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      Re: SD?

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Posted by CCF NEURO MD on June 20, 1997 at 14:13:01:

In Reply to: SD? posted by Jared Stoehr on June 05, 1997 at 20:11:57:

: I wrote to you a few weeks back and appreciate your prompt response and insight.  My previous question was with my wife's recurrent Medulloblastoma in the basal ganglia and you wrote about my concerns that estrogen supplements may have prompted the recurrence.  My question today is of Stable Disease.  I'm trying to understand what stable disease really means.  Ellen's first MRI was on 2/7/97 which showed the recurrence at 2.4 x 3.0 cm.  After 2 rounds of Cytoxan (3400mg over 2 days and 5600mg over 2 days) the MRI on 5/7 showed the tumor at 2.6 x 4.8 cm.  One would think the tumor was not responding to the Cytoxan but there were 2 months between the first MRI and treatment where the tumor was likely growing.  Ellen's latest MRI showed "no change and no increase in mass effect" compared to the MRI 3 weeks previous.  In these 3 weeks she did not receive any treatment.  We have continued with the Cytoxan (6400mg over 2 days) and will have another MRI in 3 weeks.  We're hoping for a response and will move forward to high-dose Cytoxan/Carboplatin/Thiotepa with stem cell transplant if possible.  Could the tumor be in "stable disease"?  What is stable disease anyway?  Can a malignant tumor just go dormant and How?  Could the Cytoxan perhaps disable the cancerous cells' ability to reproduce without signalling apoptosis?  You offer a wonderful service and I will not continue to ask all my questions on your Forum, but I have long been confused with "stable disease".
  Thank You  
"Stable disease" is a term physicians use to imply that there is no progression of the disease over a period of observation time.  It does not mean that the disease is cured or in remission.  It is good in the respect that the disease has not progressed and this can indicate that the treatment has slowed the progression or has helped some.  If the tumor was much larger, then the treatment would be considered a failure.  Due to the fact that there was only a slight increase in size, the tumor could be stable.  A malignant tumor may appear dormant, not causing significant effect after treatment.  Without treatment it is unlikely to become dormant or if the treatment is ineffective with the particular tumor.  Chemotherapy and radiation cause death of malignant cells and surronding brain tissue.  Many of the agents work, without our exact understanding of how.  I cannot comment on your question of apoptosis, perhaps your wifes primary oncologist would be able to answer this more accurately.  There are also
several brain tumor organizations which I will list for you.
Brain Tumor Information Services
919 N. Michigan Ave. Suite 3100
Chicago, IL 60611
Contact Person: G. J. Djohrmann
phone: 312-684-1400
Fax: 312-280-9475
American Brain Tumor Association
2720 River Rd. Suite 146
Des Plaines, IL  60018
Toll Free: 800-886-2282
phone:  847-827-9910
fax: 847-827-9918
Email: ***@****
Website: http://pubweb.acns.nwu.edu./~lberko/abta_html/abta1.htm
Please feel free to ask us further questions. We are more than happy to help you. If the Cleveland Clinic can be of assistance give us a call 1-800-223-2273 and ask for the Brain Tumor Center desk.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition.  

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