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December 11, 2004

Popping Cancer Update

The lump they removed turned out to be a soft-tissue sarcoma, specifically a "malignant fibrous histiocytoma." Pictures of tumors similar to mine can be seen here, if you're morbidly curious or just really into tumors. Here are some googled facts about this form of cancer from Cancerbacup:

The soft tissue sarcomas are a group of cancers which develop from a number of different supportive tissues in the body including fibrous tissue, muscle, ligaments, tendons and fat.

Soft tissue sarcomas are rare. They make up less than 1% of all cancers, with only about 1200 new cases being diagnosed each year in the United Kingdom. Relatively speaking, they are actually more common in children than adults, making up about 8% of all cancers in those under the age of 15.

The majority of soft tissue sarcomas develop in the limbs and they are three times commoner in the legs than the arms.

Soft tissue sarcomas can spread to other parts of the body by sending tiny clumps of tumour cells into the blood stream. The commonest site of spread for these cancers is to the lungs.

Over the years more than 60 different types, or subtypes, of soft tissue sarcoma have been identified. As the group of tumours as a whole are quite rare this means that some forms of the condition are very very rare indeed. The large number of different types has also lead to problems in classifying the soft tissue sarcomas. Most have names based on the type of normal cell from which the cancer might have started but for some soft tissue sarcomas there does not seem to be any equivalent normal cell and so special names have been given to these tumours.

The MFH is the commonest of all the soft tissue sarcomas and can arise from fibrous supportive tissues anywhere in the body, although it is commonest in the limbs. In the past these tumours were often called fibrosarcomas. They most commonly occur between the ages of 50 to 70.

MFH usually starts as a rapidly growing, painless, swelling in the soft, non-bony, tissues. Generally the tumours cause few other symptoms but occasionally are associated with fever and weight loss.

Like most other soft tissue sarcomas the treatment of MFH is surgery, wherever possible, to remove the growth. If the sarcoma is low grade when looked at under the microscope then this may be all the treatment that is needed, but if it is higher grade than surgery is usually followed by a course of radiotherapy to reduce any chance of the cancer coming back. Occasionally a sarcoma is too large or stuck down to make an operation possible, but the surgeon feels that it might become operable if it could reduced in size. In this situation the doctors may recommend a course of radiotherapy or chemotherapy before the operation in the hope that it may shrink the sarcoma and make it more operable. If the MFH is in a part of the body where surgery is impossible or dangerous then radiotherapy is used and often combined with chemotherapy. With these measures many MFH can be cured.

Here are some additional fun facts from my doctor:

-This type of sarcoma is common in past cancer patients who have undergone radiotherapy. Since I did all the radiation treatment you're supposed to do in a lifetime over the course of 6 months or so when I was 18, I think I qualify.

-My sarcoma is very high-grade. 3/3, whatever that means.

-The CAT scan Monday should help determine if it has spread (metastasized). If it was local and hadn't spread, survival rates are up near 90 percent as a baseline. If it is metastatic, survival rates drop to below 10 percent as a baseline. Spreading bad.

-My doctor says treatment will be "tricky" since I received so much radiation and chemotherapy in the past. Ideally, they shouldn't give me more of either, since I hit the limit of radiation and I did so much chemotherapy that it damaged the muscles of my heart over the 8 years of treatment when I was younger (and the bone marrow transplant). The chemotherapy drug suggested for treatment in this case is the same drug that damaged my heart (I now beat out about 35 percent of the blood in my heart per beat. The average human beats out about 60-65 percent).

Next up is the CAT scan Monday, then a second opinion meeting with a doctor in Cleveland Clinic. This is a second opinion about treatment, since choosing an appropriate response is really picking your poison in my case.

I'm happy to answer any questions you might have. It'll take my mind off Lindsay Lohan's family problems.

Posted by Dan at December 11, 2004 09:16 AM

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You need anything? Muffin basket? Money? A "Make a Wish Foundation" visit from Kirsten Dunst?

Posted by: folkbum at December 11, 2004 11:01 PM

I think I'm set for right now. We're just gearing up on treatments.

The Make-A-Wish visit sounds nice, but I'm not sure what I would wish for would be what Kirsten and the Foundation had in mind.

Posted by: Big Dan at December 12, 2004 09:33 AM

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