BAC pathology présentation in pericardium - 1246097

funnymom
Posts:24

I have not had my lung biopsied. The only biopsy material that I have is from my pericardium from surgery done over a year ago.

The pathology determined that I have adenocarcinoma. It did not clearly determine where it came from, however all roads point to Rome - in this case my lung. The pathology was noted for having papillary and micropapillary features.

I am a never smoker. I am having outstanding response to everything thrown at me. First up was chemo which practically knocked everything out on its own. I then went on Tarceva maintenance 150 daily. I have been on Tarceva since December 2011. My February, May and July scans (just a few days ago) showed no cancer.

I have never had a "tumor" in my lung per se. I did have a mass like infiltrate and some ground glass opacity when I first got sick.

I am beginning to think that whatever my cancer is, it is either unusually responsive (possible as I have the EGFR exon 19 deletion) or that perhaps it was some sort of more slow moving BAC type of thing. Would the pathology taken from my pericardium been able to differentiate if it was a BAC as opposed to straight up adenocarcinoma? Wouldn't the presence of the papillary and micro papillary features possibly be consistent with BAC?

Lastly, when I first got sick I was working out a lot on my own with weight machines. I was pressing around 100 pounds on my chest. Could a slow crush injury have opened up the genie's bottle so to say and unleashed what might have been until that point a relatively harmless BAC in situ?

My whole case has been weird and as I said, my response has been on the atypically wonderful spectrum. I will also mention that my grandmother survived cases of breast and colon cancer in the early 1950's when neither was caught early (pre mammo days for instance) and everybody else died from them. Is it possible that my grandmother had something and that maybe I do that somehow does battle better against cancer than other people? She lived to be 94.

Forums

catdander
Posts:

Hi funnymom, I see your sense of humor in your post and understand your user name better 8). How wonderful that you are having such a response. I hope your theory is right and you too live to be 94!

I will ask our BAC specialist to respond to your post. I'm talking about Dr. West, of course.

Best of luck,
Janine
forum moderator

Dr West
Posts: 4735

If the cancer is invasive into the pericardium, that indicates that has a component of invasive adenocarcinoma and isn't only non-invasive BAC. However, the rest of what you describe, in terms of the lack of a real tumor, your status as a never-smoker, and the responsiveness to treatment (at least EGFR inhibitor therapy) are all very consistent with BAC (though plenty of invasive adenocarcinomas can respond well and/or are in never-smokers). My leading suspicion is that it's a combination of some invasive adenocarcinoma that also has BAC features, or mostly BAC with focal invasion. The spectrum is described here:

http://cancergrace.org/lung/2006/10/11/bac-adeno-spectrum/

I don't think there's much chance at all that weightlifting or any other physical activity has promoted the cancer. That's never been speculated and is hard to envision as a biologically plausible mechanism.

I also strongly suspect that your situation is not directly related to your grandmother's status. Yours is a very different cancer, and this situation isn't known to be particularly associated with a strong genetic predisposition. Though I couldn't know with certainty, I suspect it's just a coincidence.

-Dr. West