunotherapy, and traditional chemotherapies. He would take each treatment until the cancer again became drug resistant.Then, the doctors would put him on a new drug. This is something that’s often difficult for people to understand.

Once a treatment works, why can’t you use it indefinitely?

There are several reasons for this.

Remember in yesterday’s blog on cancer cells, we learned about the ways that cancer cells are different from healthy cells? As these cells mutate, they act more and more abnormal. One of the ways they differ is that the cells can become drug resistant to the chemotherapy treatments that we rely on the kill the cancer cells.

One form of drug resistance in chemotherapy is similar to the way we become drug resistant to antibiotics after taking antibiotics repeatedly, inappropriately, or for long periods of time, The bacteria which aren’t killed become stronger.

In chemotherapy, some cells survive and mutate. They then continue to multiply and soon there are more cells that don’t respond to the treatment than those that do.  This is one theory as to why Dan became resistant to Tarceva. Thankfully, over the years, researchers have been working on this problem. Just in the nick of time, the FDA approved a drug called Tagrisso. This is another targeted treatment that is used when the original EGFR mutation that some lung cancer patients have, becomes drug resistant to the currently targeted treatments that are available such as Tarceva, Iressa, and Afatinib.

Chemotherapy resistance

A Drug Resistant Protein Molecule

Cancer cells use a molecule called “p-glycoprotein” to protect themselves against cancer drugs. Resistant cells often have high levels of this protein, in the cell walls. The protein acts like a pump which removes toxins from cells. This includes pumping chemotherapy out of the cell faster than it can take the treatment in. Because there isn’t enough of the chemotherapy in the cell, it can’t kill the cell.

An Inactive Gene

In a study done on colon cancer cells, researchers discovered that cells which were initially sensitive to the drug oxaliplatin and later became drug resistant, had inactivated a gene in their DNA. This caused the cells to repair these breaks and they are back in business, growing and spreading. This is known as acquired resistance. Researchers are also studying how the loss of this gene function causes tumors to be drug resistant from the outset, otherwise known as primary resistance.

Lack of Transportation

Cancer cells can become drug resistant because the protein that transports the drug across the cell wall stops working.

Gene Amplification

Sometimes, a cancer cell can produce hundreds of copies of a particular gene, which triggers an overproduction of protein rendering the treatment ineffective. This is known as gene amplification.

Multidrug Resistance

If cancer becomes drug resistant to one drug, it’s more likely that it will be resistant to others. For example, once Dan’s cancer became resistant to Tagrisso, and EGFR targeted treatment, his cancer was resistant to all of the other EGFR targeted treatments.  This is known as multidrug resistance. This is why it’s so important to choose the best possible treatment first. Sometimes, doctors give patients multiple drugs in combination, to reduce the chances of becoming drug resistant to any one drug.

Drug Resistant

We need to adjust our expectations.

Often, our expectations of cancer treatment are too high. The human body is complex on every level and when it breaks down, there is no easy fix. Sometimes the systems which protect us under normal circumstances can be the very problem we encounter when things are no longer working as they were designed to. Thankfully, researchers are continuing to look at ways of preventing drug resistance.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

 


I recently went to the dermatologist for a full exam. As a bonus, she removed a small lump that I’ve had for years. She numbed the area and in 2 seconds (maybe even less) removed the pea-sized lump, putting in a couple of stitches and a Band-Aid. Then, she labeled the sample and sent it off to the lab.  She assured me that it looked normal, so I shouldn’t worry, but that it was very important to make sure that I get the results. Then she gave me written post-biopsy care instructions.

Other biopsies

I thought about other times in my life when a biopsy has been important.  In the early 1980s, my dad discovered a tumor behind his ear. I still recall hearing my parents talking about it, worrying until the results came back benign.

It was that experience that I remembered when I felt my husband’s hard, enlarged, supraclavicular lymph nodes. Only, I knew more as an adult. It was even scarier.

I was also in the room when they did a biopsy on Dan…and when we got the results.

What is a biopsy?

A biopsy is an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease.  Usually, when we think of biopsies, we think of cancer, but they help doctors diagnose other types of disease, as well. Biopsies tell whether or not a patient is rejecting transplanted organ.

There are many types of biopsies.

I’ve already told you about my skin biopsy. The doctor removed a lump just under the skin, like any other skin biopsy. A circular “punch” blade removed the cylindrical shape sample.

If the lump had been larger or in a difficult to reach place in the body, the doctor would perform a surgical biopsy.

The most common type of biopsy, the needle biopsy, uses a needle to remove the tissue the pathologist will test.

When Dan had his biopsy done, they did a fine needle aspiration biopsy. The doctor used an ultrasound to guide her as she inserted a fine needle into his lymph node and sucked up cells to test. They pulled cells from several lymph nodes. By using this technique, they could avoid going into his lung. They also knew from the positive results that cancer had spread through the lymphatic system.

Sometimes rather than using ultrasound, the doctor will use a CT scan to guide the needle.

Biopsies vary depending on the type of tissue the doctor is collecting.

A bone marrow biopsy- When a doctor suspects a blood cancer such as leukemia or lymphoma, they insert a needle into the pelvis bone to collect the sample,

A liver biopsy- The doctor inserts a needle through the belly to gather the liver tissue.

A kidney biopsy- The doctor inserts the needle through the patient’s back into the kidney.

In a prostate biopsy- Doctors take multiple needle biopsies at a time from the prostate gland via a probe inserted into the rectum.

Some biopsies are more invasive than others.

The doctor can perform a skin biopsy right in the doctor’s office with minimal discomfort during and after the procedure. Dan’s doctor did a fine needle aspiration biopsy a clinic, as well. Sometimes patients go to a hospital for this type of biopsy and take pain medication after the procedure.

After the doctor collects the tissue, he sends it to a pathologist. The pathologist will examine the tissue under a microscope. Most of the time, the pathologist will be able to diagnose the patient’s condition. Sometimes a pathologist will attend the procedure and make a diagnosis immediately. Usually, they will take a week or longer.

It’s never fun, getting a biopsy done, but, it’s the only way to make a definitive cancer diagnosis for most types of cancer.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

The earlier cancer is detected, the more easily and effectively it can be treated. Asymptomatic, or “quiet” cancer often spreads, unchecked to other locations (i.e. metastatic). This is why some forms of cancer have a reputation for being especially deadly.

Some cancers make themselves known early on because of a side effect that sends a patient to the doctor. An example would be esophageal cancer. Because of a tumor on the esophagus, swallowing would become difficult and cause a patient to go to the doctor.

Some cancers that have few or no symptoms until the cancer is already advanced. Because of the asymptomatic presentation of these cancers, they are among the deadliest.:

  • Lung Cancer
  • Kidney Cancer
  • Ovarian Cancer
  • Cancer of the Tail of the Pancreas

Often, the earliest symptoms of cancer are easily dismissed as a run-of-the-mill ache or illness (like indigestion or the flu). It’s not practical, or even safe, to run testing because of every minor symptom. When there are risk factors, however, they shouldn’t be dismissed so quickly.

Our Story

In October of 2012, Dan was a healthy, vibrant man of 51. The day after he helped a friend install a garage door, he had a back ache that he dismissed as a pulled muscle. If he had gone to the doctor, they would have treated him for back strain—and rightly so. He had no risks for lung cancer. He’d never been a smoker. He’d never worked with asbestos. He was asymptomatic—no cough, no problems breathing. It was just a back ache.

The next day, he felt hard, enlarged lymph nodes. The cancer was no longer asymptomatic. But, it was too late. Within 2 weeks, he was diagnosed with stage IV metastatic lung cancer. The back ache was cancer that had spread to his spine.

Early Screenings

Early stage breast and colon cancer are also often asymptomatic. Fortunately, there are screening recommendations that increase the likelihood of discovering cancer. Cancer screening and prevention has led to an overall decline in cancer mortality rates. Primary care doctors are the first line of defense, reminding their patients to get screened at the appropriate time, based on their individual age and risk factors.

The following are guidelines for basic cancer screenings.

Between the ages of 21 and 29

Women should have a PAP screen done every 3 years, even if you’ve been vaccinated against HPV. Any changes in the way your breasts look or feel should also be reported to your doctor.  Men should discuss their risk of colon cancer with their primary care provider.

Between the ages of 30 and 39

Women should have PAP and HPV tests every 5 years even if you’ve been vaccinated against HPV, unless you’ve had a total hysterectomy unrelated to cervical cancer. Any changes in the way your breasts look or feel should also be reported to your doctor.  Men should discuss their risk of colon cancer with their primary care provider.

Between the ages of 40-49

Women should have PAP and HPV tests every 5 years even if you’ve been vaccinated against HPV, unless you’ve had a total hysterectomy unrelated to cervical cancer. Any changes in the way your breasts look or feel should also be reported to your doctor. You may elect to have an annual mammogram. At age 45, yearly mammograms are recommended. Men should discuss their risk of colon and prostate cancer (and screening) with their primary care provider.

Between the ages of 50 and 64

Women should have PAP and HPV tests every 5 years even if you’ve been vaccinated against HPV, unless you’ve had a total hysterectomy unrelated to cervical cancer. Any changes in the way your breasts look or feel should also be reported to your doctor. You may elect to have an annual mammogram. From ages 50-54, yearly mammograms are recommended. At age 55, you can switch to mammograms every 2 years. You should also begin testing for colon cancer at age 50 with a test and frequency recommended by your doctor. Men should discuss their risk of colon and prostate cancer (and screening) with their primary care provider. Both men and women should talk with their doctor about their lung cancer risk and whether low-dose CT scans should be done.

Age 65 and older,

Women with a history of serious cervical pre-cancer should continue testing until 20 years after diagnosis. Any changes in the way your breasts look or feel should also be reported to your doctor. have mammograms every 2 years. Testing for colon cancer is recommended. Men colon cancer testing is recommended. If you are expected to live longer than 10 years, discuss your risk of prostate cancer (and screening) with your primary care provider. Both men and women should talk with their doctor about their lung cancer risk and whether low-dose CT scans should be done, especially if you have a history of smoking.

Your Dentist

Your dentist will also evaluate you for oral and tongue cancers at your annual cleaning and exam.

The asymptomatic nature of many cancers.

The asymptomatic nature of many cancers is the reason so many cancer patients aren’t diagnosed until it’s too late. Men tend to be at greater risk because they put off seeing their doctor.

  • Get regular screenings.
  • Reduce risks by living a healthy lifestyle.
  • Don’t ignore symptoms.
  • Know your family history and tell your doctor.

Check back on April 3rd to read my next A to Z Challenge post: Biopsy. An please share this post on your social media. By doing so, you will raise awareness of asymptomatic cancer. You may even save a life!

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

 

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