Posted on 07/04/2009 9:17:04 AM PDT by SBD1
Am I the only one outraged by the misinformation that has been spread around the internet as Obama's Exhibit "A" for healthcare reform??? The issue is the staged so called kidney cancer patient with no health insurance who supposedly had health insurance when she was again supposedly diagnosed with Renal Cell Carcinoma and rather than have her kidney removed which is the only effective treatment for kidney cancer, she was treated with radiation therapy which caused her more health issues now that she has no insurance. She claims that she did not have her kidney removed because she was caring for her father who had colon cancer so had radiation instead. She must be a miracle of science to have had her RCC treated with radiation therapy in 1998 and still be alive today to complain about the effects of that treatment.
I was diagnosed with Renal Cell Carcinoma after a pathology report that occurred after surgery. Biopsy is rarely if ever used for kidney tumors due to the risk of spreading the cancer from the kidney to other parts of the body.
How this woman was definately diagnosed with Renal Cell Carcinoma without removing the tumor is beyond me and how she can state with a straight face that she did not have her kidney removed because she was caring for her father when removal of the tumor is the only effective treatment for kidney cancer is frankly insulting to me and should be insulting to other kidney cancer survivors.
* Renal cell carcinoma cells were the most radiation-resistant cells among 694 cell lines (271 tumor-derived and 423 fibroblast-derived), with D = 4.8Gy (compared with for example melanoma D = 2.51Gy) o Paris, 1996 (France) PMID 12118559 A review of human cell radiosensitivity in vitro. (Deschavanne PJ, Int J Radiat Oncol Biol Phys. 1996 Jan 1;34(1):251-66.)
* Copenhagen Renal Cancer Study Group, 1987 (1979-84) - PMID 3445125 A randomized trial of postoperative radiotherapy versus observation in stage II and III renal adenocarcinoma. Kjaer M et al. Scand J Urol Nephrol. 1987;21(4):285-9. o 72 pts. Stage II-III. After nephrectomy, randomized to RT vs observation. RT was 50 Gy in 20 fx to kidney bed, ipsilateral and contralateral nodes o No benefit for relapse rate or survival. Unacceptable toxicities from RT.
The second study above was after surgery was performed because removal of the tumor is the only acceptable treatment because chemo and radiation dont work on kidney cancer.
16-280 Attorneys Textbook of Medicine (Third Edition) P 280.130
AUTHOR: Pamela Charney, M.D.Kate Casano
P 280.130 TUMORS OF THE KIDNEYS
[6] Treatment
Radical nephrectomy (total surgical excision of the kidney and surrounding tissues) is the accepted treatment for renal cell carcinoma. Other conventional cancer treatments are ineffective or only have a role in the treatment of metastatic disease. Immunotherapy is an investigational treatment that seems a promising new approach for advanced disease.
[d] Radiation Therapy Radiation therapy has little role in localized or metastatic renal cell carcinoma. Preoperative or postoperative radiotherapy in patients with primary renal cell carcinoma has not proved effective in prolonging the interval before disease recurrence; however, radiotherapy can sometimes palliate symptoms in patients with advanced disease. Many chemotherapy regimens have been investigated in metastatic renal cell carcinoma, but response rates have been disappointing. Hormonal therapy also appears ineffective, despite encouraging results of early studies.
[7] Prognosis Untreated renal cell carcinoma has an extremely poor prognosis. The natural history of renal cell carcinomathat is, its course if left untreatedhas been a subject of great interest because of its unpredictability. Spontaneous regression of metastatic renal cell carcinoma sometimes occurs following resection of the primary tumor, but not often enough to recommend resecting a tumor in the hopes of inducing a remission of metastatic disease (Neuwirth, et al., 1990). The primary tumor and metastases have variable growth rates and may sometimes grow quite slowly. However, renal cell carcinomas usually are not diagnosed until they are large, metastatic disease usually progresses rapidly and renal cell carcinoma is highly lethal.
The misinformation from this so called town hall meeting is simply outrageous!! The possibility that radiation might be an alternative to surgery was investigated for the first time last year and the results have not even come close to becoming in use by the urologists and oncologists who treat this disease.
Int J Radiat Oncol Biol Phys. 2008 Nov 1;72(3):828-33. Epub 2008 Apr 18.
Carbon ion radiation therapy for primary renal cell carcinoma: initial clinical experience. Nomiya T, Tsuji H, Hirasawa N, Kato H, Kamada T, Mizoe J, Kishi H, Kamura K, Wada H, Nemoto K, Tsujii H.
Research Center for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS), Chiba, Japan.
PURPOSE: Renal cell carcinoma (RCC) is known as a radioresistant tumor, and there are few reports on radiotherapy for primary RCC. We evaluated the efficacy of carbon ion radiotherapy (CIRT) for patients with RCC.
CONCLUSIONS: This is one of the few reports on curative radiotherapy for primary RCC. The response of the tumor to treatment was uncommon. However despite inclusion of T4 and massive tumors, favorable local controllability has been shown. The results indicate the possibility of radical CIRT, as well as surgery, for RCC.
More proof available below.
J Clin Oncol 26: 2008 (May 20 suppl; abstr 16009) http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=55&abstractID=31016
Author(s): C. Renner, E. Oosterwijk, N. Adrian, J. Oosterwijk-Wakka, L. Cohen, G. Ritter, A. Knuth, C. R. Divgi, A. M. Scott, L. Old, S. Bauer
Abstract:
Background: Renal cell cancer (RCC) is a chemotherapy and radiation resistant disease with high morbidity and mortality when detected at advanced stage. RCC cells express the G250/CAIX antigen at high levels and can be targeted very efficiently with monoclonal antibodies.
Immune Escape Mechanisms of Renal Cell Carcinoma European Urology Supplements, Volume 6, Issue 10, Pages 616-622 B. Seliger http://linkinghub.elsevier.com/retrieve/pii/S1569905607001030
Renal cell carcinoma (RCC) represents a chemotherapy- and radiation-resistant tumor with a generally poor prognosis and a 5-yr survival rate of patients of <10%.
Best wishes for your mother's continued good health.
MEDICARE is also an ANTI-CONSTITUTIONAL pogrom brought to us by the marxist LibTards.
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.
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.
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.
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!
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.
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.
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.
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.
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.
DNV=DNC
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 210 (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.
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 (1622 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 (2432 Gy in 34 fractions over 12 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.
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.
It has been fun being in this discussion, and I am glad you have survived your cancer. Wish all my patients were that fortunate.
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!!
God works in mysterious and amazing ways. Again, I’m glad you have done well.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.