Posted By: Gary So called "smart cancers" - 11-08-2011 04:46 AM
Just for the record ALL cancers are smart (not just H&N)- smart enough to hijack healthy cells, seek out blood supplies, metastasize and defeat our immune system. Sometimes it actually seems to "feed" on radiation and chemo and everything else thrown at it. It is an highly adaptive and formidable foe. If "poorly differentiated" it will cross over into lymph, bone, muscle and soft tissue. It accounts for roughly 50% of the total death rate. It has baffled researchers for centuries and continues to do so. We have made progress for sure and the number of cancer survivors steadily increases. There is always reason for hope. 200 years ago there was practically no hope.

Consider this when you are deciding what weapons in the treatment arsenal you are going to employ. There is no easy way out and in the words of Bill W. "half measures avail us nothing".
Posted By: Charm2017 Re: So called "smart cancers" - 11-08-2011 02:25 PM
Guess it depends on your definition of "smart". My idea of a "smart" cancer is prostate cancer which every man will get if he lives long enough but the cancer is smart enough to grow so slowly in the majority of men that they die of other causes with no treatment required. "Smart" meaning here wanting to survive so letting the host live.
H&N cancer is "smart" like the scorpion in the Fable which outsmarts the frog and convinces it to ferry it across the river only to stings it. the scorpion drowns and the frog dies. Just it's nature
.
On the other hand, I have to agree with Gary on how "smart" H&N cancer is as a deadly opponent. It tricks our immune system into not recognizing it. It actually evolves during TX, with the more radiation resistant cells remaining behind to launch another attack. It can grow undetected for a long time. So it is almost a genius as a dedicated killer, to the point of being willing to do a kamikaze attack
Plus there is now hope. I'm a big Science Fiction fan and I was reading an old story from the 1930s where the whole plot was that the hero had oral cancer so it was not treatable nor curable.

Full disclosure: I'm biased because my cancer turned out to be "smarter" than me the first time. I'm hoping I've 'outsmarted' it this time by following Gary's advice of agressive maximum treatment
Charm
Posted By: Gary Re: So called "smart cancers" - 11-09-2011 01:40 AM
In my original post I was paraphrasing what my MO told me on Thursday last week.
That is true that prostate cancer is almost parasitic - unless it leaves the prostate capsule - then you are in deep trouble. Recently they determined that early detection of prostate cancer can actually increase morbidity so they are not recommending PSA tests like they used too, although my GP still routinely orders them for me.

I should also mention that cancer is patient, waiting until the immune system starts to decline in the mid 50's.

The viral connection is a fascinating new wrinkle but unfortunately now persons much younger than 55 are showing up here, which was a rarity in 2002.

Years ago I worked for a company that attempted to push for transrectal ultrasound as an early detection screening. The death rate went up 5% from complications from the biopsy, most of which were negative anyway.

The FDA takes false positives very seriously and this is what precipitated the mammography quality assurance act. Too many women were getting unnecessary biopsies... This is why new imaging modalities have been developed for dense breast tissue and also adjunctive ultrasound screening as well.
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