KRAS and BRAF MUTATIONS

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Schallen
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KRAS and BRAF MUTATIONS

Postby Schallen » Wed Apr 11, 2018 1:09 pm

Abstract
More than half of human colorectal cancers (CRCs) carry either KRAS or BRAF mutations and are often refractory to approved targeted therapies. We found that cultured human CRC cells harboring KRAS or BRAF mutations are selectively killed when exposed to high levels of vitamin C. This effect is due to increased uptake of the oxidized form of vitamin C, dehydroascorbate (DHA), via the GLUT1 glucose transporter. Increased DHA uptake causes oxidative stress as intracellular DHA is reduced to vitamin C, depleting glutathione. Thus, reactive oxygen species accumulate and inactivate glyceraldehyde 3-phosphate dehydrogenase (GAPDH). Inhibition of GAPDH in highly glycolytic KRAS or BRAF mutant cells leads to an energetic crisis and cell death not seen in KRAS and BRAF wild-type cells. High-dose vitamin C impairs tumor growth in Apc/KrasG12D mutant mice. These results provide a mechanistic rationale for exploring the therapeutic use of vitamin C for CRCs with KRAS or BRAF mutations.

http://science.sciencemag.org/content/350/6266/1391

Sharing Hope
Posts: 11
Joined: Wed Oct 25, 2017 5:02 am

Re: KRAS and BRAF MUTATIONS

Postby Sharing Hope » Fri Apr 27, 2018 10:23 am

This is fantastic! Thank you for posting!

Here’s another: https://www.onclive.com/onclive-tv/dr-o ... -mutations
Mama w/2 Sons/Smitten Wife since 1988; BD/1968; Lifelong vegetarian; Non-smoker/drinker
6/16 Baseline Colonoscopy; Sessile polyps - adenocarcinoma near Splenic Flexure; CEA .8
8/16 Robotic colon resection of Descending Colon; 30 LN clear; Stage 1
9/17 Liver tumor found/abdominal pain; CEA 16.4; Stage 4
9/17-11/17 5 TC FOLFOX/5FU + Avastin
11/17 CEA 6
MSS - KRAS G12V Mutation
12/17 Hepatic resection of left liver lobe/margins involved; current CEA .8
2/18 - 4/18
FOLFOX 5FU 6tx

Brearmstrong
Posts: 57
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: KRAS and BRAF MUTATIONS

Postby Brearmstrong » Fri Apr 27, 2018 1:35 pm

These are great articles, thanks for sharing. Wondering if anyone is doing IV vit C currently and if so, did they have to find a facility that will administer and do you have to pay out of pocket? My oncology center doesn't offer this but I'm willing to do on my own. Any estimates on how much it costs? Thanks!!

-Brenda
45 F Jan 17 Mom- two boys
tumor in appendix into colon
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery < .05
KRAS G12D MSS
FOLFOX Apr-sep 17
Clean CT scan Jul 2017 watching lung nodule 4mm, clean CT oct 17, CEA 3.4, nov 17 CEA 8.1. May 18 2.3 Jul 18 1.0
Oct 2017 clean CT 4mm lung nodule stable,3 new 2 mm nodule.
Nov 17 PET para aortic nodes uptake. Stage IV
Folfori w/avastin Dec 17 CEA 7.1
May 18- surgery to remove nodes- 5 positive. xeloda 2000mg/day
Aug 18-CT NED!

rp1954
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Re: KRAS and BRAF MUTATIONS

Postby rp1954 » Sat Apr 28, 2018 6:58 am

1. I think that any test of vitamin C alone is insufficient.
2. We found direct live tissue testing useful. Vitamin C + K2/MK4 + 5FU as a starting point, then add adjuncts
3. Anyone not doing some CA199 tests for Kras/Braf mutant related CRC patients, is not serious. We found tracking HgbA1C, LDH, hsCRP, ESR too, most useful for immunochemo. Perhaps TSH fT3 too. The more stable these are, the more stable and sensitive, CA199 is.
4. The impact of IV vitamin C on PET scanning needs to be better recognized and planned for.
5. MRI needs to be developed for direct reading of ascorbates accumulated in tumors.
6. Immunochemo, based on daily 5FU made the most sense to me, for "chemo forever". Immunochemo yielded stable, sensitive results in CA199 for us, in places CEA failed.

Cost is highly dependent on sources and circumstances.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC

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ktwmn
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Re: KRAS and BRAF MUTATIONS

Postby ktwmn » Sat Apr 28, 2018 9:53 am

Insurance never covers integrative therapy such as IV vitamin C. So these adjuncts are out of reach for those of us on limited income (I can barely cover the $5000 out of pocket for my annual health insurance costs).
Dx 7/11, Stage IIIc CC
12 txs Folfox 8/2011-2/2012
MSS, KRAS-mut G12D
NED until 3/2015, mets to liver and peritoneum
April-December 2015: 15 txs folfiri+avastin
Liver mets resolved; pelvic met remains
January-May 2016: folfox+avastin; allergic rxn to oxi
June-August 2016: 5FU+avastin
October 2016: looking into immuno trial
January 2017: maintenance chemo xeloda + avastin

rp1954
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Re: KRAS and BRAF MUTATIONS

Postby rp1954 » Sun Apr 29, 2018 6:25 pm

There are at least two possible financial directions on the IV vitamin C front.

First, employers have often had power to allow insured medical expenses themselves, as well as direct payment for their own benefit, the employee's or both. I mention this because IV vitamin C prevents and destroys some precursors of excess VEGF-A, which Avastin antibodies mop up individually at such high cost. If you were able to switch to 4-5 weeks between Avastin infusions instead of 3 weeks, it could pay for weekly IV vitamin C many times over even at $200 each in the doctors office. My only data point for this is my wife, who has never had to use Avastin but definitely had CA199 marked tumor cells and her live cells responded to cocktails of 5FU-vitamin C+extras...

Second, the cost of IV vitamin C is entirely dependent on local factors, where every step can be tremendously cost reduced by various tactics and opportunities. e.g. if you have an IV nurse next door, know personally, etc. The minimum cost of injectable vitamin C itself is based on jurisdictions of manufacture and application. Cost varies radically, from near zero to hundreds of dollars(!) per infusion just for the injectable vitamin C alone. In the US, state laws enable the lowest possible cost to an individual (f' FDA).
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC

jp81
Posts: 15
Joined: Sun Jun 04, 2017 4:45 am

Re: KRAS and BRAF MUTATIONS

Postby jp81 » Mon Apr 30, 2018 12:40 am

Hi rp1954,

You mentioned a set of tests in the previous post. How do we interpret those test results and apply it to immunochemo?
Assuming we do 5FU+VitC (and Avastin every 3 weeks), what would need to be changed when one of the test results fall outside the expected range?

Thanks
Dear Mom 57yrs, Stage 3 RC (T3CN2M0), CEA 9
MSS, Gycine to Aspartate Mutation (G12D)
6.5 CM from verge, 30mm in Mesorectal Fascia,
Capecitabine + Radiation 06/17
Surgery 08/17
5 rounds of CAPOX (Stopped when counts too low)
CEA still 6; suspicious para aortic node 1/18.
CEA 5.6, PET Scan, 1 malignant para-aortic node 2/18
Pre-op CEA 4.8; Surgery (converted to Open) - 1.6cm Inferior Mesenteric Node - 26/2/2018

Brearmstrong
Posts: 57
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: KRAS and BRAF MUTATIONS

Postby Brearmstrong » Mon Apr 30, 2018 6:42 am

Thanks all!

JP18, your mom is similar to me. I am having (hopefully) surgery to remove my metastic spread to para aortic nodes in two weeks. How did you mom make out with that surgery? I'm also MSS and Kras 12D. Wondering what her drs are saying about long term prognosis? Is she on maintenance chemo?

Will look into Vit C costs in CT but as with everything in CT, I'm sure it will be $$.

_Brenda
45 F Jan 17 Mom- two boys
tumor in appendix into colon
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery < .05
KRAS G12D MSS
FOLFOX Apr-sep 17
Clean CT scan Jul 2017 watching lung nodule 4mm, clean CT oct 17, CEA 3.4, nov 17 CEA 8.1. May 18 2.3 Jul 18 1.0
Oct 2017 clean CT 4mm lung nodule stable,3 new 2 mm nodule.
Nov 17 PET para aortic nodes uptake. Stage IV
Folfori w/avastin Dec 17 CEA 7.1
May 18- surgery to remove nodes- 5 positive. xeloda 2000mg/day
Aug 18-CT NED!

jp81
Posts: 15
Joined: Sun Jun 04, 2017 4:45 am

Re: KRAS and BRAF MUTATIONS

Postby jp81 » Tue May 01, 2018 12:03 am

Hi Brenda,

My mom has a PET scan scheduled for next month, and the doctors are waiting for the results before discussing long term prognosis.
As of now she's doing quite well, cheerful and going about her daily routine as usual. Had to shave her head due to hair loss (from folfiri + avastin), but looking ten years younger for it. :)

While I'm hopeful of good results next month, there were some delays in the scheduling of her surgery - the consequences of that worries me a bit. My mom was completely off chemo for nearly six weeks, including 4 weeks after the discovery of the mets.
That's a risk factor, please talk to your physicians about minimizing the delay between chemo stoppage, surgery and chemo restart. I think you just need a 3 week break from chemo on both sides. G12D has a tendency to spread a little faster, but studies on whether it affects survival have mixed results - some say it does and some say it's almost the same. But on a positive note, some of the promising TIL immunotherapies are for mutants.

I'll post once we receive the PET results next month. Really rooting for your surgery to go well.
Dear Mom 57yrs, Stage 3 RC (T3CN2M0), CEA 9
MSS, Gycine to Aspartate Mutation (G12D)
6.5 CM from verge, 30mm in Mesorectal Fascia,
Capecitabine + Radiation 06/17
Surgery 08/17
5 rounds of CAPOX (Stopped when counts too low)
CEA still 6; suspicious para aortic node 1/18.
CEA 5.6, PET Scan, 1 malignant para-aortic node 2/18
Pre-op CEA 4.8; Surgery (converted to Open) - 1.6cm Inferior Mesenteric Node - 26/2/2018

rp1954
Posts: 1365
Joined: Mon Jun 13, 2011 1:13 am

Re: KRAS and BRAF MUTATIONS

Postby rp1954 » Tue May 01, 2018 12:45 pm

You mentioned a set of tests in the previous post. How do we interpret those test results

1. find professionals interested in this subject, at least more than average
2. read CRC papers relevant to a particular marker. A prior CRC diagnosis changes the statistical bounds and meanings of a measure or a series vs one shot test uses for initial diagnosis
3. you can plot your numbers for trends, noise, note anomalies, and treat them
4. ask around, watch the discussions for questions; engage in discussions - bring your own data

...and apply it to immunochemo?

We use the blood test series to change the doses and the extras added, from nutraceuticals to drugs like celecoxib. "It's working" or some quantitative improvement(s) vs penalty(s) in the chemistry panels.

Assuming we do 5FU+VitC (and Avastin every 3 weeks)

I would investigate some kind of "extras" in addition to vitamin C (which somewhat roughly overlaps Avastin) to start with because 5FU "alone" seems inadequate. The starting points, with CAM and chemo, need professional insights. There are changes that deal with cancer changes, resistance and prevention, there are changes that deal with optimum health, side effects or prevention.

what would need to be changed when one of the test results fall outside the expected range?

Depends. Some doctors might want to quit, try something more conventional. We choose to add or change things related to markers, this would be where you should have outside consults on chemistry.

If people would better discuss their blood results, consults and recipes, then this process becomes easier on looking for professional help and knowing what you're looking for.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC

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dianetavegia
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Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia
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Re: KRAS and BRAF MUTATIONS

Postby dianetavegia » Fri May 04, 2018 4:18 pm

Save money! Check out Modified Citrus Pectin which comes as a nasty powder, so I mixed it in Applesauce until it dissolved and used it for about four years. It cost about $60 on Amazon. It MUST BE MODIFIED to be absorbed properly in the intestine.

Effects of daily oral administration of quercetin chalcone and modified
citrus pectin on implanted colon-25 tumor growth in Balb-c mice.

The health benefits of fruits and vegetables have been the subject of
numerous investigations over many years. Two natural substances, quercetin
(a flavonoid) and citrus pectin (a polysaccharide found in the cell wall of
plants) are of particular interest to cancer researchers. Two modified
versions of these substances - quercetin chalcone (QC) and a pH-modified
citrus pectin (MCP) - are the focus of this study. Previous research has
confirmed that quercetin exhibits antitumor properties, likely due to immune
stimulation, free radical scavenging, alteration of the mitotic cycle in
tumor cells, gene expression modification, anti-angiogenesis activity, or
apoptosis induction, or a combination of these effects. MCP has inhibited
metastases in animal studies of prostate cancer and melanoma. To date, no
study has demonstrated a reduction in solid tumor growth with MCP, and there
is no research into the antitumor effect of QC. This study examines the
effects of MCP and QC on the size and weight of colon-25 tumors implanted in
balb-c mice. Fifty mice were orally administered either 1 ml distilled water
(controls), low-dose QC (0.8 mg/ml), high-dose QC (1.6 mg/ml), low-dose MCP
(0. 8 mg/ml) or high-dose MCP (1.6 mg/ml) on a daily basis, beginning the
first day of tumor palpation (usually eight days post-implantation). A
significant reduction in tumor size was noted at day 20 in all groups
compared to controls. The groups given low-dose QC and MCP had a 29% (NS)
and 38% (p<0.02) decrease in size, respectively. The high-dose groups had an
even more impressive reduction in size; 65% in the QC group and 70% in the
mice given MCP (both p<0.001). This is the first evidence that MCP can
reduce the growth of solid primary tumors, and the first research showing QC
has antitumor activity. Additional research on these substances and their
effect on human cancers is warranted.
Altern Med Rev. 2000 Dec;5(6):546-52
Inhibitory effect of modified citrus pectin on liver metastases in a mouse
colon cancer model.
AIM: To discuss the expression of glactin-3 in liver metastasis of colon
cancer and its inhibition by modified citrus pectin (MCP) in mice. METHODS:
Seventy-five Balb/c mice were randomly divided into negative control group
(n = 15), positive control group (n = 15), low MCP concentration group (n =
15), middle MCP concentration group (n = 15) and high MCP concentration
group (n = 15). CT26 colon cancer cells were injected into the subcapsule of
mouse spleen in positive control group, low, middle and high MCP
concentrations groups, except in negative control, to set up a colon cancer
liver metastasis model. The concentration of MCP in drinking water was 0.0%,
0.0%, 1.0%, 2.5% and 5.0% (wt/vol), respectively. Liver metastasis of colon
cancer was observed after 3 wk. Enzyme-linked immunosorbent assay (ELISA)
was used to detect the concentration of galectin-3 in serum. Expression of
galectin-3 in liver metastasis was detected by immunohistochemistry.
RESULTS: Except for the negative group, the percentage of liver metastasis
in the other 4 groups was 100%, 80%, 73.3% and 60%, respectively. The number
of liver metastases in high MCP concentration group was significantly less
than that in positive control group (P = 0.008). Except for the negative
group, the median volume of implanted spleen tumor in the other 4 groups was
1.51 cm(3), 0.93 cm(3), 0.77 cm(3) and 0.70 cm(3), respectively. The volume
of implanted tumor in middle and high MCP concentration groups was
significantly smaller than that in positive control group (P = 0.019; P =
0.003). The concentration of serum galectin-3 in positive control and MCP
treatment groups was significantly higher than that in the negative control
group. However, there was no significant difference between them. Except for
the negative control group, the expression of galectin-3 in liver metastases
of the other 4 groups showed no significant difference. CONCLUSION:
Expression of galetin-3 increases significantly in liver metastasis of colon
cancer, which can be effectively inhibited by MCP.
World J Gastroenterol. 2008 Dec 28;14(48):7386-91
Expression of galectin-3 in liver metastasis of colon cancer and the
inhibitory effect of modified citrus pectin.
OBJECTIVE: To observe the expression of galectin-3 in the liver metastasis
of colon cancer in mice and the inhibitory effect of modified citrus pectin
(MCP) on galectin-3 expression. METHODS: Seventy-five Balb/c mice were
randomized into 5 groups, namely the negative control, positive control,
low-concentration MCP, moderate-concentration MCP and high-concentration MCP
groups. CT26 colon cancer cells were injected into the subcapsule of the
mouse spleen to establish liver metastasis models of colon cancer, but the
mice in the negative control group received no tumor cell injection. MCP was
added into the drinking water of the mice at the concentrations of 0, 1.0%,
2.5% and 5.0% (m/V). The liver metastasis was observed 3 weeks after tumor
cell inoculation. Enzyme-linked immunosorbent assay was performed to
determine the serum galectin-3 level. A tissue microarray of the liver
metastasis was prepared for immunohistochemical detection of galectin-3
expression in the liver metastasis. RESULTS: In the positive control, low-,
moderate- and high-concentration MCP groups, the rates of liver metastasis
were 100%, 80%, 73.3% and 60%, respectively. The number of liver metastases
in high-concentration MCP group was significantly smaller than that in the
positive control group (P<0.05). In the 4 groups with tumor cell
inoculation, the median volume of the primary lesions in the spleen was
1.51, 0.93, 0.77 and 0.70 cm(3), respectively, which were significantly
smaller in the moderate- and high-concentration MCP groups than in the
positive control group (P<0.05). The serum galectin-3 level in the positive
control group and MCP-treated groups were significantly higher than that in
the negative control group (P<0.01), but similar between the positive
control group and the MCP-treated groups (P>0.05). In the positive control
and the MCP-treated groups, the expression of galectin-3 in the liver
metastases showed no significant differences (P>0.05). CONCLUSION: The
expression of galetin-3 is significantly increased in the liver metastasis
of colon cancer, and MCP can effectively inhibit the liver metastasis.
Nan Fang Yi Ke Da Xue Xue Bao. 2008 Aug;28(8):1358-6


Stage IIIB cc surgery 1/7/09. 5/17 nodes. 12 tx FOLFOX
Stage IVa 2/15/12. CEA 6.4 PET = 1.5cm liver met. HR 4/11/12 No chemo

Nine years 6 months since my original dx and Six years post liver resection.
NED April 2018!
“O Lord my God, I cried out to You, And You healed me.”
Psalms 30:2

Eleda
Posts: 153
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: KRAS and BRAF MUTATIONS

Postby Eleda » Fri May 04, 2018 5:06 pm

Nasty is an understatement Diane lol, im trying it in yogurt atm, ( not so bad)
Like muck in water or juice, :mrgreen: :mrgreen: :mrgreen:
It's double that price here in ireland so goung to sort a us,source,,,
Tagamet has,also shown good in studies inthe 90s
And adding NKC ACTAVITORS
Ive been doing vitiman C blind since feb, unlike rp ive not gone through the bloods but too late now as surgery is Thursday, but I was lucky enough to find a GP to administer Vit C 75g for 200€, and will continue after surgery for at least a month

Will helping with tissue repair and recovery after
Adele x
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

rp1954
Posts: 1365
Joined: Mon Jun 13, 2011 1:13 am

Re: KRAS and BRAF MUTATIONS

Postby rp1954 » Fri May 04, 2018 9:04 pm

We got a blood draw with CA19-9 the night before surgery, in the hospital. That was major as it turned out, for longer term cimetidine use and KRAS correlation. Didn't know much of the rest of the list then, even cheap basic extras like LDH, ESR, even though I asked drs.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC

Eleda
Posts: 153
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: KRAS and BRAF MUTATIONS

Postby Eleda » Sat May 05, 2018 5:42 am

Rp, what do u look for in the CA19-9??? In relation to the
cimetidine?, I think im no MSS, and kras braf neg as thats what my original biopsy at colonoscopy sugestes on the he lab report that ive got a hold of but they keep saying tumor has to b removed to test??? ( conflicting)
My question is am I only waisting my time with all this if im not kras positive??? Apart from the VIT C??
My surgon refers to tumors like birds
Some can fly ( metastasize)
Some can't ( in situ)
But won't know until its fully removed during surgery and tested along with lymphs!!!!#

But when I mentioned lymph node invasion he pretty much said they may never b able to tell If they had cancer in them if they were destroyed by the radiation or weather they were just enlarged, doing their job( fighting off the cancerous tumor)

I never realised the complexity of cancer until now

THANKS ADELE X
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

rp1954
Posts: 1365
Joined: Mon Jun 13, 2011 1:13 am

Re: KRAS and BRAF MUTATIONS

Postby rp1954 » Sat May 05, 2018 9:35 am

Rp, what do u look for in the CA19-9??? In relation to the
cimetidine?,

The CA199 stained tissue is the best single marker predictive for cimetidine benefit with metronomic 5FU treatment during the first year; the CA199-CSLEX1 pair on tissue for predicting cimetidine-5FU benefit might be one of the best companion treatment tests around. Undisturbed CA199 blood tests on CRC already diagnosed is totally misunderstood in clinical oncology, they don't even understand the CRC ranges correctly, much less the cimetidine issue. ESR, LDH, hsCRP, HgbA1C are important support data for the CA199 (and CEA).

I think im no MSS, and kras braf neg as thats what my original biopsy at colonoscopy

Right this moment, you and your drs don't really know. My wife was "at least stage 2, well differentiated" at diagnosis with the initial 'scoped biopsy. Reality: "ha ha, just kidding". Look at my sig, obviously there were a few bits of information off or missing. I have issues with their initial errors and omissions that first month, that I still grapple with 8 years later.

At the very least, the extra blood tests are a safety and reality check. In about half the advanced cases, the extra information is like a winning lottery ticket, if cashed timely and correctly. My view: the extra blood tests were the investment of a lifetime for my wife.

sugestes on the he lab report that ive got a hold of but they keep saying tumor has to b removed to test??? ( conflicting) My question is am I only waisting my time with all this if im not kras positive??? Apart from the VIT C??

Your first biopsy is a small sample that may be nonrepresentative tissue e.g. missed the bad stuff, or different bird that laid an egg. Different techniques yield additional information, I would want it all for the most chances. I just had an interview with a pathologist, and it turns out that our CA199-CSLEX1 tissue stains may be more robust than the Kras test in some important ways.

My surgon refers to tumors like birds Some can fly ( metastasize) Some can't ( in situ)
But won't know until its fully removed during surgery and tested along with lymphs!!!!

Blood tests have the advantage of potentially draining marker samples from all cancers in the body, vs very limited point samples.

But when I mentioned lymph node invasion he pretty much said they may never b able to tell If they had cancer in them if they were destroyed by the radiation or weather they were just enlarged, doing their job( fighting off the cancerous tumor)

Yes. Blood tests generally, CA199 tests on tissue and blood are potentially extra odds information in this area that goes overlooked and unused.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC


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