The question/comment I wrote for Dr. Musgrave is first, and then all my supporting links for her to review as she can.

  1. I know it’s important to get rid of the huge, primary tumor, but it doesn’t seem like a good plan to ignore the new implants either — is there anything we can do to try to minimize further mets? My Mom and I both have read a number of medical and science journals about different methods to try to stop mets, and reduce those that have already appeared. Ignoring them until they get bigger seems like we’re putting Teresa at unnecessary risk. Obviously we know the primary tumor is bad, but we also know that once cancer becomes metastatic, the risk to the patient is significantly increased. We want to do everything we can to reduce that risk (“Only 5 percent of cancer research funds are spent on metastases, yet it kills 90 percent of all cancer patients”https://www.sciencedaily.com/releases/2010/06/100601101420.htm).
    1. Has anything further come from this or anything like it: “New cellular target may put the brakes on cancer’s ability to spread”https://www.sciencedaily.com/releases/2017/05/170526084549.htm
    2. “Modified citrus pectin anti-metastatic properties: one bullet, multiple targets­” – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782490/
    3. “Propranolol Repurposed to Treat Soft Tissue Sarcoma”https://www.cancertutor.com/propranolol-treat-soft-tissue-sarcomas/
    4. “Repurposing drugs in oncology (ReDO)—cimetidine as an anti-cancer agent”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268104/ Cimetidine is an H2 Antagonist just like Zantac, which Teresa is currently taking. Is there any harm in her trying Cimetidine for her heartburn instead, especially if it may have additional benefits?
    5. “Nanolaser can detect, kill circulating tumor cells to prevent cancer metastases, study finds” https://www.sciencedaily.com/releases/2017/08/170821102714.htm
    6. I read about immunotherapy gel to be used in surgery before the incision is closed to boost the immune system and stop the cancer from seeding – which was Dr. Kane’s* primary concern in operating on Teresa. I know it’s only just going into human clinical trials (or will be soon). If it shows promise for people not just mice, what would have to happen for an accelerated approval to happen like was done with olaratrumab in 2016 for the dox/olara combination treatment? (https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm525878.htm)
      1. A new study by Dana-Farber Cancer Institute scientists suggests it may be possible to prevent tumors from recurring and to eradicate metastatic growths by implanting a gel containing immunotherapy during surgical removal of a tumor.
      2. “Gradual release of immunotherapy at site of tumor surgery prevents tumors from returning” https://www.sciencedaily.com/releases/2018/03/180321141420.htm (Dana-Farber Cancer Institute, 3/21/2018)

 

*Dr. John Kane was the surgical oncologist we spoke with at Roswell Park, in Buffalo, NY, on 2/23/18.

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