Dear Dr. Roach: Two years ago, my mother had a large mass surgically removed from her colon. (A laparoscopic surgery with colon resection.) The operative diagnosis was cancer that had metastasized to her lymph nodes. A quote from radiology following her PET: 鈥淪he lit up like a Christmas tree!鈥� The lymph nodes weren鈥檛 biopsied, and she received no radiation or chemotherapy.
Last month she had another PET scan, which showed that 鈥渢he majority of the previously noted enlarged lymph nodes have resolved.鈥� Does cancer 鈥渞esolve鈥�? If this report is accurate, my mother鈥檚 body seems to be clearing up the cancer. I鈥檝e never heard of this. Right now, she experiences chills daily. Can it be that her white blood cells are actually fighting this cancer and winning?
My mother is 83. She has pretty good energy. Based on this report, she says she is cured and will live to be 100. She鈥檚 planning on leaving the assisted-living facility she moved to two years ago. She wants to move into an apartment building! As you can see, we鈥檙e depending on accurate information to inform us so that we can make good decisions.
J.B.
It is possible that your mother had a near-miraculous cure of advanced colon cancer. It sounds from the PET scan (which looks both at size of lesions and their metabolic activity inside the body) that she may be cancer-free. I can鈥檛 tell you whether those original lymph nodes were really cancerous, but in the situation of a large colon cancer, those nodes usually are.
It also is possible that the original nodes were not cancer; rather, they were part of the body鈥檚 response to the colon cancer that was removed by surgery.
In either event, it does seem that your mother may be free of cancer. Unfortunately, I can鈥檛 give any opinion on her likelihood of reaching 100 (most 83-year-old women with no medical problems do not), because her case is unique in my experience and that of an eminent oncologist I consulted. Some cancers, especially kidney cancer, have been known to have distant disease 鈥渕elt away鈥� after the initial mass is removed surgically, but it is rare even in kidney cancer, and I have not heard of that happening with colon cancer.
I鈥檓 sorry I can鈥檛 give you my advice on her leaving her assisted-living facility, but I do feel that she has been given a great gift and should live her life to the fullest.
听
Dear Dr. Roach: Should patients with heart disease or cancer get the flu, pneumonia and shingles vaccines? Can it compromise the immune system?
J.S.L.
People with heart disease definitely should get the flu and pneumonia vaccines, since these diseases can be deadly in people with heart disease. For people with active cancer or history of cancer, a flu shot (flu shots are inactivated virus; the flu nasal spray is a live virus and should not be taken by people with compromised immune systems) is very important. A paper was just presented at a national meeting showing that the high-dose flu shot, followed by a booster a month later, was even more effective.
The pneumonia shot isn鈥檛 likely to be effective during active cancer treatment, but should be taken after recovery.
The shingles vaccine also is a live virus, and shouldn鈥檛 be taken by anyone with active cancer, but is recommended for cancer survivors, people with heart conditions and their caregivers.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
