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MOM TNBC-Chemo sequence

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    Posted: Oct 25 2011 at 3:07pm

Hello

 

My Mom ( 64 yrs) was DX with TNBC  first week of September , went through mastectomy. Her tumor size was 2.5 cm with one node positive  out of 19 nodes.  Her clinical diagnosis is stage 2b. 

The doctor recommended following chemo regime: 

4X AC and 4 x T  ( with 3 weeks gap) followed by 33 radiations. 

After reading numerous posts on this and other websites, I am  not sure if her chemo regime is  adequate enough. I am very concerned and worried for her . She is not computer Savvy  and don't know how nasty this type of cancer is. I am completely overwhelmed at times reading about not so good things  on TNBC.

Can  some one  please  let me understand if this is  the typical chemo regime  for someone for  her age and stage. BTW she already completed 2 treatments of AC. Is it too late to change the chemo regime  if there are  better options?

Thanks  for your help.

UAL  



Edited by UAL - Oct 25 2011 at 3:52pm
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Lillie View Drop Down
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Hello UAL,
Welcome! How nice that you are advocating for your mother. None of us want to be here, but thank God we are here for each other.

I was diagnosed at the age of 65. My stats were very similar to your mother's. I had the same chemo regimen as your mom except my was 'dose dense'. Dose dense means every other week. I also participated in a clinical trial which added gemzar along with the taxol. I did not do radiation.

I am now a 5 year survivor and lots of changes have taken place in the past 5 years. I just wanted to say that it worked for me and I will pray that it works for your mother. Keep posting and let us know her progress.

God Bless,
Lillie
Dx 6/06 age 65,IDC-TNBC
Stage IIb,Gr3,2cm,BRCA-
6/06 L/Mast/w/SNB,1of3 Nodes+
6/06 Axl. 9 nodes-
8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4
No Rads.
No RECON - 11/2015-9 yrs NED
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Post Options Post Options   Thanks (0) Thanks(0)   Quote UAL Quote  Post ReplyReply Direct Link To This Post Posted: Oct 25 2011 at 4:45pm

Thanks Lillie, for taking your time and getting back to me on this. I am living in complete fear about my mom ever since her diagnosis As one of her primary caregiver, I try to be positive in front of her but  I breakdown at times not knowing how to handle this new challenge we are facing.

 Your post brought tears to my eyes and a new hope.  I will follow up with her Oncologist on the double dose chemo regime.

 

Thanks Again,

UAL.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Oct 25 2011 at 6:06pm
Hi, UAL.  What your Mom getting is basically standard of care, though a clinical trial showed that dose dense scheduling of the ACT chemo your mom is getting is superior (chemo every two weeks instead of every three).  Also, a retrospective study from MDA suggests that outcomes are better if the taxane is given before anthracycline (AC) instead of after.  Since your mom has already started her chemo, the order is probably going to stay the way it is, but you *could* advocate for doing treatment dose dense.   At least, you could ask her oncologist about it and see why s/he decided against the more modern protocol.  It could be that your mother is otherwise fragile and every three weeks was considered to be better because the side effects from biweekly chemo might be too much.

Good luck, and welcome!

-Denise

*if you really wanted to add something to her protocol, you could consider adding something like carboplatin to the taxol phase of treatment.  It is  not yet standard of care, but a lot of oncologists will do this if the cancer is particularly aggressive or if (like mine) chemo didn't seem to be working.  Those of us who have neoadjuvant chemo, meaning chemo before surgery, can tell whether the chemo is doing its job, but since your mom had her surgery first there is no way of knowing (they removed her lymph node, right?)
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote HappyGoLucky Quote  Post ReplyReply Direct Link To This Post Posted: Oct 25 2011 at 6:38pm
Welcome UAL, this is a great site and folks here really care. What Denise said is the standard. Hang in there, the road is long but its rewarding when you can see the results.
Peace and Love
Karen
2/2009 7cm tumor, sent nod. pos. Lumpectomy 3/19/09,a/c dose dense+avastin clinical trial, taxol avastin stopped with pneumonia. 33 Rads 01/2010 ~ reccur 2011 supraclav.and internal mammary nodes. rad
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kim T Quote  Post ReplyReply Direct Link To This Post Posted: Oct 27 2011 at 10:18am
You are wonderful for being there for your Mom!  I was diagnosed end of August and am going through the same chemo every two weeks.  I am 38 and Stage IIa with 1 positive node.  My situation is reversed though and I have my Mom and Dad taking care of me  & my family when the chemo gets me down.  Round three is on Monday for me and I believe both me & your Mom are going to beat this together!  Hang in there and best of luck to you and your family.
 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote UAL Quote  Post ReplyReply Direct Link To This Post Posted: Oct 27 2011 at 12:31pm
Thank -You Ladies for all your kind replies.  I took an appointment with my mom's oncologist for tomorrow , I will follow up with him on the DD and also about adding carboplatin to the taxol cycle.

Thanks again Denise for giving this  valuable  information , yes they removed her  lymph nodes as well during the surgery.

Kim T  , I pray you , my mom and all other wonderful ladies  will beat this  beast together and remain NED  forever.

My Best wishes to you all.

UAL.


Edited by UAL - Oct 27 2011 at 1:28pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Oct 27 2011 at 11:14pm
UAL,

How fortunate your Mom is to have such a wonderful and caring daughter in you.

When your Mom sees the MD, the question could be asked if a Vitamin D level has been done.
The reason: Many with TNBC had low Vitamin D levels on diagnosis. It's easy to bring the level up if
it should be low. There are other forums with more info on Vitamin D. ( Use Search Function at top of
page and search for Vitamin D). Many feel it is important to have normal Vitamin D levels if one has
TNBC.

Do you know if your Mom was tested for the BRCA 1 and BRCA 2 gene?
If she were positive or negative, it might help the MD and your Mom decide about carboplatin IF
carboplatin is an option.
That said.......BRCA 1 and BRCA 2 testing is usually recommended if under 60 years of age and/or
strong family history of breast cancer. A genetics counselor visit may be helpful.
(Realize you said your Mom is 64 years old)

Does the MD your Mom is seeing treat many TNBC patients?
If not, question a consult with at TNBC cancer specialist re: treatment plan.

So.........at the minimum............ask the MD about:
     Vitamin D testing.
     Genetics counseling re: BRCA testing.
     Question TNBC cancer specialist consult if current MD does not treat many TNBC.
      (and as other suggested above:    ? dose dense (every 2 week chemo)
                                                                  ? adding carboplatin )
    
With positive and caring thoughts,

Grateful for today..............Judy

----------------------------------------

Senior members:
Please add any further thoughts on BCRA testing for someone 64 yrs old.    Thanks.    Judy

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Apr 06 2012 at 9:53am
Hi UAL,

Sending a warm Hello and hope your Mom and you are OK.

With caring and positive thoughts,


Grateful for today...............Judy
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Post Options Post Options   Thanks (0) Thanks(0)   Quote UAL Quote  Post ReplyReply Direct Link To This Post Posted: Apr 07 2012 at 8:42am

Judy  ,

 

Thanks for your kind follow on my mom. My mom's treatment is close to completion, she has 2 more weeks of Radiation to finish.  She is doing well and I thank-god she went though her chemo with min side effects.  I am both happy and nervous about we are close to reaching end of this cycle. I am trying to gather as many pointers as possible from post from other members on tips to avoid  recurrence  and also trying to keep myself up to date on any TNBC news  which at times I find them both positive and overwhelming  specially when it is referred as the deadliest of all the Breast Cancer, it drops my  spirits. 

  Also I am not sure what will be her follow-up care after completion of the treatment. I am making notes to ask het oncologist about them (Scans, Timor Markers, diet) during our next schedule visit.

 Once again I thank-you all for being so generous and for kindness I have been very fortunate to receive from you . I wish   much love and  many great moments with your families for many years to come.

 

 

Warm Regards,

 

Ual.

 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Apr 13 2012 at 1:22am
Hi UAL,

So good to hear that your Mom had minimal side effects from chemo.

There is so much good info on the various threads.
There are a few that you may want to read to see if you find anything helpful for yourself and
your Mom.     If you have already read them, just disregard.

Many after completing their TNBC treatments, go on and have very busy and good lives.
Some survivors threads:
   http://forum.tnbcfoundation.org/survivors-needed_topic8221.html
   http://forum.tnbcfoundation.org/any-long-term-survivors-out-there_topic9365.html
   http://forum.tnbcfoundation.org/survivor-stories_topic7405_page4.html
   http://forum.tnbcfoundation.org/any-10-year-survivors-out-there_topic9398.html
   http://forum.tnbcfoundation.org/3-year-survivor_topic9226.html

There are threads about lifestyle issues/changes on what members have done after treatment.
Some links are:
   http://forum.tnbcfoundation.org/lifestyle-changes_topic9493.html
There are some articles on life style issues on " open access"
   http://forum.tnbcfoundation.org/open-access-links-articles-tnbc_topic9440_page2.html

There is a thread for the main support person.
(Some info on this thread is titled for spouse.......but much of the spouse info is applicable to
whomever the main support person is)
   http://forum.tnbcfoundation.org/support-infospouse-main-support-person_topic9558_page1.html?KW=survivors

You mentioned follow-up care after treatment.
There have been a few threads on this topic.....which I cannot find right now.
Maybe if someone else remembers them, they will post.
From prior posts on the forums, it seems cancer centers vary on how they follow up patients.
All centers do follow up mammograms as appropriate for the breast surgery done.     
Some centers do a follow up history and physical.
Some centers do a follow up history/physical and blood work.
Some centers do a follow up history/physical, blood work and imaging tests.

With caring and positive thoughts,

Grateful for today.............Judy

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Post Options Post Options   Thanks (0) Thanks(0)   Quote UAL Quote  Post ReplyReply Direct Link To This Post Posted: Apr 18 2012 at 11:19am
Judy , 

Thanks  for the links. Tomorrow is my mom' s last radiation ,  I  don't have got through all this without support from you kind ladies.

I wish everyone the best.

Ual


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Apr 19 2012 at 11:56pm
Ual,

Glad to hear that your Mom's last radiation was today.
It is good to be aware that people feel differently when treatment is completed.
Some really feel like celebrating.
Some are relieved that treatment is completed but they are "not quite in the celebrating mood".

Please continue to post when/if questions arise ............and/or anytime!

Hope you and your Mom can do something nice and enjoyable this weekend.

With caring and positive thoughts to you and your Mom,

Grateful for today...............Judy
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Jul 02 2012 at 6:37pm
Ual,

It's about 2 1/2 months since your Mom finished treatment.

Just wanted to send caring thoughts for a good summer to you and your Mom.


Grateful for today...............Judy
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Post Options Post Options   Thanks (0) Thanks(0)   Quote UAL Quote  Post ReplyReply Direct Link To This Post Posted: Jul 16 2012 at 12:16pm
Hi Judy,

I apologize for the late response.  Thanks for your caring thoughts and following up on my mom.

Yes my mom has finished her treatment  and slowly getting back to her routine . I pray  that she and all you fine ladies will  continue in good health for many years.

Thanks once  again for  thinking about us .

Regards,

Ual
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