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Rob Ford's Toronto

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ford bros circus.PNG

http://iconosquare.com/p/1105918806437558923_23372205
 

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Let's play Ford press release bingo:

- pray
- constituents
- working hard
- loving family
- keep fighting
- father
- mayor
- 2018

"Rob's a fighter. He has all the support in the world. We have a great medical team and the best hospitals in the world. We're confident everything's going to work out."
http://www.newstalk1010.com/news/2015/10/28/listen-rob-ford-has-new-tumour-on-his-bladder

“Councillor Ford and his family wish to extend their continued gratitude for the thoughts, prayers and support that they have received during this difficult time.”

Thank you everyone for your continued thoughts and prayers, I remain optimistic that I will be able to overcome this setback.

— Rob Ford (@TorontoRobFord) October 28, 2015
http://www.torontosun.com/2015/10/28/rob-ford-has-new-tumour-on-bladder

from that same article...
Earlier on Wednesday, Mayor John Tory said he hopes his mayoral predecessor gets better.

“Whatever our differences may be at the city council from time to time, he’s a person that we want there and we need there.”

really?!?!?
 
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Rob Ford says 'no' the most: Report tracks voting habits of council
“We found more disagreement in a day at Toronto city council than in four years at many other cities we studied,” Jeromy Farkas, a research fellow with the Manning Centre, said in a statement.
[...]
The report says: “Unlike other Ontario city mayors studied by Council Tracker, Mayor Ford is demonstrably isolated from outcomes and the rest of council.”
http://www.torontosun.com/2015/10/2...e-most-report-tracks-voting-habits-of-council
 
Newstalk 1010's doctor contributor says Ford's type of cancer rarely spreads and that the tumour is likely a whole new type. But online articles say it often spreads, even to vital organs. I'm guessing if it's connected to the first cancer that's the worst case scenario?

My reference suggests that retroperitoneal liposarcomas rarely cause distant metastases (e.g. to lung or liver) but that local recurrence is "relatively common". This could be a second primary bladder tumour, in which case Ford is just unlucky, or it could be an example of local recurrence. I would bet on the latter, though, as it's arguably more likely. Basically he had an aggressive tumour which commonly recurs locally even when "complete" resection is achieved in an initial surgery.

The survival rates that are getting quoted in most media articles reflect all types of pleomorphic liposarcoma, but the prognosis is a good deal worse for retroperitoneal sarcomas. It depends on how well the original resection went, but who really knows what's going on when the likes of Doug Ford are giving us information.
 
The famous “murder rant” video, in which Ford thrashes about in a violent rage while muttering death threats directed at an unknown person, has been a mystery since it first came to public attention two years ago. Towhey says his “sources” tell him that Ford was just engaging in an addled role-playing fantasy, in which he was fighting either Justin Trudeau, Mike Tyson or Hulk Hogan. The same night that video was filmed, Towhey says, Ford summoned his friend Bruno (presumably Bruno Bellissimo) to the house. When Bruno arrived, Ford punched him in the face so hard he (Bruno, that is) fell over.
http://torontolife.com/city/toronto-politics/uncontrollable-mark-towhey-rob-ford/
 
True enough. Harper grew up with these guys which is why he never slammed but always avoided, I've had to do that with a few folks.

I can see


He's being nice if course lol - not like he can say "screw him I hope he gets crabs" lol

Exactly! Tory is taking the high road.
 
My reference suggests that retroperitoneal liposarcomas rarely cause distant metastases (e.g. to lung or liver) but that local recurrence is "relatively common". This could be a second primary bladder tumour, in which case Ford is just unlucky, or it could be an example of local recurrence. I would bet on the latter, though, as it's arguably more likely. Basically he had an aggressive tumour which commonly recurs locally even when "complete" resection is achieved in an initial surgery.

The survival rates that are getting quoted in most media articles reflect all types of pleomorphic liposarcoma, but the prognosis is a good deal worse for retroperitoneal sarcomas. It depends on how well the original resection went, but who really knows what's going on when the likes of Doug Ford are giving us information.

Local recurrence sounds most plausible to me. He did have a second tumor in his butt, and the bladder doesn't seem that far from the original tumor site, no? Everything seems to be happening in roughly the same area, and in ways that correspond roughly to my understanding of what I've read. If that's the case, I wonder what treatment options are available. Chemo is probably on the table as way of getting to whatever cells may be floating around. But how much chemo — and how strong a course — a person can stand up to in relatively rapid succession?

Re survival stats: Yes. The media (and Rob) is taking a pretty generic view of things. My recollection is that the 50/50 odds an average of survival rates of PLS occurences in various parts of the body. And even then, there doesn't seem to be a whole lot of data kicking around to firm up the numbers. Not surprising though, given that PLS is rare.

BTW, did anyone ever say Rob's tumor was retroperitoneal? Even the statements from the doctors seemed vague on that point.
 
So if it's malignant does he have to go through chemo again?

It's going to be very individualized to whether it's a new primary or local recurrence and exactly where it is. Maybe more surgery and/or radiation.

I suppose it may not be retroperitoneal, but the multidisciplinary surgical team (including urology and vascular too?) suggests involvement with the ureter and vessels. The bladder is lower in the pelvis. Could still be a second primary.
 
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A "new primary," would be a new cancer, whereas a "second primary" would be the same cancer but in a new location. Is that right?
 
Sorry, I should avoid the jargon. A "new primary" is the same as a "second primary", as it describes some other tumour that is unrelated to the first. This is distinguished from a metastasis which is tumour that has spread and been "deposited" somewhere, but which still arise from the original tumour (the "primary").

So, in Ford's case, the original 10-12 cm tumour was the "primary", which also had a local metastasis, that is, a "secondary" tumour "deposit" in his buttock.

This bladder tumour may be an example of "local recurrence" that shares the same histology (that is, cell type and tumour biology) as the original "primary". It might also be a "primary" bladder tumour which would have a completely different histology from pleomorphic liposarcoma; that is, it would have arisen from different types of cells, and would most likely be a "carcinoma" (a malignant neoplasm arising from epithelial, endothelial, or urothelial cells which are not the same as sarcoma).

It's also possible that this bladder tumour is a "secondary" malignancy that can be attributed to Ford's prior chemo and/or radiation. This would be still be a "primary" carcinoma but would be considered a complication of treatment of the original primary sarcoma. To take another example, although it was never revealed definitively, Jack Layton acquired a "second" cancer following treatment for prostate cancer - this was also a "secondary" malignancy.

Anyway, in this case, this bladder tumour could represent any of the following:

1) local recurrence of the original primary tumour that was resected
2) a new "typical" primary bladder carcinoma not related to prior cancer treatment
3) a new "typical" secondary bladder carcinoma related to prior cancer treatment
4) a benign polyp or some other non-malignant neoplasm
5) something else entirely that's difficult to tease out because the Fords are liars

Treatment will depend on what this is and the only way to know is to get tissue, i.e. biopsy.
 
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