Topic: A query about recurrence rate?

Hello lovely people.

I have a query about recurrence after surgery that i’m not too clear about. I wondered whether someone may be able to shed some light. I understand that recurrence after surgery is very common, particularly when the disease is advanced. Does it seem to be the case that when the tumour reoccurs, it grows at a faster rate than the original tumour, or does nobody really know the answer to this? I know that this cancer seems to follow no rules, so this question may be hard to answer.

The reason I ask, is that we are waiting to hear whether my mum can have surgery, after she finishes chemo in Jan/Feb. We reckon that mum’s tumour has been growing slowly for years. We think this largely because there were potentially a lot of warning signs and symptoms that we stupidly ignored. Our surgeon and Oncologist feel that it has been there a long time too, partially because they observed the tumour as being stable for four months, before any treatment began. They consider this to be pretty slow! Given that it is so big, and given this slow rate, it is possible that it's been there a while!

So, we would hope that if she has surgery, and when it comes back, that it does so at a snail’s pace, but I sense that this is usually not the case from a lot of the posts i’ve read?

Hugs to all,
Jules

Re: A query about recurrence rate?

Jules,
While I can't answer based on personal experience, I will say there are different mutations of this disease. My surgeon said that quite often when it spreads somewhere else, it does so as a different mutation. I have at least 2 different mutations within my body. The tumor in the liver is one mutation, while the metted lymph nodes are different cell structures.
Some of these mutations are slow growing, and some are fast growing.
Based on what I know, it is, unfortunately, the luck of the draw. I do know that most oncs will suggest adjuvant chemo post resection. And your mum will be closely monitored for the first couple of years.

I hope this helps.

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

3 (edited by PCL1029 Wed, 11 Dec 2013 12:51:23)

Re: A query about recurrence rate?

Hi,
The recurrence rate is about 50-80% with the ICC on the high side of the range; extrahepatic CCA will be on the lower side of the range.

I believe when most of us diagnosed of CCA, the tumor had been there for quite a while.(ie: 2-3 years without symptoms in my case and the size is 6x5.5cm ,already stage III by the current new ICCA standard.)

I believe CCA is a slow growing cancer,in my case it grew from 2.5cmx2cm to 3.5-3cm in approximately 10-12 months for  the 2nd  recurrence roughly 20-22months after the 1st resection..The third recurrence  again was 18-22 months after the 2nd recurrence. Both with adjuvant chemotherapy to follow  for about 10-14 months.Therefore the growing rate should be the same before and after resections for the same person.

I do believe chemotherapy and targeted therapy and other options that currently available are all palliative in nature;even resections-the so call possible cure.
I believe chemotherapy is the most unfriendly treatment choice of them all;a lot of GI side effects which most of us spending a lot of time on the discussion ,but few,if any, mention cardiac ,neurological and kidney toxicity accumulation overtime.

I believe the longer a patient on treatments, the weaker the patient's health  defense will become due to the toxicity of the medications and the damage  of the procedures (ie; resections, stent insertion,RFA ,and IMRT etc.)done to the body.Complementary and alternative treatments may help to relieve the symptoms and increase the quality of life to a certain extend.

To sum it up, CCA is definitely a chronic disease if the patient is lucky enough to discover it earlier before any symptoms showing up.

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: A query about recurrence rate?

Thanks Kris and Percy for your prompt replies. They both answer my question! I will pray that whatever happens, my mum's tumour continues to grow very very slowly. I like the idea of viewing it as a chronic disease - it takes the sting out of it somehow!

Best wishes,
Jules