“Thinking of disease constantly will intensify it. Feel always I am healthy in body and mind”
Swami Sivananda
VIDEO
My doctor waited for me to have symptoms before doing any scans. Couldn’t he have found my cancer earlier if he did regular scans after my first diagnosis?
There are tests, such as scans, that might detect the presence of cancer in other organs before symptoms appear.
Research studies have confirmed that doing these tests does not improve the response to treatments used and thereby doesn’t translate into prolonging someone’s life. While that probably sounds strange, studies have shown it to be true. An additional issue is that performing routine scans and blood work can result in finding things that frighten the patient, only to learn after careful investigation the findings are normal and not cancer related. Scans cannot see microscopic disease that is starting to establish itself in another organ, either.
Even a scan that shows no evidence of disease isn’t really a guarantee that there aren’t microscopic cells growing elsewhere that can’t be detected at that time.
Your doctor will focus on the areas where you have symptoms. Shortness of breath would trigger a lung scan and chest X-ray; back pain would result in a bone scan, for example. A blood test called CA27/29 will likely be done, as well as some routine blood chemistries to provide additional information to assist the doctors in determining the underlying cause of your symptoms. It is becoming increasingly common to biopsy the organ site where the scans are showing the potential presence of breast cancer.
Your doctor might order a bone, liver, lung, or brain biopsy. Having a pathologist have access to actual tissue from the organ provides a definitive diagnosis while enabling the oncology team to learn more about the cancer that has spread. When you were initially diagnosed, the cancer cells in your breast were tested for specific prognostic factors.
These included hormone receptors, HER2 receptors, grade of the cells, size of the tumor, Ki67 to measure its proliferation rate of the cells, and other measurements. The tissue biopsied from the organ site also is tested in a similar way. We used to assume that the cells that traveled from the breast to distant sites would have the exact same prognostic factors as they originally had. We now are learning from laboratory research that this may not be the case. When the cancer has traveled and spread, it might have converted from being hormone receptor positive to hormone receptor negative, for example.
This information is critical to planning the right treatment options. The medicines and therapies prescribed are customized to work best on your specific cancer cells that have traveled out of the breast and gone to live elsewhere in your body
Terms:
Scans – A technique to create images of specific parts of the body on a computer screen or on film.
Bone scan – An X-ray that looks for signs of metastasis to the bones.
Biopsy – A procedure in which cells are collected for microscopic examination.
Pathologist – A specialist trained to distinguish normal from abnormal cells.
Ki67 – A molecule that can be easily detected in growing cells in order to gain an understanding of the rate at which the cells within a tumor are growing.
