TNBC & Pregnant

Scott,

Scott,

My wife had a double masectomy on Oct. 23rd, has had 2 rounds of AC with 2 more to go originally, but after her oncologist & obgyn talking with MD Anderson and Arkansas Childerns Hospital they have decided to add a 5th round of AC to gain the baby an extra 3 wks before inducing my wife at 35 weeks. The reasoning behind that is its most effective to start the 12 Taxol treatments between 2-4 weeks after ending AC, but that schedule would have put our Princess being brought in at 32 weeks, which all of the doctors agreed was to risky on her.  After the Taxol my wife will have 6 weeks of radiation. Thank you all for your kind words, Scott

Hi Scott and Warrior Chick. I juts want to wish you the best and give you this link to the Young Survivor Coalition website: http://www.youngsurvival.org/search?search=pregnant&x=0&y=0.  If you read the survivor stories, you'll find some by women who found their cancer while pregnant. Take care! Rena

Edited by rena - Dec 14 2009 at 2:44pm

Scott and Warriorchick - that fifth round of AC has me worried.  I thought there was a lifetime cap of 4 ACs (unless you are getting a greatly reduced dose) because of the cardiotoxicity of adria.   Is your dose smaller than the usual amount given?  If not, please look into this.  You might be much better off stopping at 4 doses, letting your pregnancy come to term and having the baby, and then starting T once you have delivered.    Do you have numbers on what your increase in risk is by having a longer delay between the end of AC and the start of T?   With drugs like Herceptin and Aromatase inhibitors, there are studies suggesting delays don't matter to long term outcome.     Anyways, best of luck.  I just wanted to give you a heads up.

love,
d

I wasn't pregnant when I was diagnosed, but my son was born at 34 weeks, 16 years ago!  He spent a week in the hospital for jaundice and not having much of a sucking reflex yet.  His lungs were perfect, no breathing issues - he was 6 lb's, 5 oz.  After a week under the lights he was good as gold and we brought him home.  Now he's 16, like I said, 5'10", smart as a whip and gorgeous.  I couldn't have asked for a better teenager while going thru all of this, this year!  So - I can attest that a baby only cooked to 34 weeks can be just perfect. 

Dear Scott and Warriorchick,

Is AC the only chemo regime approved for use during pregnancy?

Couldn't they throw another chemo regime besides Taxol inbetween the AC and T to buy you enough time to bring the baby to term?

I'm just wondering.

I'm not sure it would matter if the window isn't big enough. I mean, if there's anything that might be safe and work, what does it matter if it's used for half as long as it's supposed to?

Does chemo not work the first few rounds, then it starts to work later as it builds in one's system? I don't believe that's the case.

If A/C works for a while, then something else works for a while longer, then Taxol works to finish things off adding something that works in between AC and Taxol has to work more than just A/C followed by Taxol. Stopping for any amount of time to wait in the middle I would think would let things grow back, wouldn't you think?

dmwolf wrote: With drugs like Herceptin and Aromatase inhibitors, there are studies suggesting delays don't matter to long term outcome.

I'm just guessing here because I truly don't have a clue, but I would think that maybe a delay before the start of treatment might not matter, but if you're treating with one thing to shrink things down, then delay before switching to something else to get rid of the rest would allow the rest to grow to more during the delay.

I'm also guessing that the reason to start with one thing then switch to another is because maybe the first treatment is better suited to larger tumors while the second treatment is better suited to smaller tumors. Allowing the tumors to grow back would require another round of the first treatment.

I really truly don't know, but it makes sense to me that things would be that way.

However another reason to switch might be that A/C is just plain bad for you and you can't tolerate it for a longer period of time, but if they could they would continue with it.

Another worry I would have is that I've now seen two people who did A/C followed by Taxol where the A/C worked, then the Taxol failed completely. I don't know how often that occurs, but I heard that Taxol costs $4000/week and there are chemo sensitivity tests out there that can be done. I would guess that the test would cost somewhere around $10k (but I really have no clue. Everything medical seems to cost way more than I think it should. For example a bed for 1 hour hooked up to a machine about 2'x2'x2' and about 30 seconds with a doctor costs $3k while I think it shouldn't cost more than $100.)

But anyway, considering that Taxol might cost $4000/week it seems worth it to pay $10k for a test that takes 10 days to figure out if it will even work, and included in that cost they'll figure out exactly which drugs do work.

Here's a link to a chemo sensitivity test site that does a good job of explaining things.
http://www.chemosensitivity.com/

This is an email response from a cancer researcher who's wife was TNBC when he was asked about chemo sensitivity testing.

We had these chemosensitivity tests done. Problem is that they need to be done on fresh tumor, so requires a surgery or biopsy. Depending on where the tumors are, could be more risk. The top two places are Rational Therapeutics in Long Beach, and an oncologist at UC Irvine whose name escapes me. It is a controversial topic in oncology. I believe the data that they are predictive, however I also don't think they are worth unnecessary surgery. There is the risk that one biopsy will have different chemosensitivity than another tumor site, if they have different mutations.

I agree with his argument that it's possible that not all tumors are genetically the same if there are more than one, but if a drug doesn't work on one tumor that you test why bother using it even if it might work on the others?

Anyway I've rambled on enough.

Terje

Dear Scott,

Edited by steve - Dec 14 2009 at 11:48pm