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Does high ALLRED score mean BONE MARROW CANCER?

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I am going to Stanford for a consultation.

I am afraid that thedoctors will scare me about the itc's.

What I think I've learned about itc's is:
they tend to remain dormant

because of this, they are hard to get with chemo (unless they happen to be dividing)

but, because of this, and because I am highly ER positive it is safe to wait 4-6 months before starting the AI's (while I do surgery and radiation)

with my high ALLRED score, Ai's should make them all dormant

1. Do you agree with this?

2. Do you think doctors at a big university like Stanford will agree with this, or do you think they will think that itc's are the same as actual bone marrow cancer? do you think they will think I am doomed. I am afraid of going there and getting scared.

3. I had carbo taxol chemo 3 days ago (no neupogen) and I have lots of bone pain in my buttocks--can that be caused by the chemo?

4. I think once you said that you don't have to have neupogen to have bone pain--it can just be the neutrophils trying to grow that can cause bone pain--is this true? Is it true even when the neutrophils are at a very low number (mine are probably very low right now)--the growing neutrophils could still cause bone pain?

Thank you!


Category: Oncologist

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Category: Hematologist
Dr. Prasad Eswaran is online now

Expert:  Dr. Prasad Eswaran replied 4 Days.

Hello.
Thank you for your query at DoctorSpring.com.
Let me answer each of your questions individually.

1. Yes

2, Let me know what Stanford doctors tell you. They may have a different opinion.

3. Taxol can cause diffuse muscle ache which may itself cause pain. Technically called MYALGIA.

4. Yes. Neupogen causes greater expansion of bone marrow which can cause bone pain even later.

Let me know if I can help you any further.

Kind regards.


Patient replied :

Thank you. So, I'm scared. I don't see the Stanford doctor until August 11. I am really worried that he will tell me that the ITC's are really a hopeless thing and I am doomed. I want him to have the same opinion as you. Knowing everything you know about ITC's, do you think this is likely? I need some hope.
You seem to know a lot about the current protocols in oncology. It should be likely that a doctor at a large university would agree with that. Right?


Expert:  Dr. Prasad Eswaran replied 3 Days.

The real fact is that nobody knows all about ITCs. Its a new concept in Oncology and a new discovery is made everyday.

Till the findings are proven clinically, these concepts cannot be practiced in the patient setting. It might take another 5 years or more for this concept to enter in clinical practice. Till then, (non research) academic oncologist may not use them for clinical decisions.

So it would be better to wait for the final conclusion on ITC. Until then, it will not make a change in your treatment.

I do not think your doctors decided your treatment based on the ITCs. Is it so ? Please let me know.

Kind regards.

PS: I am not in a research setting. I am an academic oncologist.


Patient replied :

But, you think that I have a good prognosis, right?


Expert:  Dr. Prasad Eswaran replied 2 Days.

Yes. Because of your good ALLRED score. ER and PR positive status.


Patient replied :

thank you!!
I just thought of another situation. What if one (or more) of my itc's already moved to the brain or somewhere else, BEFORE I started the A/C chemo in February??? How likely is this?
How would that work out? Would it stay dormant for a while? If it tried to do anything, would the chemo have gotten it? Then it would have to wait through that 4-6 months of no systemic therapy, and it might be farther along so it might make an actual tumor. Or would it still be too slow to create a real tumor before we got to the AI's and they could make it go dormant?
Also, were you the one, that told me that breast cancer itc's usually DON'T go to the brain--but to the bone?


Expert:  Dr. Prasad Eswaran replied 1 Day.

Thank you for writing to us again.
I get your point.
How sure are you to say that it has gone to brain or somewhere else ? I mean why are you thinking like that?
Regards


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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