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Help! My Mom is a Medical Mystery
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Help! My Mom is a Medical Mystery

Mom has had cancer for 3 yrs. It's just above her left collarbone, an enlarged lymph node. Biopsy said it was *not* lymphoma, but breast cancer. Not one single scan (MRI's, CAT's, PET's) have shown cancer *anywhere*, other than this one lymph node, as well as a few smaller scattered ones in her left neck, chest, & abdomen

She did chemo last yr, & did fairly well until the last 2 mos, when she had awful bladder pain, frequent urination, etc. A urologist worked w/ her oncologist & took care of it. Her next set of scans showed that she was in remission. That lasted 1.5 mos, before the original node started swelling again. None of the other nodes have returned.

This lump is now *massive*. It's roughly 3" across, about 1" wide, & stands out from her neck by about another inch. Her oncologist saw it today, was alarmed, & has her scheduled to start radiation. He does not want to put her on chemo again, because she had such a hard time of it before, at the end.

Mom is 79, in excellent health, no pain, a great appetite & hasn't lost weight (she did during the end of the chemo, but she gained it all back easily), & goes down to the basement a few times a wk to put her tap shoes on & dance. Her spirits are generally positive, although she's very nervous about doing radiation.

They're reluctant to try to remove this lump, as they say it could cause the cancer to spread to other areas of her body.

I'd heard of a surgery (before I ever needed to be interested enough to pay attention), where the blood flow is cut off to the tumor, basically starving it to death.

Did I understand this info correctly? If I did, is it used for lymph nodes? Again, it is NOT lymphoma, but carcinoma (adenocarcinoma?), is now nowhere else in her body, & she feels terrific. It seems weird that they can't just go in & do something to either remove it, or to cut off it's supply of "fuel", so it can just die & go away.

Does any of this make sense? Did I get my info wrong? What can be done?

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Your mother has a "Cancer with Unknown Primary (CUP)". In other words, she has adenocarcinoma of neck lymph nodes withour an identified organ in which which it originated.

This is a fairly common situation in oncology practice. The usual approach is to try chemotherapy. Your mother had a good initial response, but recently relapsed.

You have asked me about the possibility of surgically cutting off blood supply to starve or choke a cancerous mass. This principle is sometimes used in liver metastases, where the hepatic artery is blocked, resulting in reduction of blood flow to the tumor, and often the tumor shrinks.

Another way to starve a tumor of its blood supply is to use a monoclonal antibody against Vascular Endothelial Growth Factor (VEGF). This antibody is called bevacizumab (Avastin) and is used in metastatic cancers of the colon, lung, kidney etc.

In your mothers case, please consult the team of oncologists - including a surgical oncologist.

All the best, and God Bless!
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