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Chemotherapy Drugs Taxol (paclitaxel) & Carboplatin

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Chemotherapy Drugs Taxol (paclitaxel) & Carboplatin

Postby jabeje01 » Sat Nov 06, 2010 2:39 pm

I am a survivor of both Lung Cancer & then Colon Cancer. I am trying to determine how Colon Cancer, which was not present when Lung Cancer was discovered four months prior, developed while I was undergoing both Chemo & Radiation for my Lung Cancer. I have discovered that (1) because advanced metastaic cells can sometimes be SO mutated from the primary such that in the strange case of CUP (Cancer of Unknown Primary), it can be very hard to tell from the metastases just what the cell type original was, and therefore where the cancer actually started (2) #1 helps to solidify my contention that my Colon Cancer could have been caused by my Lung Cancer and not take on the characteristics of Lung Cancer. (3) Metastatic cancer may be found before or at the same time as the primary or months later. Nevertheless, when a new tumor is found in someone treated for cancer in the past it is more likely to be a metastasis from that cancer than a new primary tumor. This statement also helps to solidify my contention (4) paclitaxel & carboplatin been implicatned anecdotally to cause typhlitis, also known as neutropenic enterocolitis, inflammation of the cecum, that often leads to necrosis which results from atypical body conditions - infections, cancer, serious injury etc. This leads me to the subject and the question - Is it possible that, while treating me for Lung Cancer, the drugs that took care of the NSCLC inadvertently caused the Colon Cancer which was not present, according to a full body PET scan, when NSCLC treatments began? thank you
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Postby Julie5 » Sat Nov 06, 2010 5:02 pm

In general, cancer usually takes many years to occur (often 10 to 20 years!)- it usually requires around 5-10 individual critical mutations (ie, specific mutations associated with malignancy) within a single cell, for that cell to be transformed into a tumour cell. (This is why cancer tends to be age-related - because the longer we are alive, the longer our cells have to accumulate sufficient critical mutations and become cancerous).

Most people are diagnosed when they've already had the cancer for several years. Some cancers are slower growing than others.

In the end, would it matter if the chemo for lung cancer had, indeed, caused the colon cancer? Lung cancer has to be treated urgently and with the most powerful therapies possible - the risk of subsequent cancer elsewhere may have to be one of those trade offs that has to be made, alas.

In general, chemotherapy is a bit of a 'crude hammer' to deal with cancer, as it attacks so many normal dividing cells as well (including, of course, all the fast-replicating cells of the intestine, as you've said). In the future, the new generation of targetted drugs that focus on particular biochemical pathways unique to the cancer cells (such as the new drugs that interfere with the pathways that control the way the tumour cells can grow its own blood supply to nourish them), will, I would think, increasingly take over from chemo.
However, although I have no idea whether some chemotherapy drugs can, themselves be carcinogenic in any way (radiation yes, could cause mutation in healthy cells), I have to say I think it is unlikely that there would be sufficient time between taking the chemo for the lung cancer and when the colon cancer was diagnosed? How long apart in time was the chemo from the colon diagnosis?

One other possibility as to why you have been so unfortunate as to develop cancer twice is that you may possess a genetic susceptibility to cancer. Although the vast majority of cancers are not familial - ie, they are not specifically inheritable - it could still be the case that some people's genomes come ready-made with some sub-critical mutations that, if subsequent carcinogenic mutations then occur in any cell, will tip that cell over into malignancy. It could be that some of us are 'pre-primed' for cancer?????? (Or, it could simply be pure damn chance as to what mutagens we are exposed to....)

Again, all the very best with your treatment.
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