Radiation Does Not Work For Renal Cell Carcinoma-The Obama Staged Misinformed Exhibit "A"

Personal Experience with Renal Cell Carcinoma | July 4, 2009 | Salvatore B. D'Anna

[Madame Dufarge]

My father had the same experience as your mother. The second kidney was never affected and he lived years cancer-free until his death from other causes.

Best wishes for your mother's continued good health.

[PubliusMM]

MEDICARE is also an ANTI-CONSTITUTIONAL pogrom brought to us by the marxist LibTards.

[SC DOC]

Much of what you have posted is conventional thinking about renal cell carcinoma. Yes, it is relatively radioresistant. Yes, it is best managed surgically. The paradigm of thinking about renal cell carcinoma, however, is not cast in stone. There are newer methods of delivering radiation, both in terms of the (1) physics using IMRT (intensity modulated radiation therapy) which allows for tight conformality of the radiation dose cloud around the tumor with relative sparing of normal tissues and (2) the radiobiology in which larger daily doses of radiation are given in a shorter time frame. We discovered decades ago that melanomas can respond to hypofractionation and are learning that renal cells carcinomas can respond likewise

I personally have treated renal cell carcinomas, recurrent in the flank after nephrectomy, with radiation with complete remissions. Likewise I often treat metastatic lesions in the brain using stereotactic single dose radiation with the gamma knife, with excellent results.

Currently immunotherapy has fallen by the wayside, having been replaced with new chemotherapy drugs including Sutent and Nexavar

One of the fascinating things about medicine is that dogma learned in medical school can often change 180 degrees with new information and research.

[Presbyterian Reporter]

A thought to ponder as Obama and Congress gear up to give us FREE health care-—

Why is it that we only read anecdotal stories about Canadians coming to the United States for immediate medical care?

Since the Canadian system is supposedly so good that the United States should emulate it, it seems Americans would be standing in line to get into a Canadian hospital.

[OpusatFR]

Thanks for the info. We survivors are always alert to the possibility of recurrence.

With your knowledge and experience, is it possible that the woman who claimed her cancerous kidney was left intact and was treated with radiation in 1998 is telling the truth?

Mine was removed in 1999 and there was no other option except surgery.

[Arthur McGowan]

You need to write a letter to Obama, informing him that this woman was lying to him. There’s no way Obama would want to promote national socialist health care with lies!

[Kansas58]

Deal with the world as it is.
If we try to repeal Medicare, we will find that we can not win ANY seats in Congress.
The best we could do was to try and “privatize” Medicare.

Gingrich was misquoted as saying Republicans wanted Medicare to “die on the vine” when all Gingrich meant was that Medicare Advantage, PRIVATIZED Medicare, would be better than old fashioned Medicare.

Anyway, as a health insurance agent, I can tell you that Obama has cut our Commissions on Medicare products several times now.

Obama’s regulations are designed to make agents mad at their insurance companies, rather than the Democrats who are screwing us out of income that we thought we earned 6 and 7 months ago.

Obama has done this, in part, by a redefinition of the word “renewal” as it applies to commissions, through the Center for Medicare and Medicaid Services.

[SC DOC]

It is possible, but one would have to ask why radiation was chosen over surgery. She may have had many co-morbidities such as bad heart disease, lung disease, vascular disease, that would preclude surgery. The reason that radiation has not been used in the past is because the success in eradicating renal cell carcinomas has been poor, prior to IMRT and the types aggressive radiation doses, now capable of being delivered. However, even in the the 80's and 90's with less effective doses, patients were occasionally treated with radiation, and some were cured, albeit, probably less than 25%. Hence the reason surgery was, and still is, the gold standard.

But as I stated in my last post, medicine changes. When I was in medical school, it was heresy to consider anything but a radical mastectomy for breast cancer. Thirty five years later lumpectomy and radiation is now an equivalent and often-preferred option.

[SBD1]

I agree with everything that you have written and have not stated otherwise. The key here is that radiation therapy has shown effectiveness for RCC, but when it has mestasized to other parts of the body, not in the primary location of the RCC in the kidney. As I quoted in my original post, there is a recent study that uses a specific type of radiation therapy that has shown effectiveness in treating primary RCC, but these are new studies. This so called Exhibit A is referring back to 1998 and is claimimg that she was treated for primary RCC in her kidney with radiation therapy which is unbelievable and would go against the scientific data for this disease.

[SBD1]

Please show me the study or medical journal that states

“even in the the 80’s and 90’s with less effective doses, patients were occasionally treated with radiation, and some were cured, albeit, probably less than 25%.”

I have been researching RCC since 2006 and have not found a single study that shows what you have stated above for the treatment of RCC in the kidney as opposed to other RCC sites in the body it has spread to.

[chris_bdba]

Thanks for the info. So it appears that not only was she a DNV volunteer but that this story is just that...one big lie to tung the heartstrings of those too dumb to know any better.

[chris_bdba]

DNV=DNC

[SC DOC]

The 25% is a guess on my part. All of us in radiation oncology have treated a handful of unresectable renal cell patients in our careers, and some patients have been fortunate enough to survive.

Here is an interesting article:

Hypo-fractionated Stereotactic Extra-Cranial Radiosurgery(HFSR) for Primary and Metastatic Renal Cell Carcinoma

B. Gilson, G. Lederman, G. Qian, M. Fastaia, L. Cangiane Cabrini Medical Center, New York, NY

Purpose/Objective(s): HFSR is precisely delivered radiation using an external stereotactic frame and hypo-fractionated high dose radiation in an attempt to control extra-cranial sites of kidney cancer.

Materials/Methods: 92 patients (pts) with 204 renal cell cancers completed treatment between June 1997 and May 2005 and were radiographically evaluated. Included were 171 extra-cranial metastases and 33 primary kidney cancers. For the primary renal cell cancers, 14 pts, age ranged from 31 to 85 years (mean 62), had 33 cancers treated with a volume ranging from 2.4 to 1366cc (mean 356cc).

For the extra-cranial metastases of kidney cancer, 78 pts age ranged from 31 to 84 years (mean 61) had 171 metastatic sites treated with volume 0.06 to 3166cc (mean 165cc). Patients were treated with 1200 - 6000cGy(median 4000) in 2–10 (median 5) fractions. All cancers were radiographically evaluated after treatment using contrast-enhanced scanning and reviewed by a multi-disciplinary panel. Control rate of the treated site is defined as cessation of growth, shrinkage or disappearance of cancer.

Results: The overall control rate for the 204 renal cell cancers was 87%. The control rate for the primary kidney cancers was 94% with follow-up ranging from 2 to 73 months (mean 17 months).

For primary kidney cancers, the control rate was 88% for 16 cancers with volume 196.48cc.

For the extra-cranial, extra-renal sites of disease, the control rate was 87% with follow-up ranging from 1 to 73 months (mean 10 months). For metastatic renal cell cancers, the control rate was 86% for 101 cancers with volume 37.3cc vs. 89% for cancers with volume 37.3cc. Dose and volume of treated area were not statistically significant in multivariate analysis.

Conclusions: HFSR is an option for those who are unable or unwilling to undergo surgical resection of their primary site or in whom the primary site is symptomatic in the face of metastatic cancer. Body radiosurgery offers high control rates in patients with extra-renal sites of disease whose disease has not been controlled by systemic therapy or other means. HFSR offers an appealing method of treatment that at this time shows high control rates while avoiding systemic effects associated with other methods of treatment.

Author Disclosure: B. Gilson, None; G. Lederman, None; G. Qian, None; M. Fastaia, None; L. Cangiane, None.

[SC DOC]

Another report:

The Treatment of Primary and Metastatic Renal Cell Carcinoma (RCC) With Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiosurgery (SRS)

L. Doh1, C. Bloch1, A. C. Paulino1,2, M. Galli Guevara2, S. Chiang2, S. Shen2, D. Baskin2, E. B. Butler2, R. Amato2, B. S. Teh1,2 1Baylor College of Medicine, Houston, TX, 2Methodist Hospital, Houston, TX

Purpose/Objective(s): RCC is often regarded as a radioresistant tumor. However, brain metastases from RCC have been successfully treated with SRS. Therefore, metastases to extra-cranial sites may be treated with similar success using stereotactic body radiation therapy (SBRT), where image-guidance allows for the delivery of precise high dose radiation in few fractions. We report our experience with SRS/SBRT in the management of primary and metastatic RCC.

Materials/Methods: The image-guided Novalis radiation therapy system was used. Thirty patients with brain metastases were treated with SRS (16–22 Gy in a single fraction). Five of these patients underwent resection of their metastatic lesions after SRS and their pathology was reviewed. Twenty patients with extra-cranial metastatic lesions (orbits, head and neck, lung, mediatinum, sternum, clavicle, scapula, humerus, rib, spine, abdomen) and 2 patients with biopsy proven primary RCC (not surgical candidates), were treated with SBRT (24–32 Gy in 3–4 fractions over 1–2 weeks). Immobilization using a body cast and image-guidance was used for all patients with treated with SBRT. 4D-CT was utilized in the treatment planning to assess tumor motion.

Results: Overall local control rate was 96%. Of the 30 patients who received SRS to brain, follow-up MR images showed decreasing or stable lesion size in 25 patients. 5 patients had an “increase in size” in their treated lesions, and underwent resection of the lesions. Pathology revealed necrotic specimen without any viable RCC in each case. Of the 20 patients with extra-cranial metastatic lesions, 18 patients achieved symptom relief after treatment; 2 patients had local progression. In the 2 patients with primary RCC, tumor size remained unchanged but their pain improved, and their renal function was unchanged post SBRT. There was no significant treatment related side-effect.

Conclusions: Precise high dose radiation can cause significant tumor cell death in “radio-resistant” metastases from RCC. It also offers excellent local control and symptom palliation, without significant toxicity. Therefore, SBRT may represent a novel non-invasive, nephron-sparing option for the treatment of primary RCC as well as extra-cranial metastatic RCC. A prospective clinical trial using SBRT for primary and metastatic RCC is ongoing. Author Disclosure: L. Doh, None; C. Bloch, None; A.C. Paulino, None; M. Galli Guevara, None; S. Chiang, None; S. Shen, None; D. Baskin, None; E.B. Butler, None; R. Amato, None; B.S. Teh, None.

[SBD1]

Appartently she forgot to tell Obama she served in the US Marines for 4 years!! Oh wait, wouldn't that qualify her for Veterans Health Insurance?? The news story below from April 21, 2009, my birthday by coincidence I am sure also neglects to say what kind of cancer she supposedly had or has!! Virginia Health Reform Campaign Begins By Debra McCown Reporter / Bristol Herald Courier Published: April 21, 2009 ABINGDON, Va. – Debby Smith spent four years serving in the U.S. Marine Corps and 25 years working as an accountant before she found out she had cancer – and now she can’t get health insurance. “Since … I can’t work, of course, I don’t have health insurance, which means I have to pay out of pocket for … all my prescriptions and all my doctor visits and everything, and if you don’t work it’s hard to do that,” said Smith, 51, of Appalachia, Va. “A lot of people, they think that people are just sitting around not doing any work just getting government assistance … and don’t try to do anything for themselves and ask the government to pay for everything,” she said. “I’m not one of those people. ... I’d rather be working and doing my job and making a decent wage, but I’m not able to do that.” With 12 years to wait for age-related Social Security benefits, she relies on a hospital charity fund for twice-yearly cat scans; a pharmaceutical company’s patient assistance program for help with her cancer drugs and her fiancé, who pays $515 a month for her remaining medication and regular doctor visits. She says she’s lucky; those like her who have no loved ones to help can’t get the care they need – and, ultimately, they die. Her horror at what she calls a broken health care system is what drove her to get involved in a growing regional and national effort to mobilize people on the need for comprehensive health care reform. While she’s not sure she’ll be physically able to ride a bus to Washington, D.C., to tell lawmakers her story firsthand, she’s among many in Southwest Virginia who hope a new administration in the White House will mean an overhaul for the American health care system. The bus – or buses – headed to the nation’s capital from the region this June are going with the Virginia Organizing Project, which does grassroots organizing around the state and is focusing on health care issues this year. read the rest here

[SBD1]

There is a difference between Radiation Therapy and RadioSurgery which from what you posted seems like the current cyberknife treatment which is very promising for all types of tumor resection.

[ApplegateRanch]

The correct word is disinformation.

The ACTUAL word is LIE: deliberate stating of a known FALSEHOOD, to obfuscate mislead, misdirect, or otherwise deceive.

Don't Clintonise the language; plain English is quite precise enough.

[SC DOC]

You are intuitive and somewhat correct in noticing the difference between stereotactic radiation which sometimes involves more complicated patient immobilization and conventional conformal/imrt fractionated radiation. The cyberknife is an excellent tool for stereotactic radiation, but conventional linear accelerators which are the workhorse of radiation therapy can perform many stereotactic procedures. In the case of renal cell carcinoma, IMRT is suitable with daily IGRT (Image Guided Radiation Therapy) in which a volumetric CT scan is obtained with the linear accelerator, and then anatomy is matched to the original data set for targeting. If there is any discrepancy where the "crosshairs" are, the table upon which the patient is lying can be moved in the x,y,z direction to get things targeted properly. The most important variable in my view is the fractionation, or how the daily dose is given. With conventional radiation therapy, the amount given daily is 1.8-2.0 Gy (a unit of radiation dose-used to be called Rad). With hypofractionation, the daily dose may be 2.5-10 Gy, but the total dose is significantly less. I don't want to bore you with the details of radiobiology, but there are a number of different factors that interplay such as oxygen availability, tumor repopulation, DNA repair, etc.

It has been fun being in this discussion, and I am glad you have survived your cancer. Wish all my patients were that fortunate.

[SBD1]

I survived because my dad saved my life. I was 33 at the time and had no health problems, but my dad was having health related issues that his doctors could not figure out. My siblings and I wanted my dad to get a full body scan just to make sure that nothing was out of the ordinary. He did not want to do it.

Once I told him that the scan would include a virtual colonoscapy and how it was performed as opposed to the regular way, he was more receptive. He finally agreed, but only if I had a full body scan at the same time.

It turned out he was fine and that the scan found something in my kidney. I didn’t think anything of it and scheduled another scan with contrast dye thinking it would turn out to be nothing since I had no symptoms at all. That scan found a 2.5 cm enhancing tumor.

Long story short, the first surgery to remove the tumor had positive margins and not wanting to risk it, I flew to the Cleveland Clinic and had the nephrectomy performed by Dr. Novick who was one of if not the top expert in RCC. His death last year was a great loss to those who have or had kidney cancer!!

[SC DOC]

God works in mysterious and amazing ways. Again, I’m glad you have done well.