Two Independant Cancer Growths Found at The Same Time, No Known Risk Factors, and Not Genetically Linked: One Thrivor
Cristina Torres, 51, is a mother of 4 children: adult male triplets and a teenage daughter. Not wanting anyone to know she had two cancer diagnoses, she reflects, “The mental part has been the hardest part. Your doctors, your family, everyone around you, my friends, the support is what takes you through, because it’s hard, it’s very hard.”
Cristina’s concern with one cancer soon doubled as learned she had two. Through surgeries, radiation treatments, and recovery, her community supported her while she wrestled with the unknown; why did she get two cancers when she had no genetic markers linking them, and with no associated risk factors? “You don’t know if it’s what you eat, how much you weigh, if it’s something you did do, or didn’t do. That’s what’s scary about the whole thing…the mental is more worried it’s somewhere else,” Cristina explains. Although science can’t provide that answer at this time, fortunately, Cristina went from two synchronous cancer diagnoses and treatments to being cancer-free in just 6 months, and that is entirely because she found it early from doing a routine mammogram screening.
“I love all three of my doctors. They’re amazing; you feel like they care.”
– Cristina Torres
Two Centers, One Collaborative Program
Cristina was diagnosed with two cancers at the same time and treated at two centers within one program. These centers are working seamlessly together to offer advanced oncology care in Los Angeles, California. Her treatment plan bridged the 405 freeway from the Disney Family Cancer Center (DFCC) in Burbank, California to Saint John’s Cancer Institute (SJCI) in Santa Monica, California.
Initially, Cristina was diagnosed with pre-invasive breast cancer called DCIS in late October of 2023 (stage 0 breast cancer) after a biopsy came back positive when a yearly routine mammogram showed a mass in Santa Clarita, California. Referred to a team of specialists at the Disney Family Cancer Center in Burbank, California, many unknowns become sighs of relief. Cristina had genetic testing while waiting for another appointment because DFCC has walk in genetics testing. Since she had early-stage non-invasive breast cancer, even more options were available to her. She opted for a partial lumpectomy included with oncoplastic surgery (plastic surgery for bilateral breast reduction), followed by external beam radiation.
The added benefit of having surgery with Dr. Crystal Fancher, breast surgical oncologist and expert in oncoplastic surgery, Cristina was given the option for cosmetic bilateral reduction, something she always wanted while being treated for something she never wanted, cancer. Oncoplastic surgery is a treatment option only offered on the west side, typically. Dr. Fancher typically practices in the Margie Petersen Breast Center at Saint John’s Health Center in Santa Monica. She also sees patients at the Disney Family Cancer Center in Burbank, California, where she performed breast surgery on Cristina.
Since kidney cancers are typically found too late, and by accident, Cristina avoided progressive kidney cancer by way of a breast cancer diagnosis.
Incidentally found on a CT scan while she was getting routine scans for her breast cancer, Cristina was diagnosed with an aggressive stage 1A renal cell carcinoma in early February 2024. “Just as I ended one treatment, I had to start all over,” she mentions in her testimonial. Further tests discovered the cancers were unrelated.
Since her second primary cancer was detected early as well, the tumor was localized, which necessitated a partial nephrectomy. Only 25 percent of her right kidney was removed. Dr. Ramkishen Narayanan performed the surgery in late March at Saint John’s Health Center in Santa Monica.
Dr. Narayanan is a urologic surgical oncologist who typically sees patients at the Disney Family Cancer Center in Burbank. For more advanced minimally invasive surgical techniques, he utilizes the da Vinci robotic surgery system at Saint John’s Health Center in Santa Monica. The Saint John’s Cancer Institute’s urologic oncology fellow and now graduate Dr. Joshua Gottlieb assisted Dr. Narayanan with Cristina’s surgery.
“I feel great right now, and it’s a month after…not even a month after.”
– Cristina Torres
Listen to Dr. Fancher & Dr. Narayanan Interview Cristina Torres
Crystal Fancher, MD, Ramkishen Narayana, MD, interview Maria Torres at Saint John’s Health Center in Santa Monica, California
What are Synchronous Primary Cancers?
In oncology, synchronous multiple primary malignancies refer to two or more independent primary cancers that occur within two months of each other. It’s not uncommon to find two independent primary malignancies over the course of a thrivor’s lifetime, and oftentimes this is due to an underlying risk factor such as, smoking for instance. However, it is more uncommon to find two primary malignancies at the same time (1.33 – 5.8%) and even more rare for those malignancies not to be linked with a common risk factor, such as smoking, genetics, viral infection, or environmental. From a study in 2016, there have been only eight previously reported cases of breast cancer synchronous with kidney cancer, suggesting Cristina’s case is a rare occurrence. 1,2
If Cristina had metastatic breast cancer that spread to the kidney, her treatments would have been more aggressive, and prolonged. Thankfully, Cristina caught cancer early, and others can too.
What is Multi-Cancer Early Detection?
Early detection of cancer is still the best way to cure cancer. At Saint John’s and Saint Joseph’s, we are leading a study that can detect up to 50 different cancers (including kidney) from a single blood draw called MCED (Multi-Cancer Early Detection). We are implementing the study at both locations and offer testing as part of our comprehensive focus on prevention and early detection.
Saint John’s Cancer Institute and the Disney Family Cancer Center are part of MCED’s two-year multi-institute national clinical trial to alleviate the morbidities of late-stage cancer. The PI (principal investigator) of this clinical trial is now the executive director of both cancer centers, Ora Gordon, MD, professor of genetics.
“Our mission is to provide the most innovative, world class cancer care, while keeping the patient’s individual needs at the forefront-always doing everything we can to ease their way.”
– Ora Gordon, MD
With the ability to have multiple disciplinary teams working across hospitals seamlessly, Cristina received the kind of care we wish possible for everyone.
Meet Cristina’s Care Team
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Crystal Fancher, MD, FACS, Breast Surgical Oncologist and Assistant Professor of Surgical Oncology, Margie Petersen Breast Center
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Ramkishen Narayanan, MD, Urologic Surgical Oncologist and Director, Urology Center at Saint Joseph’s, Burbank California
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Erwin Grussie, MD, Medical Oncologist, and principal investigator for multiple clinical trials at Roy and Patricia Disney Family Cancer Center in Burbank
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Resources:
- Synchronous/Metachronous Multiple Primary Malignancies: Review of Associated Risk Factors – PMC (nih.gov)
- Breast Cancer with Synchronous Renal Cell Carcinoma: A Rare Presentation – PMC (nih.gov)