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Attention Newbies: Important New Chemo Study

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Dagmar View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dagmar Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 7:38am
Hi Bliss and others,

Mixing the Cottage Cheese with Flax Oil actually changes it's composition and as such fits within the diet. The important thing is to stick with it. What I forgot to mention is that I also use Curcumin/Turmeric, an Indian herb I use in capsule form and in my food/curries.

What concerns me a bit about the way we talk about this study "Taxol before Adriamycin" (I believe Cytoxin isn't mentioned as this study piles up all sorts of chemo next to Taxol first), is that it doesn't focus on TNBC, but breast cancer in general. Unfortunately TNBC is a different animal and needs to be treated as such. AC and Taxol, followed by surgery was the best tested and tried way to go in my situation given the size of the tumor and spread to lymph nodes. My medical team shared solid information about research and gave me confidence about the direction we took as a team. 

Have a great Saturday.

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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 11:15am
Originally posted by dmwolf dmwolf wrote:


The clear winner was paclitaxel, followed by anthracycline-based therapy with 5-fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide or 5-fluorouracil, epirubicin, and cyclophosphamide, Dr. Ricardo H. Alvarez reported at the San Antonio Breast Cancer Symposium.



Cytoxan was included in this study.  Cyclophosphamide is the generic name for Endoxan, Cytoxan, Neosar, Procytox, Revimmune, also known as cytophosphane.  The only difference was the anthracycline drug, either Adriamycin or Epirubicin was used.

Donna


Edited by 123Donna - Jan 15 2011 at 11:17am
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 bonsi77 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 11:19am
They actually were getting Cytoxin as well. Here is the line from the study. It says doxorubician (Adriamcyin) and cyclophosphamide (ie: Cytoxin). See excerpt below. It seems as though the C was grouped in with Adriamycin and 5-FU to be called anythracyclien based therapy ie: (AC). So they were getting Cytoxin. Here is the excerpt from the article. 

< ="utf-8">"The clear winner was paclitaxel, followed by anthracycline-based therapy with 5-fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide or 5-fluorouracil, epirubicin, and cyclophosphamide, Dr. Ricardo H. Alvarez reported at the San Antonio Breast Cancer Symposium."


My Mom DX 7/13/2010 at age 61 TNBC Stage 2B/3A - 4.5cm tumor 3/19 nodes . Chemo AC x4 DD, Tx4 DD. BMX 12/10/10.
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Dagmar View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dagmar Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 11:26am
Just concerned we're not jumping to conclusions to fast. TNBC -as we all know too well- is not comparable to other breast cancers. Any MD out there to shine some light...
Female 48, diagnosed April 2010; April/September 2010: AC/T 8/12; October 2010: Lumpectomy/Axillary Dissection Complete Pathological Response; November/December 2010: 30x radiation. Vegan, Raw, Budwig
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 11:39am
Dagmar,

I think what we'd like to see from this study is for the results to be broken down by breast cancer sub-type.  Unfortunately, the article doesn't do it and it leaves us wondering if the results would be the same for Triple Negative or different (maybe even better).  If there was a way to get access to the entire study, there may be more detail by breast cancer sub-types.  I agree with you, we can't treat all breast cancer the same.

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 bonsi77 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 11:41am
I think you can't get too caught up in all of this if you have already had treatment. Every day things are changing and they are finding better drugs or different regiments to use. Think women who were dx years ago and got AC and T every 3 weeks were probably saying the same things when DD proved to give a better outcome. There's always going to be break through's in science and them finding better ways to treat and cure BC.  There are women who were DX 20 years ago when standard of care was who knows what and they are alive today and cancer feee.  
 Info like this is more important for women who have just been DX so that they can make sure they are getting the best up to date info on what treatment is the most effective. My mom was DX in July and she got AC then T. Nothing we can do about that now as at that time this press release didn't exist. But if she got DX today I'd want to point out this research to her Onc ya know. 
 
Anywho here's to hoping that they continue down a path that finds all BC to be curable and rates go up to 100% instead of numbers like 70-80 etc. 
< ="utf-8">
My Mom DX 7/13/2010 at age 61 TNBC Stage 2B/3A - 4.5cm tumor 3/19 nodes . Chemo AC x4 DD, Tx4 DD. BMX 12/10/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 11:58am
Yes BUT survival rates improve every decade, presumably because of improved treatments. So you can't really infer anything from people who received older treatments who are still around to wonder about this.  Though I agree that what's done is done and we might as well accept that we made the best choices we could based on the available information.     And so we return to the luck of the draw, right?
May we all have excellent luck!!
d
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 dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 12:05pm
One more note:  I wouldn't expect that epirubicin vs adriamycin would make a difference, but they do have a third drug in there, 5-FU in FEC, that those of us who got AC didn't get.  True, it is a close relative of cytoxan so maybe it doesn't matter, but still.    We'll get some answers - although from a much smaller patient population - from the ISPY1 trial once the data from the extension patients come in.  The last about 80 patients got T followed by AC.   Rumor has it they did significantly better than the ACT folk in the initial cohort, but I haven't seen any data yet.    ISPY2, which just started and includes investigational drugs like PARPi's, has all patients getting T before AC.

d
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 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 12:14pm
Denise,

Do you know when the results of ISPY1 will be released?  I wonder why 5-FU isn't widely used?  I was at a party in 09 and met a woman who was a 19 year bc survivor.  She had the same surgeon I did and had a mastectomy.  The only thing she can remember was she had a chemo drug called 5-FU.  She kind of laughed at the name and said it was the only reason she could remember it this long.

I agree with you that the only thing those of us who've had treatment is know we made the best decision at the time given the information we had.  It's keeping the would of, should of, could of thoughts away that's hard to do.

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 bonsi77 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 12:23pm
Agreed! Survival rates increase as better tx come out. I was just saying that women who treated in the past have to go with the fact that they got the best TX at that time as there isn't much else you can do. I brought up the every 3 week thing to DD just as away to say that I'm sure those women were feeling the same thing - wishing that the DD had existed when they got treated etc.  My mom only recently being DX it is disappointing that this article wan't around. When I found this article on BC.org and originally posted it here I was thinking to myself damn if this was only around a few months ago. But alas it wasn't  but  I wanted to post it on here so that if anyone was dx now or recently could benefit. Every day there is something new and that is how science and technology operate. But thank goodness for science and it getting better so that future people can benefit and hopefully BC will no longer be the 2nd leading killer among women in the US. 
 I admire all of you women on here who have been a great help and plethora of information for me during this time. Everything I have read on here has helped me help my mom to deal with her DX and treatment etc.  Thank goodness for the internet.

 Wishing you all the very best and hoping for cancer free future!

Diane
My Mom DX 7/13/2010 at age 61 TNBC Stage 2B/3A - 4.5cm tumor 3/19 nodes . Chemo AC x4 DD, Tx4 DD. BMX 12/10/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 12:31pm
Diane, thank you so much for posting it.  Think - you might save some lives with that single act of kindness! 
d
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 NinaE Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 7:57pm
Donna and others who commented -- did this study compare CA-T to T-AC?

As I understood it, it didn't. But based on what you just posted today, I wonder if I misunderstood.
Stage IV at dx in Dec 09, at age 38. Mets to lung, axillary, IM and mediastinal nodes.

4xAC-->dd Taxol. Dbl mast, 6/10. Radiation, 8/10. NED since June 2010.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote bonsi77 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 15 2011 at 8:23pm
Denise it is you and all the other great women on here that deserve the thanks. I was glad to be able to contribute a small amount and help but it is all of you who have poured so many hours into this site that deserve the thanks. You guys have helped me gain so much knowledge and as we all know knowledge is power.  I'm thankful for this forum b/c without it I don't know that my mom would have gotten the right treatment or maybe something would have been overlooked. 

Diane

My Mom DX 7/13/2010 at age 61 TNBC Stage 2B/3A - 4.5cm tumor 3/19 nodes . Chemo AC x4 DD, Tx4 DD. BMX 12/10/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jan 18 2011 at 1:48pm
Bump
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 LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 18 2011 at 7:35pm
My mother in law had a Halston Radical Mastectomy 40 years ago for her breast cancer and that was all, and all her lymph nodes removed.  It was a very rough surgery back then, but the surgery of choice then.  There were no lumpectomies back then either.  She is still alive and doing very well in her 80's.  They didn't know about hormone receptors back then, but I'm assuming since she had no chemo, no relapse, etc, she was probably HR positive - but she has no idea.  My husband died of esophogeal cancer at the age of 46  - 23 years ago and he had 5 FU (its Flourocil spelling may be incorrect) and cisplatin.  So 5 FU is actually an older drug, but is still used often today.
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote PTE Quote  Post ReplyReply Direct Link To This Post Posted: Jan 19 2011 at 1:25pm
Thank you all for the vast amount of information posted.  My wife went to her doctor/patient meeting to discuss the future treatment.  We thought for sure it was scheduling the chemo.  Doctor hit us with a "choice".  Chemo or no chemo!  Here are some facts.
DX 11-11-10 TRNB.  Lumpectomy 11-29-10.  Tumor was 0.9cm X 0.6cm X 0.5cm (kinda small oval) entire tumor removed and "hoped" for clear margins. 5 nodes pulled, all clear-no traces.  Stage 1, Histolic Grade 3.

 Had to go back in 12-21-10 to get remaining DCIS on medial edge.  Last path showed ALL cancer and DCIS is gone. Neg for BCRA (wife is first in family to ever have BC)

This is what the doctor said:
   national study has shown that 71/100 women survive 10 years cancer free WITHOUT further  
   treatment (in her situation)
   Same study shows that with chemo the rate is 78/100 survive that same period.  This is only a 
   7% increase with chemo.  Radiation is still a must.

However (this was a biggie)  The treatment can be hard on heart health.  Wife has a family history of heart trouble.  Grand mother died at age 45 congestive heart failure.  Mother died age 70 same thing.  Brother (age 54) currently has heart problems (enlarged heart etc).  All the above were/are diabetic, wife was DX'd as "pre-diabetic" but is controlled via diet.  Wife has never been diagnosed with any heart trouble (to date) wife is 60 years young.

Here is our question.  Which way to go.  With chemo or without chemo.  Doctor told us to do some research, think about it and get back to her next week, no life emergency here (we were set for the doctor to "tell" us this is what's going to happen, not give a choice in treatment).  Anyone on the forum ever have to make this decision?  What further questions do we need to ask?  Our heads are swimming!!!
.
Pete



Edited by PTE - Jan 19 2011 at 1:37pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TracyAMac Quote  Post ReplyReply Direct Link To This Post Posted: Jan 19 2011 at 2:05pm
Dear Pete

Glad you are posting on this site - I am sure many will chime in with their thoughts including from women who decided not to have chemo.

My initial thoughts:

Keep in mind chemo is the only current treatment for triple neg. BC (other than clinical trials which have not been adopoted yet for standard treatment).  There are no targeted hormone therapies for TNBC as there are for non-TNBC (I had one of those too!)  Stage 1 is great but her grade level is high.

Re the heart issues - perhaps one question to ask the onc.  is if there are chemo options that would eliminate or reduce the heart risks. Your wife's age , general health, and menopausal status (pre or post) may also be factors to consider. My onc. wanted me to have Adriamycin along other chemo agents, however I had had the "life time limit" of Adria. 30 years ago for another cancer.  I haven't had any heart problems but having more of the A may have caused heart problems. Instead, I had 6 rather than 4 standard rounds of Taxotere and Cytoxan. Many  women on this site have had this drug protocol as well. 

Tracy in Toronto
TN&non-TN tumors April/10 Gr3&2;1 metaplastic
Rmast.1/9 nodes w/isolated t.cells
Taxotere&Cytoxan x6
Bone cancer 1980 age17;surgery&chemo AC+Methotrexate
BRCA-ve
On hormone therapy & Metformin Trial
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jan 19 2011 at 2:26pm
Pete,

I think Tracy has offered you some great advice.  Another thought is to get a second opinion from another facility, maybe associated with NCCN or a teaching hospital. 

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 LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 19 2011 at 4:29pm
Pete:
 
I think all the advice you have gotten to this point is very good.  I am in favor, as Donna is, of another opinion.  I know that anything .5 mm and smaller is not usually given chemo, your wife's tumor being a bit larger than that, and being TN, I think I would be seeking a second opinion.  If by chance she decides to do chemo (and I was a just turned 62 yr. old, otherwise totally healthy, when I was diagnosed and began chemo), I was given three choices and was told to go as agressive as possible as I have only this one chance at killing this beast.  Of course my tumor size was not as small as your wife's, as mine was 1.2 cms, but no nodes.  I chose the AC&T - very agressive and that is the chemo that can cause heart problems.  My heart was tested prior to the chemo and after, and has been fine.  There is a 2% chance of heart damage, but of course, no one certainly wants to be in that 2%.  I don't understand why they would want to use such an agressive chemo on her with a .9 tumor - why not T&C?  That is why I feel a second opinion and most especially from someone knowledgeable in TN breast cancer.
 
I wish you both every success and an uneventful cancer journey.
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Belle_Laide Quote  Post ReplyReply Direct Link To This Post Posted: Jan 19 2011 at 5:18pm
Donna, thanks for the article. Denise and everybody, yeah, life is a crap shoot. We do the best we can with what we've got at any given moment.

Did everything right; got screwed anyway. BRCA Negative.
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