10/26/2022, 6:47 p.m., Photo: Disclosure.
The case of journalist Susana Naspolini, who died on Tuesday (25), at the age of 49, raises the question of why some people can have several types of cancer throughout their lives. Experts cite a genetic predisposition and increased likelihood of metastasis – when the tumor spreads to other organs – in some forms of the disease. (read more below)
At 18, the journalist discovered Hodgkin’s lymphoma. Almost two decades later, she was diagnosed with a malignant tumor in her breasts and another in her thyroid. Recently, he discovered pelvic cancer, which had spread to the bone marrow and other organs. There have been at least six treatments for the disease since the initial diagnosis, always in young people (read more below).
According to Fernando de Moura, oncologist at BP – Beneficência Portuguesa de São Paulo, patients who have been treated for Hodgkin’s lymphoma in the past, either with chemotherapy alone or with chemotherapy plus radiotherapy, have a risk up to four times higher. high to have a second cancer compared to the general population. (read more below)
“Breast cancer and thyroid cancer, for example, are neoplasms that we see with a higher incidence in this group of patients,” says Moura.
The oncology surgeon at the Morumbi Unit of Leforte Hospital, Marina Canal Budib, adds that “there are still cases of patients who have a genetic predisposition to certain types of tumors. They may have more than one type of tumor, and there are tumors that are metastatic, when the same type can spread to other places.” (read more below)
What is the incidence of Hodgkin’s lymphoma? Can it spread even decades later?
Hodgkin’s lymphoma accounts for 10% of all lymphomas (the remaining 90% are what we call non-Hodgkin’s lymphomas) and only 0.5% of all malignant neoplasms. Lymphomas are commonly diagnosed in young patients. (read more below)
“It is a highly curable disease with a peak incidence in young adults between the ages of 20 and 35. However, people who have treated Hodgkin’s lymphoma in the past, either with chemotherapy alone or with chemotherapy plus radiation therapy , are at up to four times higher risk of having a second cancer compared to the general population,” says Fernando de Moura, oncologist at BP — A Beneficência Portuguesa de São Paulo and collaborator of the scientific committee of the Instituto Vencer o Câncer (read more below)
Recently, journalist Susana Naspolini was diagnosed with pelvic cancer, which had spread to the bone marrow and other organs. It was already the sixth treatment for the disease (read more below).
According to Moura, in this case it is advanced breast cancer, and the referred lesion in the pelvis is what is called a metastasis (read more below).
“A recent study on the Brazilian population showed that approximately 6% of breast cancer cases in Brazil are already diagnosed with metastases. However, even cases diagnosed in the early stages have this risk of recurrence years after treatment. initial, with a recurrence that can occur in other organs, such as bones, lungs, liver and brain,” he adds.
Treatment, which often includes chemotherapy, radiation therapy and oral medications, aims to reduce the risk of recurrence. In addition, we know that the earlier the diagnosis is made, the lower the risk (see below).
what is the treatement?
Defining the ideal treatment for each patient will always depend on the stage at which the disease is diagnosed and the specific type of tumour. In cases of advanced or metastatic disease, chemotherapy is often an important weapon for disease control (read more below).
Treatment of early breast cancer, for example, always involves surgery. In some cases, additional treatments are needed, which may involve chemotherapy, radiotherapy and oral medications, which we call hormone therapy.
How to maintain the patient’s quality of life in these cases?
The primary goal of treating any cancer is always to increase the chances of recovery.
“However, in cases where cure is no longer possible, our main objective is to increase life expectancy, always aiming for quality of life. Symptom control, through the proposed cancer treatment , is essential in this sense”, observes the oncologist of BP — Hospital Beneficência Portuguesa de São Paulo.
The oncological surgeon of the Morumbi unit at Leforte Hospital, Marina Canal Budib, says that “one way for us to have a quality of life is, if possible, to practice physical activity, which helps a lot in the cardiopulmonary recovery and immune system recovery, as well as in improving patient fatigue and rehabilitation.”
A healthy diet also plays an important role in the patient’s quality of life.
What are the possible reasons why cancer appears more than once and in different ways at certain times in a person’s life? In the case of the journalist, can we say that it is a case of metastasis?
Yeah. “According to the journalist’s reports that were published during her treatment, we can say that she was dealing with a disease that already had metastases, in the bones and the liver,” says Moura.
Still according to the specialist, when we talk specifically about breast cancer, for example, the organs most frequently affected by metastases are the lymph nodes, lungs, liver, bones and brain.
When the cancer comes back some time after the initial treatment, a tumor cell has managed to reach the lymphatic system and/or the bloodstream.
Chemotherapy aims to fight these cells that could have been circulating there since the initial diagnosis.
“However, several factors, many of which are still unknown to us, contribute to the fact that some of these cells resist treatment, stay alive and, years later, are able to multiply out of control, giving rise to metastases” , explains the Collaborator of the Scientific Committee at the Beat Cancer Institute.
There are also cases of patients who have a genetic predisposition to certain types of tumors.
“You can have more than one type of tumour, and there are tumors that are metastatic, while the same type can go elsewhere. For example, breast cancer that can go to the lung, to the bone, to the the pleura (species that lines the lungs) or the central nervous system, because it is a systemic behavior,” explains the surgical oncologist from the Morumbi unit at Leforte hospital.
And he adds: “That is to say, it falls both into the lymphatic vessels, causing metastases in the lymph nodes, and into the bloodstream, causing metastases in the aforementioned organs”.
Is the immune system weakened after the first illness or the start of treatment?
According to the Victory Cancer Institute oncologist, in some cases it is known that certain failures in the immune system may indeed be responsible for the tumor’s ability to resist over time.
Marina Budib adds that the immune system can be more vulnerable, especially after chemotherapy. “However, once the patient is done with chemotherapy, recovered, and has good nutrition, they go back to how they were before,” she points out.