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kizzie
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Location: Atlanta, GA
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Topic: help?? Posted: Sep 20 2013 at 7:41pm |
I have to say I am a little disappointed and heart broken. I didn't expect to feel like an outcast here... I have asked for advice and assistance on the TNBC facebook page and here...and have gotten zero response. Please tell me... Do I smell bad ?? Am I asking the wrong questions? All I want and need is to feel like somebody understands but so far I am not getting that at all. I am reposting the question I asked earlier - in hopes that maybe some of you "veterans" will have pity on me and give me some advice. I am newly diagnosed w/ TNBC - My journey started April 2012. I went for a well woman exam and my obgyn found a lump in my left breast. They sent me for a mammogram/ultrasound and My insurance denied both requesting medical records from my gyn. Gyn apparently forwarded someone else's records in place of mine and insurance was denying my diagnostic tests stating that the breast issue was pre-existing. This was only the beginning of the nightmare. biopsy results-. A core biopsy performed on the left breast on 05/12/2012 was positive for infiltrating ductal carcinoma of the breast. ER 5% PR 0%, HER-2 negative Little did I know...for the next year - any time I went to have ANYTHING done - BCBS was going to use their little stall tactic of denying anything my providers wanted to do as pre-existing. When I went to my breast surgeon and she did a biopsy -- the biopsy came back as breast cancer. She sent me to get the routine mammogram to determine if the cancer was in my right breast and my lymph nodes. It was not. However, they found a spot on my liver and a giant mass in my chest cavity the size of a grapefruit (11.3 cm in diameter) they determined that the spot on my liver was a hemangioma (like a birthmark) but the mass in my chest was so big they needed to determine what is was. It took 3 weeks to even get in to have the mass biopsied courtesy of BCBS stall tactic -- preexisting. Once that was done they determined that the mass was benin so they could proceed with chemo. In the 3 weeks that they delayed treatment the mass in my breast grew at least 2 cm. I started chemo in June -- I did Adriamycin along with Cytoxan. I did these every other week for 4 weeks and then I switched to two other drugs per the dictation they are as follows: n 06/ 2012 the patient started neoadjuvant chemotherapy with. dose dense AC followed by paclitaxel and complete 4 cycles of AC and 4 cycles of paclitaxel on 09/12/ 2012. I had a bilateral mastectomy on Oct 15 and then Dec 3 had a sternotomy whereby they cracked my chest open the way they would a heart patient - and removed the mass. I died 4 times on the OR table and had to have a total blood transfusion. I am grateful to God and my surgeon to be here. I started radiation in February; once I was cleared to do so. My surgery was so invasive they said they didn't want me to do the radiation too soon because it would interfere with the healing process. I finished radiation by 3/31/13. I've had pain intermittenly since radiation. Most people dismissed it as "normal" and made it seem like I was making a mountain out of a molehill. When I was still complaining of pain in July my Oncologist finally decided to order a CT scan. The CT scan showed abnormalities and so she ordered a PET Scan. The PET Scan showed hypermetabolic activity. In the left lung (where the schwanoma was attached to my lung-- there was what they thought was scar tissue) well THAT area lit up on the PET SCAN as well as my hilar lymph node. Biopsy confirmed it was cancer. Specifically -- metastatic triple negative breast cancer. My question to you kind folks was and is as follows: I have been on the ketogenic diet for three weeks now in hopes of starving the cancer....& I've been exercising daily.... with the exception of yesterday- I had a biopsy of the mass in my lung to determine the nature of the cancer...what proteins are driving it etc...
I was able to log in last night and view the dictation from my first visit with my Dr & it said that my oncologist back home (Atlanta) suggested ixabepilone (xeloda) & capecitabine. I wanted to ask you all what treatments you all have tried & what has worked for you? I really don't want to do chemo again but I will if it will give me longevity along with quality of life.... we meet with my oncologist Monday (hopefully to discuss a treatment plan) & I want to have as much knowledge going into this appointment as possible. Any experiences you can share, advice etc would be extremely helpful & appreciated please respond????
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ann u
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Joined: Jan 08 2010
Location: Arizona
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Posted: Sep 20 2013 at 8:20pm |
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Hi Kizzie
I just wanted to welcome you to the forum, albeit under unfortunate circumstances. I don't have any advice concerning your options. I'm sure others will chime in shortly. Sometimes the "Talk" forum receives a little more traffic. Again, welcome, and I'm glad you found this site - their are many knowledgeable and kind people here - hang in!
Ann
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8/06: IDC 1cm, 0/9 lymph nodes, lumpectomy, Mammosite radiation, 4 x A/C
5/07: BRCA1+ (5382insC)
11/09: IDC 3mm, double mastectomy w/reconstruction
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123Donna
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Joined: Aug 24 2009
Location: St. Louis, MO
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Points: 13510
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Posted: Sep 20 2013 at 8:48pm |
Hi Kizzie,
I don't think I saw your other post, I'm sorry no one responded. That's not usual with this forum. None of us can give you medical advice, but I looked up the drugs they are recommending. ixabepilone is commonly called Ixempra and capecitabine is Xeloda. Maybe if you post your questions under the Metastatic/Recurrence thread, more will see it and comment. Ixempra and Xeloda are more often given for metastatic bc. I don't think that many members have had that combo so probably the reason you haven't seen a response yet. I found this previous thread on this chemo combo:
I'm sorry you were given the runaround and delaying tactic. It's just shameful and criminal in my opinion. Can you get a second opinion from an NCCN Facility? Getting a second opinion on treatment options will help you make a better decision regarding treatment options and possibly look into clinical trials. Some of the new clinical trials for metastatic TNBC are looking at inhibitors, like Parp and PI13K. Some of our members have had good response to these trials.
Here's a list of clinical trials for metastatic tnbc. You can further refine your list by state, city, etc.
Donna
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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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Lillie
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Location: Eastern NC
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Points: 3616
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Posted: Sep 20 2013 at 9:17pm |
Hello Kizzie,
I am so sorry you even have the need to be posting here. I am also sorry you feel as though you were ignored.
I do not have any personal knowledge of the drugs you mentioned. I have heard about them, but only via others.
None of us should have to fight with insurance companies. Having cancer is stressful enough on its own. You are facing a big challenge and I wish I could give you the answers you seek, but I can't. What I can do is pray that your journey, going forward, will get better.
Love and God Bless,
Lillie
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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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denise07
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Posted: Sep 20 2013 at 11:24pm |
Hello Kizzie,
So sorry you were ignored I did not even see your post so very sorry you are dealing with this, I really have no advice but is there some thing in your state that can help with your insurance issues? I know of many people in my area diagnosed had NO insurance at all and did get tests and treatment covered it is insane for cancer patint to de denied any tests from ther insurance really having cancer to deal with is not enough. I am sure some one will chime in with better knowledge for you.Donna and Lillie will be a great help for you as you can see from there replies.
Good Luck to ... hopefully everything will turn around for you soon. We are here for you.
You will be in my prayers.
Hugs to you...
Denise
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DX Idc 10/07,st2,gr3,2/6 lymphnodes
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kiwikid
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Joined: Jun 07 2013
Location: New Zealand
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Posted: Sep 20 2013 at 11:25pm |
Hi Kizzie
- I had 12 months on capectibine (xeloda) for my re-occurrence. I
took two tables in the morning and two at night for 14 days then had 7 days
off. The only side effect I experienced was a bit of
fatigue. I had significant regression on this chemo
treatment. I liked this treatment because family and work life ticked
along as normal and we could also travel. No hair loss was also a big
bonus for me...I like my hair and was thrilled to keep on this treatment. I was
taken off it after 12 months because my cancer markers began to rise so my
oncologist thought that the drug had done all it was going to do and wanted to
change treatment.
I then
went onto weekly vinorelbine (which has also been very manageable with side effects etc.)
and are currently on a chemo break whist
I have a treatment review. My cancer is currently stable and it has been nearly
two years since my re-occurrence.
I was told by my oncologist when I was first diagnosed with the re-occurrence
that chemo was the best option for longevity.
I personally never considered not doing chemo I was pleased that there
were treatment options available for me.
I am currently researching drug trials in the US and are leaning
towards the immunotherapy trials. I am BRAC 1 negative but my BRAC 2 came back as
uncertain significant which ruled out the PARB trail I was looking at.
I am sorry you have not had a response to you first email. I normally only look at the re-occurrences
forum as it seems the most relevant to me.
Please don’t be discouraged by the lack of response to your first
email. This forum is truly a blessing and the best possible place to get feedback
and tips to help you. Wishing you the very best and I will watch out for your
updates. Xxx
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Grateful for today
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Posted: Sep 23 2013 at 9:07am |
Kizzie, Sending caring and good thoughts to you for your appointment today (I think.) There's been some good recent posts that you may like to consider asking your oncologist about. You may have already seen these posts........but I thought it was better to see twice than not at all. Please just disregard if you have already seen. Kitkat posted at: http://forum.tnbcfoundation.org/national-mestatic-breast-cancer-convention_topic11533.html
Kitkat wrote:
I went to the Convention that was here in Houston this weekend. ........ We broke out into classes, which I attended the one for TN Dr. Jennifer Litton with Mdanderson was the speaker. She had alot in information to give, wished we had had more time! She said that over the next 2 years, they were going to have alot more drugs to give us to keep fighting. She said that instead of there being 7 sub types of TN, there are actually close to 100 and that soon it would be released. She also said that the new way of treating us will be thru gene mutations, because of there being so many different types. She also said that when you have your original biopsy, to the time it shows its nasty self again in your body, that the tumor can change, which is why it is important to have another biopsy. And if you go into remission and it comes back again, to have another biopsy. The tumor can change any of the - to + status. lots of good imformation, but she only had an hour to speak. gene mutations and DNA are the only way to really identify what each of us have. We are all so unique. I was diagnosed stage 4 in january, had biopsy of lung met, wasn't enough cells left to test her2 status. Last month, I had 4 biopsy's done for gene mutations and her2 status....it did change. Originally my tumor tested 1.2 her2, this last biopsy,,,, I testes 6.2, which we are hoping is why the tumors are so mean and wont die with 2 previous chemos. 2 weeks ago I started carbo, taxol and herceptin. God Bless each and everyone of us TN. Why do we have to be so special??? | Donna's post on http://forum.tnbcfoundation.org/genome-sequencing-personalized-medicinetnbc_topic9553_page2.htmlon "Future Frontier: Fighting Cancer at the Genetic Level" Thread Donna started on Sept 20, 2013 at: http://forum.tnbcfoundation.org/research-on-new-targets-for-tnbc_topic11529.htmlon "New Targets for Triple-Negative Breast Cancer" Maybe some considerations for you to think about discussing with your onc: (Note: I post to share thoughts and considerations.........never advice.) 1. CONFIRM genetic/DNA testing was/is being done on your most recent biopsy tissue. (ALL available, appropriate and necessary testing to help in making the best treatment plan.) You mentioned "checking proteins driving it"...........so it sounds like the appropriate testing is being done.............but again just to confirm. If not being done/or additonal testing would help, how/where to get done ASAP. 2. As mentioned in above posts, importance of a 2nd/3rd consult if you want more opinons and recommendations......especially if you are not at a NCCN or NCI Cancer Center ( NCCN=National Comprehensive Cancer Network. NCI=National Cancer Institute) Some people have insurance coverage and travel means for the additional consults. Sometimes when travel is a challenge, one's oncologist will consult with at TNBC expert at a NCCN or NCI Cancer Center and get additional input that way. 3. Confirm you have had BRCA testing done. (BRCA testing is expensive. COnfirm you have insurance coverage.......just so there's no surprises.) Confirm you have had Vit D3 testing. If not, discuss to get done ASAP with your onc. 4. Confirm the time within which you and your onc have to make a decision within which. SO sorry to learn of all your problems (which should NOT have happened) in getting your diagnostic workup......treatment plan.....follow-up etc. Will be thinking of you today..............lots of caring thoughts, Grateful for today.........Judy Info on BRCA testing and Vit D3: BRCA TESTING: http://forum.tnbcfoundation.org/very-important-news-re-tnbc-brca-testing_topic8458_page1.html?KW=BRCAVITAMIN D3: See especially page 26 http://forum.tnbcfoundation.org/vitamin-d3_topic5338_page26.htmlKizzie, Addendum: Just read Lee's post...........sorry I missed that you are at MD Anderson. I wrote above post not realizing your apointment today is at MD Anderson. You are a wise woman in getting an MD Anderson consult..........and glad you are able to do this. J.
Edited by Grateful for today - Sep 23 2013 at 10:35am
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Lee21
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Posted: Sep 23 2013 at 10:23am |
Kizzie, I am very sorry to hear of your recurrence but glad to know that you are at MDA for a treatment plan. I hope they are planning to drill down on your metastatic tumor genetic makeup and come up with a customized plan based on that information. ( http://www.ascopost.com/issues/march-15-2012/next-generation-sequencing-in-metastatic-triple-negative-breast-cancer-yields-rewards.aspx) Here are links to 2 articles that discuss current treatment regimens for MBC: http://meetinglibrary.asco.org/content/306-114(you can download the pdf from the abstract) http://connection.asco.org/Forums/forumid/8/threadid/699/scope/posts.aspxThese are from 2012. I haven't seen similar articles from this year's ASCO meeting. Here is the abstract to an article on ixabepilone and capecitabine from 2011: http://www.ncbi.nlm.nih.gov/pubmed/21128114and a review from 2012 (free): http://www.ncbi.nlm.nih.gov/pubmed/22645612I don't think there is a magic bullet for all forms of metastatic TNBC; each tumor is unique and the question really is whether the driving mutations can be identified and coming up with a treatment plan based on that. Hope to hear of a treatment plan from your meeting with the oncologist today. Best wishes, Lee
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12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant 1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30 11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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arabella
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Posted: Sep 23 2013 at 2:18pm |
Wishing you the best at your MDA appt. today! Please keep us updated. Kaye
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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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arabella
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Posted: Sep 23 2013 at 2:58pm |
Kizzie..... are you on Dr. Seyfried's ketogenic diet??? What does MDA say about this and his way of thinking? I don't know much about it, but it makes sense to me. I've just ordered a book on it. Again, wishing you the best at today's appt. Kaye
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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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denise07
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Posted: Sep 29 2013 at 12:36am |
Kizzie,
How did your appt. go at MDA? What are they suggesting from here on you are at one of the top notch centers.What about the new testing to see what treatment will or will not work for your tumor genome- sequencing-in mestastic tnbc breast cancer is this a option for you? Hope everything went well and they will be moving you along with a treatment plan soon. I hope you feel well and respond soon, another option what about the moon shot program I hear they are making progress with that also this are just some suggestions and not medical advice certainaly i am here out of true concern for you. Remmber there are always miracles and I pray you will be one of them very soon.
Praying for the best treatment for you with amazing results...
i am praying for NED and nothing less...
Denise
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DX Idc 10/07,st2,gr3,2/6 lymphnodes
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Grateful for today
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Posted: Oct 04 2013 at 8:44am |
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Kizzie,
Sending caring and good thoughts your way.
Hope you and your treatment team have found found some good options to consider all the pros and cons of for your best plan of care.
Grateful for today.................Judy
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