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Adriamycin or not?

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Maxiega View Drop Down
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    Posted: Nov 12 2015 at 12:35am
I was just diagnosed with TNBC  state IIb on the 14th of October.  I just met with an Oncologist on the 9th of November.  Her chemo drug of choice is Adriamycin, followed by Toxol and one that starts with a C I can't remember right now.  I have a pacemaker and my mother had Congestive Heart Failure along with 3 heart attacks, my father died of a massive heart attack.  From what I have been reading Adriamycin can cause congestive heart failure up to 20 years or more post receiving it.  She said she spoke with my cardiologist and he was okay with it.  However, I have only seen this man twice since moving to our current home.  My husband spent close 26 years in the Army so I have moved a lot and unfortunately some of my medical records have been lost.  The thought of developing CHF is terrifying especially after researching more and seeing there is a pretty high mortality rate for chemical induced CHF.  I would like some input from others out there with TNBC.

Thanks for any insights!  God Bless!
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gordon15 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2015 at 9:19am
My wife had TAC(Taxotere, Adriamycin and Cyclophosphamide (“TAC”))
 in 2008 for Stage 2B non-TNBC. The "A" can damage the heart muscle and in her treatment now for TNBC she was told there is a lifetime limit and she can't have more. I think they ascertain via EKG weather it's too risky, although the "A" is instrumental in treating bc I read, if you can have it.(my wife never had a recurrence of that cancer) They are telling my wife now they want her to have Taxol alone, you should discuss and maybe get a cardiologist's opinion too perhaps.
 

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123Donna View Drop Down
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Post Options Post Options   Thanks (1) Thanks(1)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2015 at 7:22pm
Yes, CHF is one of the possible side effects of Adriamycin.  Can you consult with another cardiologist or oncologist to get their opinion before starting the chemo?








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 (1) Thanks(1)   Quote Alabama_Survivor Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2015 at 10:14pm
I was thinking the c might be for cytoxin.  I had Adriamycin, and I don't have any problems with my heart.  My oncologist did a MUGA scan before I started chemo to make sure my heart was healthy enough to tolerate it.  From everything I've seen, I think AC with either Taxotere or Taxol is the treatment of choice.  I had 4 bi-weekly dose dense AC treatments (meaning I got the same dose every two weeks that they normally would give every three weeks).  I didn't have any major problems except for very low blood counts, and fatigue.  They will monitor you very closely, though.  The drew blood every week, and I saw the oncologist every 2-3 weeks.  Our cancer center keeps a really close eye on us and encourages us to call 24/7 for ANYTHING that seems off.  I was fortunate that I never had to call.
6/2014 Stage 3C TNBC Age 55
4 DD A/C; 12 Weekly Taxol
BMX
Radiation
Completed 4/2015
8/2015 Restaged to stage 4, mets in chest/sternum
Currently on Xeloda 1500 mg. 2x per day, 7 days on, 7 days off
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Kellyless View Drop Down
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Kellyless Quote  Post ReplyReply Direct Link To This Post Posted: Nov 13 2015 at 6:04pm
I had a MUGA test as well, I think it's a pretty extensive test of heart function. It measures the function of all the parts of your heart. That is how they determine if you should be ok with the chemo. Perhaps you should tell your Oncologist you want the heart function test results before you choose which chemo to take? That seems a reasonable request.
IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/16 Local recurrence same breast, same spot 1.8cm Carb.4x every 3 wks, Taxol 12x once wk. Dbl Mast. PCR!! Reconstruction fail, NED!
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Post Options Post Options   Thanks (1) Thanks(1)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Nov 13 2015 at 6:46pm
My mom had congestive heart failure too so I was pretty anxious about what the testing would turn up. But my heart tested good and I came through it just fine.

It is worth you while however to ask your oncologist about the MD Anderson testing that demonstrated Taxol first, followed by the AC has a better outcome for Tnegs. There's been several discussions here on the board about the research as many have had the Taxol 2nd and done just fine. Still, it's a good thing to check that out.

Also, even though your tumor is thankfully small it may be a good opportunity to ask about a clinical trial. Too often we see here the smaller Tneg tumors not treated as aggressively and then the devils return. The first round with Tneg is the one with the most opportunities to get it right and fight the right fight so push for a strong treatment path.
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Lillie View Drop Down
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Lillie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 14 2015 at 1:55pm
If adriamycin is being considered you should have a MUGA scan prior to treatment.  This is to determine if your heart is strong enough to tolerate the drug.  As Mainsailset said in her post above, we only get 1 first chance to receive aggressive treatment.  It seems that triple negative is a cancer that requires aggressive treatment to stop it in its tracks. 
I know that you are scared and I pray that you are strong enough to tolerate the needed treatment.  Please know that all of us are supporting you.  Let us know how things go.
 
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 - 11/2018-12 yrs NED
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MLindaG View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MLindaG Quote  Post ReplyReply Direct Link To This Post Posted: Nov 16 2015 at 9:47pm
I had the MUGA test before and then after Chemo to make sure my heart was working well.  I also had IMRT Rads......... I had A/C every three weeks x 4 as well as taxol every week for 12 weeks and did have a PCR (Pathological complete response to chemo).  So far I'm almost 3 years out from finishing treatment and having no problems.  I would definitely ask about the MUGA test before chemo.  You might want to get a 2nd opinion about the chemo they might suggest.   
Dx TNBC 6/12; age 59; Stage 3, Grade 3; 3.5 cm, 3/10 nodes + chest wall nodes; A/C x4, T x 12 completed 12/12 with PCR, 2/13/13 lump; IMRT Rads x 33 completed 5/22/13 BRCA 1 negative.
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Lillie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lillie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 17 2015 at 10:21am
Dear Maxiga,
I wanted to add that I had a MUGA scan before and after chemo was completed to make sure my heart was working OK.  I am repeating what MLindaG said in her post above.   I do pray that your heart if found strong enough to withstand the treatments that are needed to give you a good chance of survival.   We are supporting you all the way.
 
Love and 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 - 11/2018-12 yrs NED
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