Our doctor said that this time, the cancer is inoperable because it has spread extensively. He said that the cancer has come back aggressively. My question -- and I posed this to him -- is: was something missed? After they removed the cancer, they did find microscopic traces of cancer in one lymph node. Why did it come back so quickly? Should have they administered chemo as well as radiation?
Abstract Radiotherapy and chemotherapy are given in multiple doses, which are spaced out to allow the recovery of normal tissues between treatments. However, surviving cancer cells also proliferate during the intervals between treatments and this process of repopulation is an important cause of treatment failure. Strategies developed to overcome repopulation have improved clinical outcomes, and now new strategies to inhibit repopulation are emerging in parallel with advances in the understanding of underlying biological mechanisms.
Summary
The repopulation of surviving tumour cells during treatment with radiation and chemotherapy is an important cause of treatment failure.
The rate of repopulation often increases with time during treatment with either radiotherapy or chemotherapy.
Mechanisms that underlie tumour repopulation are poorly understood, but might involve the proliferation of tumour cells that are distant from blood vessels and that were destined to die in the absence of cancer treatment.
Prolongation of a course of fractionated radiotherapy requires a substantial increase in total dose, to counter the effects of accelerated repopulation.
Accelerated repopulation during successive courses of chemotherapy can lead to an initial response followed by tumour regrowth in the absence of any change in the intrinsic sensitivity of the tumour cells.
Accelerated radiotherapy and dose-dense chemotherapy (with support from growth factors) represent promising strategies for reducing the effects of repopulation by shortening the overall treatment time.
The use of molecular-targeted cytostatic agents during radiotherapy, or between courses of chemotherapy, is a promising strategy to inhibit repopulation and thereby to improve therapeutic outcome.
Disclaimer: Please see your own dentist/doctor for a proper diagnosis as my words should not, in any circumstances, be taken as dental/medical advice.
"If you see what is small as it sees itself, and accept what is weak for what strength it has, and use what is dim for the light it gives, then all will go well. This is called Acting Naturally." Lao-Tsu, Tao Teh King
Posts: 3268 | Location: St Luke's Hospital, Bradford and Pinderfields Hospital, Wakefield | Registered: 14 December 2002
