d********r
发帖数: 303 | 1 Go to following link. choose the link to "brain cancer" it is an NIH lecture
(for none clinicians) on brain tumors. in particular glioma.
http://videocast.nih.gov/PastEvents.asp?c=45
Also, here is another good link in China on glioma.
http://cache.tianya.cn/techforum/content/100/621740.shtml
My opinion is, since the patient is an adult, his tumor most likely will be
high grade glioma. The prognosis is poor. Also it is difficult to do surgery
in brain stem, which makes the prognosis poorer still. |
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f******I
发帖数: 769 | 2
if you are worried about brain tumor, hard to imagine that after 24 yrs the
tumor would still not causing any other problems, |
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l*******n
发帖数: 68 | 3 Steve Jobs suffered from malignant pancreas neuroendocrine tumors which is
different from adenocarcinoma of the pancreas. The prognosis for malignant
pancreas neuroendocrine tumors is very good if the surgery is done early
enough. However, the adenocarcinoma of the pancreas has very poor prognosis
with extremely high mortality rate. |
|
f******I
发帖数: 769 | 4
duke staging system is kind of old staging system comparing to TMN staging
system, but duke b means it's localized without lymph node involvement,
which is always a good news,
if i read it correctly, it says that CEA is negative, it would be a
important tumor marker to follow along his treatment and while in eremission
as well, as the elevation of this tumor marker CEA would indicate the
recurrence of the cancer,
the only thing i have question is since he has duke stage b, that means by
TMN sta |
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m****a
发帖数: 98 | 5 these are molecular oncology marker,what is clinically important may be ER.
it is estrogen receptor negative, which means that the tumor's growth is not
on estrogen, which is well established to be one of the most important
factors for development and growth of breast cancer. for er + tumor,
tamoxifen, an estrogen antagonist can be used. |
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f******I
发帖数: 769 | 6
in general, PR/ER negative means the tumor is less likely to respond to
hormone therapy(such as tamoxifen), whether this has any prognostic means is
under debate, for early stage breast cancer PR/ER negativity suggests of
less risk for recurrence, but over time the advantage decreases,
meanwhile, p53 and Her overexpression often means poor prognosis and more
likely hood to metastasize to liver and brain, that often has shorter
survival comparing to PR/ER positive tumors that like to go to soft |
|
g***r
发帖数: 285 | 7
interesting, when the term of ablation mentioned, either radiofrequency
abalation, to me, it means to apply a probe that emmits heat to burn the
tissue, or cryoabaltion, the probe that emeits cold or whatever to freeze
the tissue; either case you have to place the probe directly into the tumor,
which has to be invasive, though less so comparing a lobectomy,
even in chemo-embolization, like they do for liver mets, you still have to
insert the catheter through the tumor site to deliver chemo agen |
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t*******n
发帖数: 4445 | 8 Yes. The surgeon can do their best to look for metastasis. But that does
not guarantee against recurrence.
The reason is the tumor constantly sheds cells into the body's circulation (
If I remember correctly, up to 100,000 cells for a 1cm x 1cm tumor). Most
of them are killed by the body's immune system, but a single one spared can
lead to metastasis. |
|
p********5
发帖数: 7433 | 9 鼻咽癌:
Too hard to do surgery to take primary tumor. The surgery can only take neck
淋巴结. Then use radiation therapy to treat primary tumor.
Good survival rate. |
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c********e
发帖数: 496 | 10 could you define the location where your mom feels numb.
numbness after anesthesia, there are two typical conditions.
one is feeling numb right after, and then becoming better, means nerve fiber
stretch.
the other is feeling numb, and nothing change later on, this is nerve damage
.
for your case, feeling nothing and then numb after two days, it is really
hard to tell what is the cause.
one possibility is the tumor or something else compress the nerve after
surgery.
Tumor in the neck, what kind o |
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D*******y
发帖数: 189 | 11 I am sorry that I cannot answer most of your questions without pathology and
imaging reports. It is likely that
she will need a combination of therapies including surgery plus radiation or
chemotherapy depending on the
pathology and extent of the tumor.
Parotid gland cancers involving the deep lobes are tricky and require great
experience and skills. A surgeon
who has done hundreds of such surgeries may have a better chance to
completely remove the tumor than one
who has done few. In general, th |
|
c********e
发帖数: 496 | 12 are you pregnant?
it is not like brain tumor, symptoms of intracranial tumor is more severe in
the morning than the rest of a day, this is special. |
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r*****t
发帖数: 45 | 13 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: runcolt (小马 * 淡泊宁静), 信区: MedicalCareer
标 题: 帮忙看一下中文翻译成英文的狗屁不通之处
发信站: BBS 未名空间站 (Mon May 31 15:36:39 2010, 美东)
Small cell lung cancer case
Patient: Male, 40 years, heavy smoker
Branchus Endoscope
Observations:
Sharp Eminence.
Right lung upper lobe narrowed by external pressure. Biopsy sent. Local (pul
monary alveolus) cleaning liquid sent for pathology. No tumor seen in mid lo
be and lower lobe. No tumor seen in left branchus and left lung.
Diagnosis sugges |
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I****a
发帖数: 407 | 14 ER or PR (+) means tumor's growth some how is dependent on estrogen and it
is a good predictor as one can give either Tamoxifen or aromatase inhibitor
to block the estrogen. Her2/neu + traditionally means that the tumor is more
aggressive and hard to treat. Since Her2/neu monoclone antibody (herceptin)
is introduced, Her2/neu positivity is not that important because we now can
block the her2 pathway with herceptin and even with small tyrosine kinase
inhibitor such as Tykerb.
Overall for your mom... 阅读全帖 |
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d*w
发帖数: 384 | 15 If the tumor is localized, it may be possible to preserve vision by laser
surgery, chemo and/or radiation therapy (including local delivery of chemo
and radiation). They key is time; a single day counts. So I suggest to start
treatment right away with a good ophthalmologist in Beijing, as the patient
is already there.
If the tumor has spread, then enucleation is necessary in preserving the
life of the patient.
, |
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t*******n
发帖数: 4445 | 16 It's currently on Phase I trial, for details see
http://clinicaltrials.gov/ct2/results?term=aln-vsp
Looks like they tried it on mice who were implanted with one type of tumor,
and the treated ones live significantly longer. That does not necessarily
mean it works for humans with various kinds of tumors, and is different from
a cure (治愈). |
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t*******n
发帖数: 4445 | 17 Still possible if cancer is confined within liver.
The Milan criteria:
* < 5 cm for a single lesion, or no more than 3 lesions with the largest
measuring ≤ 3 cm
* No extrahepatic manifestations
* No vascular invasion
The USCF criteria:
* Single lesion ≤ 6.5 cm, or multiple lesions ≤ 3 cm
* largest tumor diameter if multiple ≤ 4.5 cm
* Total tumor diameter if multiple ≤ 8 cm |
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t*******n
发帖数: 4445 | 18 In post-treatment cancer patients, elevated tumor markers MAY SUGGEST
recurrence of the tumor. |
|
f****o
发帖数: 2770 | 19 女性得neuroendocrine tumor最常见是从肺部originated。非常罕见的癌症。病理
unknown。她30岁就得这个实在是太不幸了。
Median survival for neuroendocrine tumor originated from lung
localized disease 227个月，regional 154个月，distant 16个月。
J Clin Oncol 26:3063-3072.
看医生如何stage了。很罕见的病。有钱的话就去米国的MD Anderson吧 |
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S**********r
发帖数: 226 | 20 一次普通的体检发现calcium level偏高，然后家庭医生推荐去看specialist。
specialist让我去做了parathyroid ultrasound和Scan，发现有甲状腺内部有一个类似
parathyroid或者belign tumor的东西over-reacting，然后让我吃vitamin D，8个星期
后再次验血，parathyroid hormone含量从110多下降到80多（仍然稍高于60多的正常水
平），然后
calcium level还是11，所以specialist让我去做biopsy，下个星期才知道结果.不过他
说告诉我可能是overreacting parathyroid或者bilign thyroid tumor之一，都需要做
手术。在版上看了一下,好象大家都甲状腺瘤的情况下可以做手术也可以不做.
在这里请教专家，医生的建议和诊断合理么？这个parathyroid的问题严重么？需要做
手术么？ |
|
S**********r
发帖数: 226 | 21 一次普通的体检发现calcium level偏高，然后家庭医生推荐去看specialist。
specialist让我去做了parathyroid ultrasound和Scan，发现有一个类似parathyroid
或者belign tumor的东西over-reacting，然后让我吃vitamin D，8个星期后再次验血
，parathyroid hormone含量从110多下降到80多（仍然稍高于60多的正常水平），然后
calcium level还是11，所以specialist让我去做biopsy，告诉我可能是overreacting
parathyroid或者bilign thyroid tumor之一，都需要做手术。
在这里请教专家，医生的建议和诊断合理么？这个parathyroid的问题严重么？需要做
手术么？
谢谢！ |
|
l*h
发帖数: 4124 | 22 In principle, I agree with you on the use of pathway inhibitors. I think I
disagree with you on the practical issues.
1. her dad's oncologist doesn't seem to have a good knowledge of the
mutations of the tumor, the complexity of the pathways and the mechanisms of
these inhibitors.
2. his intracranial metastasis is a real big concern. if you think those
more conventional drugs are bad in getting into the brain (and the tumor),
currently available TKIs are worse. certain chemo drugs have been show... 阅读全帖 |
|
l*h
发帖数: 4124 | 23 craniopharyngioma is one of the tumors with benign histology but malignant
behavior.
if at all possible, perform a total or subtotal resection. she will likely
need hormone replacement therapy. she will possibly need radiotherapy too.
for the surgery, the approach depends on the location and size of the tumor.
the most commonly used two approaches are subfrontal and transphenoid for
this area.
"十年存活率才有70%左右" is about right. |
|
l*h
发帖数: 4124 | 24 because of the location, it is unlikely a metastasis. however, to be safe,
some exams can be done if they don't delay the treatment.
i don't think the description of 脑干 is accurate, but rather in front of or
behind it, ie, pituitary/supersellar or pineal region.
there are numerous types of non-germinoma germ cell tumors. choriocarcinoma
is so special that it responds to methotrexate extremely well, with >90%
cure rate if treatment is done early.
primary intracranial germinoma has a long-term rem... 阅读全帖 |
|
l*h
发帖数: 4124 | 25 AFP: yolk sac tumors, 100%.
biopsy can be done but is strongly discouraged because these tumors are
highly vascular and debulking doesn't improve outcome, ie, risk outweighs
potential benefit.
lumbar puncture: it depends on whether she has CSF blockage and if yes,
where the blockage is.
dexamethasone is routinely given if brain edema is suspected. it is also
routinely given during radiation and in some cases chemotherapy.
germ |
|
C*******e
发帖数: 2163 | 26 If it is cancer, 90% of cancer cells are visible as a tumor, and the rest of
them are distributed in the tissue around. The closer to the solid tumor,
the higher the cancer cell concentration is.
So basically there is no way to cut off all the cancer cells.
bless |
|
l*h
发帖数: 4124 | 27 a few more words:
1. Intracranial germ cell tumors are much more common in east Asian
population. Some groups' data show for certain types, incidence in east
Asian population is 10 times of that in Caucasian.
2. Formal training cannot be overemphasized. In the US, rare diseases are an
essential part of residency training and board certification. Residents are
taught about these rare diseases including some of those that are so rare
that the whole department doesn't see one for the length of 3 - ... 阅读全帖 |
|
l*h
发帖数: 4124 | 28 what is the genetic testing of her tumor? cetuximab is expected to be
effective if the tumor is overexpressing EGFR and there is no constitutively
active downstream signal mutations (kras etc.). |
|
l*h
发帖数: 4124 | 29 it really depends on a few factors:
1. location of the tumor and whether there is big vessels passing through.
this will determine how difficult the surgery will be (surgeon's charge and
OR time/charge)
2. overall health, along with 1, will decide anesthesiologist's charge.
usually meningioma is the easier tumor in neurosurgery. |
|
a**********2
发帖数: 3726 | 30 If it is Glioblastoma, then this is the worst brain tumor. It tends to
develop very fast and spread to the opposite side very early. Treatment is
surgery plus adjuvant therapy (radiation therapy and chemo). Early surgery
is very very important. You need to find a very good hospital who has
extensive experience on this kind of tumor. (I saw a patient with GBM who
did two surgeries 10 years ago at the beginning and then several years ago
after it recurred. Now she is under palliative care because... 阅读全帖 |
|
H***a
发帖数: 506 | 31 我爸爸得的是gbm，生病前非常健康的一个人，20多年没有进过医院，从走路开始不稳
当，然后一边胳膊活动不便开始发现有问题，在天坛医院诊断和手术的。gbm发展起来
非常快，从完全行动自由到一边身体有行动障碍大概就2个月不到。手术前说瘤有5公分
左右，后来打开发现有将近7公分。天坛医院很难进，病人太多了，当时也是走了很多
的关系。手术前医生跟我说一般gbm病人术后愈后不会太好，也就12个月的survival
time，手术的风险也很大，有可能下不了台子。所幸的是手术非常成功，我爸爸手术后
恢复的也不错，也做了化疗和放疗巩固，基本功能都恢复了。除了放化疗，他过了大概
18月几乎象健康人一样的生活，还出去讲课，短期旅游什么的，可是gbm是手术也清不
干净的，18月后，tumor又卷土重来开始压迫神经，影响到他一侧的腿，手和吞咽，医
生说只是因为年龄（70岁），tumor长的相对慢一些。后来2年多，他就几乎完全卧床，
靠鼻饲进食，生活质量很差。我爸爸去年10月去世了，在确诊gbm后survive了4年半。
从他生病，我也看了很多资料，在国内的家人也到处求医问药，我爸爸在放疗后一直从
一个中医那里... 阅读全帖 |
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H***a
发帖数: 506 | 32 是的，虽然爸爸去世心里上还是很难接受，但这的确算是个miracle了。主要是1）手术
作的非常成功，大夫的技术还是很棒的；2）年龄大，后来tumor卷土重来的时候发展相
对慢，3）不知道是不是原因，但家里人相信看中医吃调理的药也帮助延缓了tumor的发
展。 |
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d****t
发帖数: 114 | 33 我担心 X-rays 增加得Cancer的风险- brain cancer or thyroid cancer.
A recent issue of Consumer Reports questions the need for yearly X-rays,
particularly for children. It seems that many dentists have been re-
evaluating the need for yearly X-rays in light of a study that was released
in April that found that frequent dental X-rays, particularly in childhood,
may be linked to an increased risk of brain tumors, or meningiomas, in
adulthood.
The study, published in the April issue of Cancer found that having... 阅读全帖 |
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j****i
发帖数: 496 | 34 Neuroendocrine tumor is a very rare form of colorectal tumor (the same type
that former Apple CEO had). Does the patient have the related hormone
imbalance symptoms? If not, you may want a second opinion on the glass
slides. Targeted therapy works better for adenocarcinoma. How is the CT
scan results? Any distant metastases in liver or lung? |
|
W********r
发帖数: 158 | 35 It depends on the stage. Overall, the cure rate for Wilm's tumor is 90%. You
need to find a good surgeon do a complete gross total resection,
immediately followed by radiation, then a few months chemotherapy. Most kids
will be cured with almost no long term side effect. If there is pulmonary
metastasis, will need whole lung radiation and the outcome is still
excellent. The tough ones are the ones with bilateral wilm's tumor. |
|
l*h
发帖数: 4124 | 36 she did pretty well. about 50% develop resistance at 6 months. after
treatment, the # of mutations per tumor is much higher than that before
treatment.
if she still want to take the active/proactive approach, AND if new tumor
samples can be obtained, here are the recommendations:
1. test EGFR mutations in the new sample
2. test RAS mutations in the new sample
if RAS is mutated, the chance of EGFR inhibitors to work is very low. then
focused, multipoint radiation therapy should be considered the ... 阅读全帖 |
|
l*h
发帖数: 4124 | 37 there are a few points here:
1. afatinib has only been tested in a few hundred patients. its actual
efficacy, IN REALITY, is not known.
2. regarding T790M mutation, the claim "50%的抗药是因为癌细胞变异成t790m" is
very wrong. it is a misinterpretention of results of some articles, mainly
William Pao's highly cited report. the actual results are in ~50% of tumors
resistant to gefinitib or erlotinib, T790M was detected. this doesn't mean
the resistance is necessarily caused by this mutation. only some T790M-
p... 阅读全帖 |
|
l*h
发帖数: 4124 | 38 she did pretty well. about 50% develop resistance at 6 months. after
treatment, the # of mutations per tumor is much higher than that before
treatment.
if she still want to take the active/proactive approach, AND if new tumor
samples can be obtained, here are the recommendations:
1. test EGFR mutations in the new sample
2. test RAS mutations in the new sample
if RAS is mutated, the chance of EGFR inhibitors to work is very low. then
focused, multipoint radiation therapy should be considered the ... 阅读全帖 |
|
l*h
发帖数: 4124 | 39 there are a few points here:
1. afatinib has only been tested in a few hundred patients. its actual
efficacy, IN REALITY, is not known.
2. regarding T790M mutation, the claim "50%的抗药是因为癌细胞变异成t790m" is
very wrong. it is a misinterpretention of results of some articles, mainly
William Pao's highly cited report. the actual results are in ~50% of tumors
resistant to gefinitib or erlotinib, T790M was detected. this doesn't mean
the resistance is necessarily caused by this mutation. only some T790M-
p... 阅读全帖 |
|
l*h
发帖数: 4124 | 40 are you sure T0?
it means primary tumor cannot be found. even if the tumor is very small and
is removed completely by the tiniest biopsy, you cannot call it T0. |
|
j**i
发帖数: 29 | 41 First, if her tumor's largest dimension is more than 2 cm, but less than 3,
it is IB. As mentioned above, her tumor should be checked for EGFR mutation
and ALK rearrangement. Whether she needs systemic therapy after surgery is
depending on her risk factors, such as positive margins, viseral pleural
involvement, wedge resection, etc. I am still concern about her bone scan
result since lung cancer mets to the bone is common. There a couple things
can be done. One is get biopsy of one of the lesion... 阅读全帖 |
|
l******n
发帖数: 35 | 42 Really unfortunate and big big bless!
Don't know much about terminology in Chinese, but I just checked it up for
you the staging in US.
"Separate tumor nodules in a different ipsilateral lobe" are considered T4,
so for this case it is T4N0M0 (if negative from the bone scan), which makes
the staging of IIIA.
For your reference, the general median survival is 14-23 months, and common
treatment is surgery + concurrent chemo-radiation. Patient treatment however
depends on details such as age, pathol... 阅读全帖 |
|
j**i
发帖数: 29 | 43 First, if her tumor's largest dimension is more than 2 cm, but less than 3,
it is IB. As mentioned above, her tumor should be checked for EGFR mutation
and ALK rearrangement. Whether she needs systemic therapy after surgery is
depending on her risk factors, such as positive margins, viseral pleural
involvement, wedge resection, etc. I am still concern about her bone scan
result since lung cancer mets to the bone is common. There a couple things
can be done. One is get biopsy of one of the lesion... 阅读全帖 |
|
l******n
发帖数: 35 | 44 Really unfortunate and big big bless!
Don't know much about terminology in Chinese, but I just checked it up for
you the staging in US.
"Separate tumor nodules in a different ipsilateral lobe" are considered T4,
so for this case it is T4N0M0 (if negative from the bone scan), which makes
the staging of IIIA.
For your reference, the general median survival is 14-23 months, and common
treatment is surgery + concurrent chemo-radiation. Patient treatment however
depends on details such as age, pathol... 阅读全帖 |
|
a**m
发帖数: 184 | 45 肠镜结束时候直接出来的report说
3-4mm nodule removed with cold biopsy forceps
然后等了5天拿到biopsy结果
说是有tumor，具体结果如下：
RECTAL NODULE BIOPSY: Colonic mucosal biopsy with presence of carcinoid,
margin can not be definitely assessed. Tumor is positive for CD56 and
synaptophysin and negative for chromogranin confirming the diagnosis.
爸妈知道以后强烈要求回国具体查。这边极不靠谱，联系不上医生不说，一开始说是
nodule not removed completely，之后又说要double check，切片结果要了好多次要
不到。现在第二次的结肠镜怎么也约不上。
请问严重吗？需要回国么？
包子答谢 |
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j****i
发帖数: 496 | 46 You are welcome! Hope this link helps - http://www.mskcc.org/cancer-care/adult/thymoma-other-thymic-tumors/thymoma-expert. If I were you, I would start by writing to Dr. James Huang (h****[email protected]) and briefly tell him your mom's case and her desire to travel to US to seek definitive diagnosis and treatments. He is a brilliant surgeon and has been the PI on a number of thymic tumor trials. Good luck!
Also, I would try to do the PET/CT in US. The quality of machine and
radiologist is much ... 阅读全帖 |
|
j*****1
发帖数: 105 | 47 I am not GI doctor. Let me just tell you what I think. I think they are
trying to figure out whether it is bleeding caused by benign gastric ulcer
or bleeding gastric tumor. Endoscopy still is the best way to go. What's
more, you need biopsy to make the final diagnosis no matter what. Endoscopy
is only way to get it unless you will have a surgery. PET/CT really is not
that sensitive nor specific for small GI tumor. If it is very positive, of
course it will suggests the possibility. If it is kind... 阅读全帖 |
|
j*****1
发帖数: 105 | 48 I am not GI doctor. Let me just tell you what I think. I think they are
trying to figure out whether it is bleeding caused by benign gastric ulcer
or bleeding gastric tumor. Endoscopy still is the best way to go. What's
more, you need biopsy to make the final diagnosis no matter what. Endoscopy
is only way to get it unless you will have a surgery. PET/CT really is not
that sensitive nor specific for small GI tumor. If it is very positive, of
course it will suggests the possibility. If it is kind... 阅读全帖 |
|
d*w
发帖数: 384 | 49 1. PET has little use in the initial diagnosis of lung cancer. and her 18-
FDG was not normal either.
2. that sentence of mine was kind of sloppy. i didn't intended to say VATS
was not suitable for her, but rather should have said "surgery is necessary
as long as the patient can tolerate it." whether it should be an open chest
surgery or VATS depends on many factors in addition to the size of the tumor
, in this case the most important factors probably would be how close the
tumor is to the two ... 阅读全帖 |
|
l******4
发帖数: 9 | 50 最近一个月 后脑右侧上部一跳一跳疼，剧烈疼。开始只有每天晚上跳几下，持续几秒
，隔几天发生一次。最近每天都发生几次，持续时间有时候长达10几分钟。没有呕吐眩
晕视力下降等症状
昨天约了家庭医生，问了持续多长时间，哪里疼，然后我给你开点药吧！我说能给我做
脑CT吗？我担心有tumor ,医生说好吧！ 于是昨天下午四点去做，中午护士给我打电话
说是 sinus infection,给开10天的抗生素。我目前还没有看到片子
请问各位这是什么病？ 和鼻窦炎有关系吗？（我没有鼻窦炎啊，只是最近一周感冒，
鼻子不通气） 这种东西通过ct看到的和其他的如tumor是完全不同的东西ba ?不会有误
诊的可能吧？！一般来说还需要进一步检查吗？
多谢各位！！ |
|
