Things Doctors Say . . .

******

. . . I will preface, I am skeptically enthusiastic about my new GYN. I had to find her because my other new GYN, whom I was skeptically enthusiastic about last year, has ditched conventional GYN care.  My newest newbie, who is no-nonsense and a look-you-in-the-eye kinda gal, won brownie points with me today when she performed my ultrasound in-office, had read my med hx, and essentially confirmed that the radiologist who reads my PetScans is a moron: (1) contrary to his findings (which he confirmed after a second look) I do NOT have a prominent uterus displaying heterogeneous metabolic activity; and (2) contrary to his findings (which he confirmed after two second looks) I have NOT spontaneously re-grown my right ovary - a little item that was surgically removed in 1981 during a right-salpingo ooverectomy. She did, however, find dime-sized cysts...but that is another appointment and not of any remarkable concern.

Then, my newbie said the darnedest thing.

I was thinking about you yesterday.

Really, because it was birthday?

Chuckle...no, but Happy Birthday!  A patient who came in yesterday was visibly upset. I asked her what was wrong. She told me that her BFF had just died. Apparently her friend had been diagnosed with breast cancer three years prior. A few weeks ago this friend started having shortness of breath. She was diagnosed with Valley Fever and her PCP started treating her as such. Then she started having headaches. When she collapsed and taken to hospital, they found she had masses in both her lungs and brain. She died 5 days later.

I immediately thought of you.

Oh.

What is your doctor doing about your breathing issues?

The antibiotics didn't work. The breathing treatment worked only for a day. The steroid shot too only gave relief for a day. They want to now assess me for Valley Fever.

Get a second opinion if that is the conclusion.

Yup.

 

******

Stress Fuels Breast Cancer Metastasis to Bone

ScienceDaily (July 17, 2012) — Stress can promote breast cancer cell colonization of bone, Vanderbilt Center for Bone Biology investigators have discovered.

---

The studies, reported July 17 in PLoS Biology, demonstrate in mice that activation of the sympathetic nervous system -- the "fight-or-flight" response to stress -- primes the bone environment for breast cancer cell metastasis. The researchers were able to prevent breast cancer cell lesions in bone using propranolol, a cardiovascular medicine that inhibits sympathetic nervous system signals.

Metastasis -- the spread of cancer cells to distant organs, including bone -- is more likely to kill patients than a primary breast tumor, said Florent Elefteriou, Ph.D., director of the Vanderbilt Center for Bone Biology.

"Preventing metastasis is really the goal we want to achieve," he said.

Elefteriou and his colleagues knew from their previous studies that the sympathetic nervous system stimulated bone remodeling, and that it used some of the same signaling molecules that have been implicated in breast cancer metastasis to bone.

"We came to the hypothesis that sympathetic activation might remodel the bone environment and make it more favorable for cancer cells to metastasize there," Elefteriou said.

Evidence from the clinic supported this notion. Breast cancer patients who suffered from stress or depression following their primary treatment had shorter survival times. Both stress and depression activate the sympathetic nervous system.

To explore this possible link, the researchers studied cancer cell metastasis in mice. They followed fluorescently "tagged" human breast cancer cells that were injected into the mouse heart to model the stage of metastasis when breast cancer cells leave the primary site and move through the circulation.
They found that treating the mice with a drug that mimics sympathetic nervous system activation caused more cancer lesions in bone. Using physical restraint to stress the mice and activate the sympathetic nervous system also caused more cancer lesions in bone. Treating the restrained mice with propranolol, one of a family of blood pressure medicines called "beta-blockers," reduced the number of bone lesions.

The investigators demonstrated that sympathetic nervous system activation increases bone levels of a signaling molecule called RANKL, which is known to promote the formation of osteoclasts -- bone cells that break down bone tissue. RANKL has also been implicated in cell migration, and Elefteriou and colleagues were able to show that breast cancer cell migration to the bone depends on RANKL.
The findings suggest that beta-blockers or drugs that interfere with RANKL signaling, such as denosumab, may be useful in preventing breast cancer cell metastasis to bone. Propranolol and other beta-blockers are inexpensive, well characterized, and safe in most patients. They may be a good choice for long-term treatment if future studies in patients with breast cancer confirm their ability to block cancer cell metastasis to bone, Elefteriou said.

"If something as simple as a beta blocker could prevent cancer metastasis to bone, this would impact the treatment of millions of patients worldwide," he said.

Efforts to reduce stress and depression in patients with cancer may have unappreciated benefits in terms of metastasis prevention, he added

Guessing at the Causes & Effects...the "What ifs" when you live with the Big C

******

Pain shoots through my armpit (axillary if you are medically squeamish) down the inside of my arm.

I instinctively hold the area.

The pressure makes it worse.

Pain radiates across my abdomen.

Catching my breath.

I take deep yoga breaths trying to calm my inner self ~ both physically and emotionally.

I rise from the chair and my spine crunches and compresses.

I walk for the first few minutes gripping my elbows behind my back (thank G-d for good muscle memory & flexibility from bygone dance and martial arts).

I am so damn clumsy! Either I am emitting a negative polarity to solid objects, or going through another adolescent growth spurt. (Oops...5-0 bday looming...I mean second adolescence.)

The newest blood work came back, concerning low white blood cell and red blood cell counts,even after 6 weeks of being on supplements for both. (On a new vegan prenatal vitamin with 45 mg of iron picolinate...NO...I am not preggers I just covet their multi vitamins.)

My body is fighting an invader so my white blood cell count should be on terminator mode (think Nintendo Brawl fully loaded...yes, I have a 10 year old).

Is it apoptosis** performing seppuku with the cancer cells in my...yes say the icky word with me...armpit?

Is it apoptosis** inducing the controlled suicide of suspected infiltrating cancer cells in my peritoneum?

Is the high dose of Vitamin C I dread taking into my veins weekly ~ dread because of the pressing frontal headache, spaciness, fatigue and violent nausea that accompanies the cold drip into my sore veins ~ finally becoming my personal avenger?

Is it because all those years of pirouettes, leaps and grande battements taking its toll?

Is it because all those years of full contact sparring (sweetened with too many concussions and broken ribs) my body is rebelling?

Is it something as simple and treatable as anemia repressing my body from donning its crusader role?

The problem with cancer is the "what ifs"? Before you have, or least before you know you have cancer, you assign your symptoms to mundane causes and shake it off.

Now that the disease has infiltrated my body, my mind becomes hypervigilent with considering the "what ifs."

The mundane becomes the secondary thought, and shaking it off becomes a learned and concerted effort.

==========================
italicized words = dripping sarcasm

**Apoptosis, or programmed cell death, is a normal component of the development and health of multicellular organisms. Cells die in response to a variety of stimuli and during apoptosis they do so in a controlled, regulated fashion. This makes apoptosis distinct from another form of cell death called necrosis in which uncontrolled cell death leads to lysis of cells, inflammatory responses and, potentially, to serious health problems. Apoptosis, by contrast, is a process in which cells play an active role in their own death ~ which is why apoptosis is often referred to as cell suicide.

Random Thoughts ~ Sunday October 1, 2011

******

Why is it so hard to talk about the morbidly large Pink Elephant in the room?

Why is it so hard to take ownership that it's there? That it exists whether we acknowledge it or not?

Is it because we think that if we ignore it it will eventually ebb away, like a bad hangover?

Every moment changes.

Time is not static.

We feed this mindset with platitudes of reassurance that "this too will pass"; "time heals all"; "keep looking forward"; "hakuna matata".

But such prosaic statements work no magic on a Pink Elephant.

So we keep quiet.

And there it sits, large.

Grotesque.

Is it hard to speak out loud, not because we are afraid of what the Pink Elephant might say; but rather, because we are afraid that once it starts speaking we will never get it to shut up?

Such it would seem is the nature of metastatic breast cancer.

Random Sunday Thought (9/25/2011)

******

Why can I never remember how to spell
M-E-T-A-S-T-A-T-I-C;
M-E-T-A-S-T-I-S-I-S; and
M-E-T-A-S-T-A-S-E-S and all variations thereof?
Why can I never pronounce these words without spewing spittle?
My fingers just can't type out the words comfortably.
They always hesitate on the key board while my brain stutters
...................M-E-T-E...<oops>...M-E-T-A-T...<oy>...M-E-T-A-S-T-I...<#%&!!!!!!>
The syllables trip over, around, and get stuck under my tongue.
And the letters just never look right juxtaposed together.
METS tourettes, I suppose.