Is it true that chemotherapy increases the likelihood of cancer returning in new cells later?

[OutofSyncGirl]

So says a friend of mine who had stage 4 cancer about 3 years ago but refused chemo (even though it was advised) because of an autoimmune condition she has. She is thankfully ok and the cancer has gone into remission.

She says that while chemo kills the cancer it also increases the likelihood of it returning later in different cells.

Is there any evidence to support this?

How can stage 4 cancee go into remission without chemo? Did she have radical surgery and then radiotherapy?

I believe some forms of chemo can leave you at greater risk of other cancers later. But that is probably a much, much smaller risk than the risk of death from stg 4 cancer.

She only had radical surgery and also refused radiography.

Maybe!

Having one cancer doesn’t automatically prevent you from getting another, and done cancer treatments are definitely known to increase your risk of another cancer.

But for most of us the choice is pretty stark - have this drug which has a very high chance of leaving you with no evidence of disease, or have a life expectancy of 2-5 years (prognoses will vary, but that was my choice). But if you take it, there’s an increased likelihood of pretty serious side effects, including in the longer term and including precipitating further diseases. Most people take the ‘I’ll try to keep living, and let the 5+ future take care of itself when I’m still alive to deal with it’

It may not of course be the treatments that cause the next cancer, there is for example s higher incidence of leukaemia amongst those who have had breast cancer than there is in the general population (though of course leukaemia is pretty rare and most people won’t get it ever).

It might be tempting to link that to treatment regimes, but it might actually be a wonky 22 chromosome for both.

DH has stage 4 lung cancer and had a lung removed last December. The surgery itself was touch and go because the tumours had started to penetrate his aorta, so there was a high chance it had started to spread. Usually surgery would be contraindicated in that circumstance but the surgeon operated anyway due to the size and position of the main tumour (was strangling his pulmonary artery and he would have had a stroke before the cancer could have killed him). Pathology after the operation showed the cancer had spread to his lymph nodes in two of the places they biopsied.

Chemo was recommended to him but he was told that 19 out of 20 ppeople with his aggressive form of lung cancer would see no benefit from it, but it would not leave him any worse off than doing nothing. Even a 5% chance of an improvement seemed like a good trade off so he went for it. He has been told that he has a 60% chance of living for 18 months (now down to 14 months since he was told that) but he is agreeing with every treatment recommended.

Chemo is hard on the body and he has picked up a nasty injury when a vein collapsed during treatment and the chemo drugs went into the surrounding tissue and burned his arm. He also has pleurisy, partly because he only has one lung and it's a common illness for people with lung cancer, but even so for him chemo was the right thing. Even if it means he is susceptible to more cancer later, he doesn't have a great prognosis anyway so he feels that the longer he can have with us and the kids, the better, and if the chemo has any chance of helping he will do what it takes. Unfortunately he won't be able to have it by iv any more, he will need a picc line due to the injury

Chemo saved my life!
I had it for breast cancer 25 years ago. It was super aggressive too.
My sins wouldn't have had a mum without it and my daughters wouldn't be here at all.

AndNone - I'm really sorry to hear about your DH. But what you say makes sense of course.

Ledkr - yes I think that you are right. Personally I would take medical advice, if, god forbid this ever happened to me. I worry that my friend has more risk of the cancer coming back because she refused chemotherapy. Hopefully not.

When my mum had stage IV stomach cancer and secondary ovarian cancer, she was in with a lot of “alternative medicine” types who filled her head with all sorts of nonsense - it’s not cancer that kills you, it’s the treatment, or being in a hospice, or what have you. Of course I’m sure this had nothing to do with the tens of thousands they were weaselling out of her for their own “treatments”. She was told she was in remission and she spent months talking about how superior these alternative treatments were... until tests showed she wasn’t in remission at all, they’d just completely missed the primary cancer which had progressed significantly. Intensive chemo and other drugs bought her a lot more time and she was well for the majority of that time.

All I can say is that there’s a very good reason that the cancer “cure rate” (don’t ever like the word cure around cancer, to be honest) is so high now is entirely because of advances in the treatment of cancer, including chemotherapy and many other things besides.

Stage 4 Cancers don’t go into remission without Chemo. Some bowel and Liver cancers can hide before coming back stronger than ever. Your friend is an incredibly stupid lady.

She had breast cancer and has had a mastectomy.

Yes I agree with all of you. Some of the misinformation out there is pretty frightening. Usually peddled by those who talk of 'evil big pharma'

Stage 4 means the cancer is present elsewhere in her body. Removing her breast will not get rid of that, it's what the chemotherapy is for.

Maybe i got it wrong (the stage) This was 3 years ago so it would seem that it's in remission? I think it had spread to the lymph nodes but the affected ones were removed?

It sounds more likely that it was stage 3, rather than 4.

I don't want to sound pernickety as I'm not sure if it's her words or you are paraphrasing, but it sounds like she has a rather limited understanding of cancer.

What does she mean about "returning in different cells"? Cancer isn't in the cells, like an infection. The actual cell itself is cancerous. If the original cancer returns, it will be breast cancer cells even if they are in a different location (breast cancer commonly spreads to the liver, bones and lungs, for example, but it is still breast cancer rather than liver/lung/bone cancer).

Hopefully your friend will be fortunate and her cancer will not return.

Regarding evidence, there has obviously been a huge amount of research into the effectiveness of chemotherapy and other treatments. They are also developing ways of better predicting who will benefit from different regimes, so that people can avoid unnecessary treatment.

She thinks that cancer stem cells, (which I assume she means pre cancerous) get activated by chemo. I know very little about cancer myself. I just hope she is going to be ok.

That sounds like bollocks to me. Is she very woo?

Yes, I believe there is.

My dad had chemo for an autoimmune disease and was warned that one of the risks was cancer/lymphoma. Sure enough he got lymphoma and it was that which killed him. However without the chemo the autoimmune disease would have killed him.

It was dads consultant who told us this.

He’d never had any form of cancer before so it wasn’t a case of reactivation.

www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/second-cancers-in-adults/chemotherapy.html

Obviously chemo is 'good' for the body, tbh it ravages it. My dad will be starting his second lot of chemo next month. He felt pretty shitty whilst having it last time....but he's been off it 4 months and is now in so much pain. I won't go into it all but he said whilst he feels crap some days on the chemo, he also has good days in between. Without the chemo he's in pain that's becoming unmanageable. So basically whilst there are negative points to chemo I think the majority of the time its offered its the better option

Isn't good that should sat

Say ffs

I am having a mono clonal antibody treatment for an auto immune illness. Because of the way in which it works, it is classed as chemotherapy (it's Infliximab).

I was told there is a chance of a significant increase in getting a rare type of cancer which is difficult to detect and treat - it isn't known why, but it's been observed that people on this treatment are more likely than average to get cancer, by a small percentage.

This was presented to me as an acceptable risk but one I had to be aware of, as it affected my decision to proceed with treatment. I didn't consider refusing the treatment because I'm very ill and I imagine if I has cancer I would take the chance of the treatment working to suppress it.

So the mechanism of chemotherapy being cancer causing doesn't yet seem to be fully understood, so I don't think your friend is right. In any case, i think a risk of cancer in the future is better than definitely having it in the present. I hope your friend gets some advice from a doctor so she can get concrete information on the risks and make a decision.

Yes she is pretty 'woo'. Often going on about Big Pharma.

'i think a risk of cancer in the future is better than definitely having it in the present'

I couldn't agree more. My friends oncologist tried to persuade her to have chemotherapy and was very worried about her decision not to. Apparently repeatedly emailed her and she replied 'I don't want your poisonous chemotherapy'

@OufOfSyncGirl that is a bit worrying then. Yes yes big pharma, it is a huge problem but it... also saves lives. I hope she has been well advised. Personally i would so have the chemo.