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Chemo/Radiation in elderly

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FREINDOFFRIEND View Drop Down
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    Posted: Sep 14 2016 at 12:25pm
A friends frail mother 80 years old has been diagnosed with stage 2 TNBC with mets to the liver.  Any input is welcome. Debating treatment vs quality of life.  Thanks much!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TriplePositiveGirl Quote  Post ReplyReply Direct Link To This Post Posted: Sep 14 2016 at 1:39pm
Hi FOF,

That's a really tough call. What did the doctors recommend as possible treatment options? I would assume chemo is the only option for treatment, which on someone who is 80 and frail could be very hard to handle. 

I'm so sorry she has had this diagnosis so late in life. Having been through the treatment process myself, I am not sure I would want to experience this as an 80 year old. 

Can I ask how they determined the staging as stage 2? Usually mets to the liver is a later stage diagnosis. Is any of this operable?


Diagnosed Jan 2010; Stage IIa, grade 2, 3.2cm in rt. breast, no nodes and BRCA-. 4 cycles Carbo/Gemzar 3/10; Lump 6/10; 2 cycles carbo/gem after surgery 8/10; 35 Rads finished 12/1/10. NED.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote FREINDOFFRIEND Quote  Post ReplyReply Direct Link To This Post Posted: Sep 14 2016 at 1:53pm
PET scan revealed the liver mets.  She was told yesterday.  Chemo/radiation was only treatment discussed/offered.  Personally, I think the treatment will do more harm than the CA.  My mother had breast CA, not TNBC stage 1 at age 82.  Underwent treatment and today 3 years later, her dementia has rendered her to that of a 6 year old.  I feel the lumpectomy and post treatment accelerated any dementia she may have had.  At the time of her diagnosis it was not evident.  At age 82 one has lived a full life and is at the shorter side of a future.  Live it to it's fullest with breast CA at that point rather than totally unaware, cancer free for the next few years.  Thank you for your response.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TriplePositiveGirl Quote  Post ReplyReply Direct Link To This Post Posted: Sep 14 2016 at 2:33pm
I think you are right. Quality of life is so important. It might be better to live out the remainder of life not having to undergo chemo and radiation, not to mention the unpleasant side effects of all of that.

My best wishes to your friend. 
Diagnosed Jan 2010; Stage IIa, grade 2, 3.2cm in rt. breast, no nodes and BRCA-. 4 cycles Carbo/Gemzar 3/10; Lump 6/10; 2 cycles carbo/gem after surgery 8/10; 35 Rads finished 12/1/10. NED.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote snugltz Quote  Post ReplyReply Direct Link To This Post Posted: Sep 14 2016 at 3:02pm
I nearly quit chemo at 58.  Cant image how hard it would be on a frail 80 year old. Plus when you do surgery  or something as difficult as treatment it is a very very common thing for people of that age to get dementia.My doctors all said this about my parents.  And it proved correct.  My mom and dad had surgeries and sure enough.  Both started down that slope.  I have talked to many others and their parents had the same reaction. But it is a hard decision because we want to keep our parents as long as possible but unfortunately the time we then have with them is not the easiest.
1 cm, 0/2 neg nodes, lumpectomy 6/16/10, cytoxin/taxotere 4x every three weeks, rad start 11/8 33X
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Katdoll Quote  Post ReplyReply Direct Link To This Post Posted: Sep 14 2016 at 6:14pm
My dad, age 81, started chemo for metastatic (to liver and lungs) prostate cancer and it didn't go well at all. I won't get into detail unless you ask me to, but I do think the chemo (which he stopped after one infusion) weakened him, that he never bounced back to where he was before it, and that it robbed him of some quality of life and robbed me of quality time with him. I don't think the doctor did a good job of discussing the pros and cons of chemo at an advanced age, but I think my dad would have done the chemo even if the doctor had done a better job.

Consider talking with a palliative care specialist about pros and cons of chemo. They are typically more experienced, willing, and able to discuss tradeoffs like this.
Tested positive for BRCA1 mutation (187delAG) in 4/09 @ age 44; BSO 9/09; diagnosed w/TNBC in 10/09; 1 cm Stage 1 TNBC IDC, grade 3 + 1.5 cm DCIS; BMX 11/09, nodes clear; chemo (AC/T).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 07 2016 at 7:38pm
Hi: my wife has had diarrhea since her last chemo she has done lots of research to see what happens to the intestine, I think the lining sheds, where she is vulnerable , it's gotten lots worse,  she has a list of foods that are no good, she takes culteralle enzymes...she isn't losing weight, but the trips to bathroom are really concernings, any suggestions? thanks


wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (1) Thanks(1)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Nov 07 2016 at 9:43pm
Hi Gordon, that's really concerning, I'm sorry. Couple of thoughts.

I wonder whether she could have more than one thing going on. Whether she's gotten food poisoning and/or could the chemo have knocked out the natural bacteria in her gut as well as lowering her resistance. So maybe something got into her system and with a lowered immune system it is taking hold.
For me, this is the kind of side effect that needs to be attended to front and center. While using chemo it seems everything speeds up when it comes to side effects.
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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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jacklin Quote  Post ReplyReply Direct Link To This Post Posted: Nov 08 2016 at 8:39am
Hi Gordon, I'm with mainsailset, diarrhea that continues is of concern.

I am also having the same problem and my oncologist is staying on top of things. Although I am now 2-1/2 months post-chemo, I am still dealing with ongoing diarrhea. This week I'm on IV hydration and using Immodium along with bananas, rice, applesauce and toast for the umpteenth time. Please, let your wife be careful, dehydration happens quickly and can be life-threatening if unchecked. 

Hope your wife has a good day today and things settle down soon for her.
Dx: Nov. 27/15, TNBC, left breast & lymph, BRCA -; Chemo: Dec 4/15 - Mar 4/16; 4 DD A/C, 3 DD Taxol; BMX/ALND: April 26/16; Stage 3C; Radiation: June 10-July 15/16; 1 cycle Xeloda: Aug 15 - 28/16
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cheeks Quote  Post ReplyReply Direct Link To This Post Posted: Nov 08 2016 at 11:28am
Hi Gordon,
I developed C diff during chemo so you might want to check about that. As I remember I also had a lot of stomach burning.

Blair
Lump found 11/08
DX: 2/09 @52 TNBC
L. Mast. 3/26/09, SN-, BRCA-,
4.5 cm (post surgical)T2NOMO
Chemo: 4/09-10/09 Taxol x 12,
A/C x 4, No rad.No recon. NED 1/17. New Primary right breast TN, 2/2018.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2016 at 3:46pm
Thank you all for taking the time to respond. My wife had IBS after chemo in 2008, I think it didn't subside for about a year. (as did her blood counts) @ 58yrs old.
This time is the same or worse, she's not dehydrated, but thank you for reminding me of this urgency. I appreciate it. She finished chemo in May, her surgeon said "this is not normal" and she has an Onco apt in 2 weeks, he said he would refer to Gastro-Ent last time she say him. I'm urging her to it, although she is trying to use diet to remadie.
She's tried the over-the counter Immodium or prilosec, stuff mostly, then she get's constipated, what she is really concerned is that any inflamation, cancer can migrate to there, thank you cheek also, I don't think she has that C-diff, Mayo symptoms say it occurs after antibiotics, and cramps in abdomen, so she doesn't have that. It's just a repeated "urge" after eating almost anything, she's due for mammo usual screening soon, my wife has asked for an ultrasound also, and she's due for a PET also in the next month, last time her GI track was clear, so I guess this is something we all deal with and try to get stable. hanks again, all.

wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Renate Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2016 at 10:00pm
I also developed C-Diff after my 4th chemo and almost died. The diarrhea was really starting after the 3rd AC chemo and they kept telling me to take more ammodium D which did not help. Long story short after the 4th chemo I was so dehydrated I could hardly walk. I was in the bathroom and fell on the floor where I stayed. The only thing that saved me was a friend stopping by. I spent two weeks in the hospital. Telling you all this to make sure you take it seriously and have her checked out. It took over 2 months after the hospitalization to get rid of the C-diff.

Best of luck to your wife

Renate
Dx: 2/12/16, TNBC, left breast&lymph, age 68, Chemo: 5/23 - 7/6/15 4 A/C, 9/26/16 Taxol 7 out of 12 only; Radiation starting 1/9/17 BMX: 3/4/16; Lymph node removal 4/7/16 Staging: Stage 3A, Grade 3;
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 11 2016 at 6:44pm
Renate I am very sorry to hear about your complications ans appreciate you advice, she tried the ammodium, she went the other way with constipation. She takes pepto, I told her about C-diff, I will tell her again, she's not dehydrated, but the stomach is sending a signal to her intestine to "move" how does the signal go from the stomach that quickly? thank you God bless you overcome this also.
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Jacklin Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2016 at 10:28am
Morning Gordon,
I'm just wondering 'out loud' here......has your wife's medical team considered using pancreatic enzymes? They would help her with digestion as well as the ongoing digestive tract issues. My oncological team has started me on them and it has helped in just 2 days. I know that I have to be on it for approximately 6 weeks to get the full effect, but am excited to already have some relief. 
Dx: Nov. 27/15, TNBC, left breast & lymph, BRCA -; Chemo: Dec 4/15 - Mar 4/16; 4 DD A/C, 3 DD Taxol; BMX/ALND: April 26/16; Stage 3C; Radiation: June 10-July 15/16; 1 cycle Xeloda: Aug 15 - 28/16
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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 2016 at 12:05pm
Hi. What are those enzymes called? Rx? thanks
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Jacklin Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2016 at 7:45pm
I am currently taking "Cotzyme ECS 8", sometimes also called Cotazyme. These enzymes help my body to metabolize fat, proteins and carbohydrates. Here in Canada, they can be purchased over the counter or prescribed, mine are prescribed.

I take 3 pills at the start of each meal and 1 pill before all snacks. Honestly, I'm shocked by how much better I feel today, only the 2nd day. After almost 11 weeks of feeling this lousy, maybe, just maybe, I have something to help me start feeling better, finally. It's been a good day today, no diarrhea and very little cramping in my belly. Hopefully your wife will find some relief soon too.


Edited by Jacklin - Nov 12 2016 at 9:31pm
Dx: Nov. 27/15, TNBC, left breast & lymph, BRCA -; Chemo: Dec 4/15 - Mar 4/16; 4 DD A/C, 3 DD Taxol; BMX/ALND: April 26/16; Stage 3C; Radiation: June 10-July 15/16; 1 cycle Xeloda: Aug 15 - 28/16
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 15 2016 at 3:00pm
J: thanks for the info, my wife discovered that this supplement might cause blood clots, I have no idea what's true, she's ordered from Amazn lots of supliments, she thinks it's "too little" stomach acid, she's keen on bloodclot info b/c it runs in her family, her Mom, a propensity to  it. pm me anytime, thanks for everything. G
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Jacklin Quote  Post ReplyReply Direct Link To This Post Posted: Nov 15 2016 at 7:20pm
Hey there Gordon, are you sure about what your wife indicated about causing blood clots? I know that the product is used FOR (not cause) blood clotting. Personally, being a biochemist, I'd be very cautious about ordering various supplements and adding them to my diet. Not all supplements are carefully regulated, please be sure that what was purchased is from a reputable supplier, there are so many fly-by-nighters out there; keep an eye on where it is manufactured as well, please.

FYI, I had a lung blood clot as a result of chemo so I know what that means. I specifically checked with both my oncologist and oncological nurse to make sure I wouldn't increase my risk again, both said not an issue.

Still hoping your wife feels better soon, it's rotten to feel lousy.
Be well,
J
Dx: Nov. 27/15, TNBC, left breast & lymph, BRCA -; Chemo: Dec 4/15 - Mar 4/16; 4 DD A/C, 3 DD Taxol; BMX/ALND: April 26/16; Stage 3C; Radiation: June 10-July 15/16; 1 cycle Xeloda: Aug 15 - 28/16
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 17 2016 at 6:48pm
Hi Jackilin, sorry not getting back sooner, my wife has blood clots running in her family, on her Mom's side. I don't know if this med is good or bad, she consults Dr. Google on a reg basis. if she's spooked by it, fine by me, less Amazon charges on our credit. :~) She can ask oncologist soon, at her apt. She's ordered lots of stuff, to stabilize he intestinal problems, and changing her diet, this doesn't happen overnight, after Taxol, it might kill microscopic cancer cells but it does a number on the intestine, that I guess takes time to figure out. She has PET soon also, so any cancer in gut should be discovered, there wasn't anything last time. thanks for you concern, anything I can help, just ask/
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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