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Billi View Drop Down
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    Posted: Aug 23 2013 at 9:54am
BACKGROUND:
After 15 years of NED, in January 2012 my breast cancer has metastasized as a tumor in my throat (an enlarged lymph node) that was pressing on my trachea & esophagus. A prophylactic tracheotomy was performed so I could breathe and I still have the danged thing.

In the past, my cancer was not TN but now it is. I had radiation followed by Taxol infusions (9 cycles-3 on 1 off) which helped in shrinking my tumor from 5.5cm to about 1cm. Chemo was stopped and 2 months later when I started having a little more difficulty breathing & swallowing another CT scan was performed and it showed the tumor has grown back to 3.5cm. This was in Europe and the doctors there were pretty much stumped as to what to do next--said if I have a chance to go to US, I should.

I came to MSKCC in April of 2013 for further treatment (was treated here 15 years ago and followed every year since) where I got almost 3 cycles of Abraxane (3 on, 1 off) before it was shown not to be effective. I was swallowing and breathing harder, my CEA was elevated and PET & CT scans confirmed that the tumor was growing.
I was taken off of Abraxane and placed on Carbo/Gemzar (2 on, 1 off) which I am still on. (3rd cycle out of 4, maybe 5)
Finally, an improvement! Breathing easier, swallowing easier, CEA slowly back within "normal" boundaries.

My oncologist at MSKCC said something yesterday that really upset me, perhaps because I'm still not completely up on TNBC.
She said that treatment options are very limited for TNBC and that chemo infusions vs. chemo in PILL form will be something I'll be on maybe for the rest of my life. That is, as long as there is evidence of disease. If I ever get to NED, I'll get a break from chemo until tests show that I have to get back on it, and it'll always be in an infusion form.

QUESTION:

Is it true that there are no pills (as maintenance) to deal with metastatic TNBC once off of chemo infusions?
Has anyone here with metastatic TNBC ever been on a drug in pill form?
Has anyone with metastatic TNBC ever been in remission and how long?

Please forgive me if this topic has been covered in different ways before. Tried to search and got lost. Or maybe I'm too terrified and can't focus properly. SO much to take in, don't know what's right and what isn't...but I do know one thing: to trust those who have been through something I am going through.
So thank you in advance, and may God bless us all on this difficult journey!

XXXX
Billi
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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: Aug 23 2013 at 6:35pm
Hi Billi,

I've heard of bc metastasizing and changing hormone status.  Sorry that yours came back after 15 years.  You probably thought you were clear.  I know I would after that length of time.  How are you taking the news?

Regarding your question about targeted treatment for TNBC.  Your oncologist is correct as we don't have any targeted therapy like ER+ breast cancers who can take tamoxifen in pill form.  All we have is chemo (surgery and radiation).  The only chemo drug I know of that you can get in pill form is Xeloda.  There may be others, but that's the only one I can think of.  All other chemos are given through infusion.  There could be some clinical trials that are testing new drugs in pill form.  

There have been some members who participated in clinical trials that got to NED and were off the chemo.  Some may get off the chemo but still take the study drug.  Here are a few links from members who've had some success with NED:







Donna
 


Edited by 123Donna - Aug 24 2013 at 10:55am
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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Billi View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Billi Quote  Post ReplyReply Direct Link To This Post Posted: Aug 23 2013 at 6:57pm
Thanks, Donna, I'll enjoy reading that.

A diagnosis of TNBC is bad enough it seems, but a metastasis in my throat, a tracheotomy and a tumor that's inoperable is just too much to take at once. Now when I think of my stage 4 BC of 15 years ago (right mastectomy 14 involved nodes) with chemo and radiation, it seems like a walk in the park in comparison.
It's all relative, I guess, and I never loose sight that it can be worse. So I am grateful at the moment that it isn't.
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arabella View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote arabella Quote  Post ReplyReply Direct Link To This Post Posted: Aug 23 2013 at 7:52pm
Billi,
So sorry to read about your history and everything you're presently going through.  Just wanted you to know that I'm wishing the very best for you.  I think you will find this site and all members very helpful.  Please keep us updated.  I think you are wise to stay with your gratitude attitude as much as you can.
Warm regards,
Kaye
Dx TNBC 1/2013; age 63; 1.1 cm; Stage 1, Grade 1(?); lumpectomy clear margins; ALND -; severe SEs to first TC and treatment stopped; radsX25; BRCA -
Recur 6/2015 Mastectomy
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SagePatientAdvocates View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote SagePatientAdvocates Quote  Post ReplyReply Direct Link To This Post Posted: Aug 24 2013 at 8:03am
Dear Billi,

Welcome to our TNBC Foundation family and sorry you have need to be here.

I believe MSKCC is one of the greatest cancer centers in the world. Period. 

But, I am also a great believer in second opinions. I would suggest that you seek second, even third, opinions at other cancer centers that have experts in TNBC. If you have good insurance and the strength to travel, here are a couple of suggestions-

Dana Farber in Boston
Johns Hopkins in Baltimore
MD Anderson in Houston
UNC in Chapel Hill, NC
Stanford University Cancer Center in Stanford, CA

There are many drugs being tested that can be taken orally. I have no idea if any of them will ever be appropriate for your care. I am not a medical professional and will never give you medical advice but I would be happy to talk with you if you wish. I am a patient advocate working on a volunteer basis and will send you my contact information.

good luck to you and very sorry you are dealing with such a serious recurrence. We will be here for you.l

warmly,

Steve
I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates
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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: Aug 31 2013 at 8:57pm
Hi Billi,
I am so sorry you are having to deal with this after 15 years.  I hope you get a lead on a drug that will get you to NED.
 
You said you were Stage IV 15 years ago.  Do you remember what receptor status you were and what chemo you took.   That is a wonderful accomplishment and I pray you will fare well in this journey.
 
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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