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Chemo optional?

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zoomommy2 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote zoomommy2 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 14 2011 at 3:44pm
Cindy,
You can do this absolutely!  Taxol should be easier on you.  It is for most people, but no guarantees. 
Lee in Denver
dx6/09,stageII,gr3,(L)mastectomy 7/09,ACx4,Taxolx7,Avastin study,gall bladder surgery 1/10,4/11 Stage 4, mets to lung, 4/11 Started Taxotere and Xeloda, 5/11 Taxotere stopped, off Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: Mar 14 2011 at 4:21pm
Thank you, I must admit I am VERY apprehensive.  I keep telling myself "just breathe".....
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LauraT Quote  Post ReplyReply Direct Link To This Post Posted: Mar 14 2011 at 5:27pm
Cindy - Lee is right!  You CAN do this and we'll be here every step of the way.
 
Love,
Laura
DX 10/09 @44, Stage I IDC tnbc, DCIS other side, Neoadjuvant TCx4, Bilateral Mastectomy w/Recon 1/10, 1.2cm 0/7 Nodes, 5/11 Mets to Lungs/Lymph Nodes, Avastin/Taxol, 10/11 Bone Mets, Xgeva
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Post Options Post Options   Thanks (0) Thanks(0)   Quote zoomommy2 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 14 2011 at 5:34pm
Cindy,
Virtually everyone finds the anticipation of starting chemo is far worse than the actual experience.  Hoping that's what you will find, too.
Lee in Denver
dx6/09,stageII,gr3,(L)mastectomy 7/09,ACx4,Taxolx7,Avastin study,gall bladder surgery 1/10,4/11 Stage 4, mets to lung, 4/11 Started Taxotere and Xeloda, 5/11 Taxotere stopped, off Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote trip2 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 15 2011 at 8:01pm
Yes once you begin it will become a sort of routine.
 
I found packing up a chemo bag helpful.  That way you have things to fiddle with while getting your infusion.  Books, newspaper, laptop, Ipod, phone, paper/pen, lap blanket, water, snacks, whatever you might want to have with you.  The meds they give you can sometimes make you sleepy so the blanket feels good, comforting, having someone come with you, run out to bring lunch back or just a big cold drink with ice, whatever sounds good.
 
Check out our chemo tips in the tnbc news/resource section and best wishes for a smooth journey.
Be sure and ask questions and call the office if you have any concerns after treatment is given.
Stage 2 2003
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: Mar 16 2011 at 1:17am
Alrighty...seems the addendum re: her2neu to the initial path report did not make it to initial med onco; I provided it to 3rd opinion med onco who I met with today (2nd one backed out after onco dx could not pe performed) 3rd  found info re:her2neu reading that completely changes chemo approach and regimen. Needless to say, I WILL NOT start chemo St. Patrick's day, but I know I will soon once everything reports, slides, etc. have been gone over again. 

I'm going underground again... will post details later....I'm done for now.

Thanks for all the support.

Peace,
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Mar 16 2011 at 6:38am
Originally posted by Cinderwee Cinderwee wrote:

Alrighty...seems the addendum re: her2neu to the initial path report did not make it to initial med onco; I provided it to 3rd opinion med onco who I met with today (2nd one backed out after onco dx could not pe performed) 3rd  found info re:her2neu reading that completely changes chemo approach and regimen. Needless to say, I WILL NOT start chemo St. Patrick's day, but I know I will soon once everything reports, slides, etc. have been gone over again. 
 


Cindy,

Are they saying the Her2 reading was changed on your path report?  Is it now Her2 positive and making a difference with your treatment?  Hope you get your answers soon.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote SagePatientAdvocates Quote  Post ReplyReply Direct Link To This Post Posted: Mar 16 2011 at 6:57am
Dear Cinderwee,

thank you for sharing with us..

it sounds like, reading between the lines (always dangerous to do), that, as Donna suggests, your HER2/neu was positive? If so HERCEPTIN may become an option for you?

Your experience again points out the importance of a second pathology opinion...especially if FISH technology was not used the first time. 

Several months ago, a woman I know, had her pathology re-done and she, too, found out that she is not TN and a new treatment plan was commenced.

good luck with your new treatment plan!!!

and please try to find the beauty in each day.

all the best,

Steve
I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mjhoover@gmail.com Quote  Post ReplyReply Direct Link To This Post Posted: Mar 16 2011 at 12:20pm
Cindy, I agree with everyone here about second opinions and third and fourth ones too if needed. Glad you are thorough and getting good clarity on the markers (ER PR HER2). It does change things for sure! My first treatments were Taxetere, adriamycin, cytoxin. It was hard on my body (my body just doesn't like all these chemicals!!), but I did it one treatment at a time and I was sure I gave myself 'permission' to call the nurse anytime I had a question even if it seemed 'dumb' to me! These drugs can cause side effects you might not expect but a good onc and onc nurse can prescribe many things for side effects. The goal is to get through it if you can! I just kept asking questions until I was ok with the answers given. Take care and good luck to you...we are here for you on the boards too!! MJ
7/08 IDC L Br, mast 1/16 node +,St 2 gr 3, 6 rounds TAC
7/10 Mets to lungs, nodes abdomen BRCA-
8/10-1-11Abraxane/Avastin
7 11 3.3 cm tobrain sstem/rt cerribellium WBR 15 rds
Poss trial at MDA after
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: Mar 16 2011 at 4:30pm
Core biopsy 11/19/10, initial path report 11/23/10, HER2 addendum 12/18/10

The HER2 FISH Analysis reads (in part):
Results: 1.3 negative
Comment: HER2 Genetic Heterogeneity (GH) is present. See Below.
<1.80=Negative
1.80-2.20=Equivocal
>2.20=Positive
Karyotype: nuc ish 17 cen(D17Z1x 2-4), 17q11.2-12 (HER-2x 2-6) [40]
*HER2 FISH Results:
Number of Tumor Cells Counted: 20+20
Number of Observers:2
Average Her2 Signals/Nucleus: 3.7
Average Number of CEP 17 Signals/Nucleus: 2.9
Ratio Average: HER2/CEP 17: 1.3

THIS WAS THE CLINCHER:
Results of GH Region
7.5% of invasive tumor demonstrates HER2 amplification.
Amplified cells are scattered.

Suggested regimens:
1) Taxotere and Cytoxan + Herceptin every 3 weeks x 4 doses, include 3 days of Decadron
Neulasta shot day after infusion
Then Herceptin every 3 weeks x 1 year.

2) Taxol 1x week x 12 weeks
Cytoxan every 3 weeks x 4 doses
Decadron day of
Herceptin include with either above and continue every 3 weeks for 1 year

Option 1 is favored by the 3rd med onco as it is most widely used; Option 2 seems "less scary" to me.  The facility he is at (AZ Cancer Center in Tucson) is also going to have a BREAST path review core biopsy slides for hormone growth dependency for potential follow up hormone therapy, this should not hold up my starting chemo.

I had the FULL path report faxed to my init med onco, discussed over the phone and meet with him tomorrow. 

Thanks for listening....will definitely keep you posted and would appreciate all feedback on either suggested regimens  above.

AND - Thanks for all the wisdom and support; I am truly grateful.


Edited by Cinderwee - Mar 16 2011 at 4:49pm
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: Mar 20 2011 at 2:30am
the Her2 is being retested further due to the amplification of some cells.  The intent is to determine if I will need aromatose inhibitors long term.
It has been determined with finality that I am 3NEG; just that the ER is weakly positive at 5%, and there are some scattered Her2 amplified cells....sigh...I'm going for treatment option 2.  I don't like the sound of option 1 due to triple decadron, nor my body being slammed, then attempting to heal, then slammed again, especially since it slams so hard it has the potential to mess with my bone marrow causing the need for Neulasta shots....unless the second path report reveals some other anamoly, chemo to commence 3/24.  Wish me luck, and as always - THANK YOU!
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Mar 20 2011 at 10:18am
Cindy,

Good luck with your treatment.  I know it's so hard to decide when you get different opinions and anomalies with your tumor type.  Keep us posted.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote zoomommy2 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 20 2011 at 12:29pm
Cindy,
The treatment options sound very similar except for the days of Decadron.  I had 3 days of Decadron with my A/C and didn't have a problem with it.  It was supposed to be for the possible nausea.  I never had any nausea.  Sounds like you definitely need the Herceptin.  The Cytoxan will zap your white cells, but the Taxol/Taxotere shouldn't be so hard on you.  If you get Cytoxan every 3 weeks, your white count may well recover by the time of the next treatment.  Either decision sounds reasonable.  If it's your choice, go with what seems best for you.  We never know if we are making the best choice.  It's just the best decision we can come up with for us.   Good luck and keep us informed as to how you are doing.
Lee in Denver
dx6/09,stageII,gr3,(L)mastectomy 7/09,ACx4,Taxolx7,Avastin study,gall bladder surgery 1/10,4/11 Stage 4, mets to lung, 4/11 Started Taxotere and Xeloda, 5/11 Taxotere stopped, off Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote bondande Quote  Post ReplyReply Direct Link To This Post Posted: Mar 21 2011 at 12:06pm
I also had the three days of decadron with the a/c.  I am sure it helped with the nausousness but I hated the depressed crash when I finished it.   good luck to you all,   Bonnie
age55,Stg2a,Gr3,3.8cm tumor,mod.rad.mast.lft brst3/4/09,4ac,4taxol,33 rads.done11/2/09.BRCA1+oophorectomy1/5/2010,mast.rt brst 2/18/10,NED,bonescan 8/16/10,NED,catscan11/29/10NED catscan 3/17/11 NED
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: Mar 21 2011 at 9:09pm
I just want to say "THANK YOU" to everyone for your support and wisdom.

Much love,

Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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Post Options Post Options   Thanks (0) Thanks(0)   Quote trip2 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 22 2011 at 1:17pm
Best wishes and hoping for a smooth journey, please let us know how you are doing.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote janet c. Quote  Post ReplyReply Direct Link To This Post Posted: Mar 22 2011 at 7:55pm
Cinderwee,
The Decadron is actually a steroid given just in case you happen to be allergic to the chemo. Either Emend, Zofran or copazine are for nausea. I had the neulasta shots and after the first shot two days after I had terrible bone pain and when I went for my next shot my oncologist nurse told me to pre-medicate with Tylenol. I went home and took extra strength Tylenol every 6hrs. for two days and I never had another bone pain again. I did this for each neulasta shot and I actually started the Tylenol right before I got the shot and then every 6hrs. I didn't get the Emend anti-nausea pill but I had the Zofran and the Compazine and I started to pre-medicate with those after my chemo and I didn't get nauseous. I wish you the best of luck and hopefully you will do fine.
dx 12/08 @47yrs.old TNBC stage 2a grade 3, 2.1cm. partial mastectomy sentinal node negative BRACA negative Cytocan/Taxatere x4 radiation 36 or 38rounds
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: Mar 25 2011 at 8:00pm
Yesterday was my 1st (option 2) infusion, tired today, not much appetite...but grateful to have finally gotten started.  Chemo nurse says I did well and can hopefully cut both the Benadryl & Decadron; and have also decided it would be wise to get a port.  So wow, I'm 3NEG yet ER weakly positive @ 5% and SOME Her2 amplification....I now know for certain....NOTHING is black & white...
Chopped my hair last Saturday and actually like it better than before, so liberating too!
 
As always - thank you & God Bless Heart
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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Post Options Post Options   Thanks (0) Thanks(0)   Quote unklez Quote  Post ReplyReply Direct Link To This Post Posted: Mar 26 2011 at 1:56am
Dear Cindy,
As Janet indicated, Decadron is a steroid intended to reduce chances of allergic reactions to (the solvent used for) Taxol. FYI some oncs use a larger dose of Benadryl instead of Decadron.
Hope this helps.

Wife Dx: Jul/09. Age: 37. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. E5103. DD ACB-> DD Abraxane (Taxol reaction). Zometa (S0307). Canadian Fraction Rads.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Barbi Quote  Post ReplyReply Direct Link To This Post Posted: Mar 26 2011 at 8:41am

Also, Benadryl gives me restless legs so we switched to claritin after a week and it was sooo much better.  Also decreased the decadron after a couple weeks as I hadn't had any reaction.  Made life a little easier afterwards.

Barbi
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