Hi I hope someone can help me a bit as i have been unable to get any answers on the internet. My da.d was diagnosed with throat cancer last august which his dr thought would be treatable. He then had three rounds of chemo each lasting a 24/7 with a 2week gap then he had seven weeks of radiotherapy (weekends off) with on day of chemo at the same time. During this whole time he had a swollen gland which was apparently normal. Initally after treatment the dr said it was looking good and could no longer see the tumour in his throat. Anyway two months after treatment(end of this february) he again brought up this gland and the dr agreed to more scans. So last wednesday he went back for his normal app at the hospital and they had the results of his scan which showed the cancer has spread to his lung although he is not yet showing any sympotms for this .they said there is nothing more they can do. I was not at this app(as we were not expecting anything too bad plus i have panic atacks which upset my dad so im best keeping away)and obviously my dad was to upset to ask questions or take much in as what i have wrote is all he has told me and he says it is all he knows and does not want to keep talking about it. He has another app in 5 weeks. So to get to the point i dont understand firstly how it spread to a distant site during treatment? And also why is there nothing they can do? how can they just say that without further investigation?I am aware that people cant give medical information but any info would be greatly appreciated as right now im scared and confused (bit angry too) and i think i will be more help and comfort to my dad if i can get my head together.

Hello talluhlabelle

Most patients with head and neck cancer have metastatic disease at the time of diagnosis (regional nodal involvement in 43% and distant metastasis in 10%). When oral cancer spreads, it usually travels through the lymphatic system. The lymphatic drainage of the unmanipulated neck is systematic and predictable. While it can also spread to other parts of the body like the lung, it is not common.

from Chapter 8 'Invasion and Metastases'of Cancer Medicine, 5th Edition

quote:

Our understanding of the processes of invasion and metastases has improved, but our ability to detect occult metastatic disease or metastatic potential prior to development of occult disease still lags. Some patients with cancer have benefited from improved screening techniques wherein they are being diagnosed earlier, such as in breast cancer. Despite this, approximately 30% or patients still will have clinically detectable metastases at the time of initial diagnosis, and a further 30 to 40% of patients will harbor occult metastases. Continuing with the breast cancer example, the relapse rate in stage I, with less than 1 cm disease, remains 20 to 25%, indicating that the unveiling of metastatic potential is an earlier event than had been thought (Fig. 8.1). Thus, less than one-third of newly diagnosed cancer patients potentially can be cured by local therapeutic modalities alone. The size and age variation in metastases, their dispersed anatomic locations, and their heterogeneous composition over time hinder complete surgical extirpation of disease and can limit the effectiveness of many systemic anticancer drugs.

Elusive disseminating cancer cells hold key to metastatic cancer relapse

quote:

The cure for cancer lies in the biology of circulating and disseminating tumor cells that, unfortunately, evade detection and treatment very easily, according to one of the world's leaders in the field. In a plenary lecture, Klaus Pantel, MD, described the properties and clinical relevance of the cells that eventually cause metastatic relapse but remain elusive at primary diagnosis.

In a pooled analysis of nearly 5,000 patients, (disseminated tumor cells) DTC-positive patients had significantly worse survival than DTC-negative patients. Some patients with DTCs, however, survived for years, suggesting that "the biological relevance of DTCs may be heterogeneous," Dr. Pantel said (N Engl J Med 2005;353:793-802).

My understanding is that by the time a cancer is detected, some cancer cells have usually spread to other parts of the body. This does not mean that the cancer has spread and the prognosis is poor as the cells can remain quiet for years and years and be held in check by the body's defenses if they aren't destroyed. They may activate later or not at all. These cells are difficult to detect. It explains why after all the local aggressive treatment that should have killed the cancer cells, they suddenly appear elsewhere! Hence, a prognosis that is good one day can change the next. If these cells activate, the oncologist looks wrong footed! It is all quite complicated. In addition to treatment, one needs good luck too.

Hope that helps 'explain' things.

Best wishes
Vinod

yes thank you. I take from that that although they checked to see if it had spread it was at the time undetectable and is only now showing up on scans etc. Can anyone explain or does anyone have any knowledge about why they wouldnt be able to do anything>does the fact that they said that they could no longer do anything is weird i think. from what else i have read on other threads people are offered treatment to prolong life whereas my dad was just given this awful news and sent on his way. is metastatic cancer never curable?thanks in advance and again i am aware nobody on here is an oncologist i just cant bring myself to ask my dads right in front of him