Newly diagnosed

Hi Judy,

Hi Mandy,

Since my hair is gone, I've decided to buy all the fun holiday hats, santa, reindeer, snowman and the kids love it.  It makes them happy and not so worried about me.  Although my kids are alittle older, they still enjoy seeing there mommy happy, styling and profiling, lol.

a lot of woman like the wigs, I'm not one those women.  I still feel pretty in my wraps and caps.  Just remember to wear makeup it will make you feel so much better. except of course after your treatment days you may not feel like it.  Did you get a port? You are not allowed to wear false eyelashes because of the adhesion, during chemo your skin is very sensitive to everything. You don't want to pull your eyelid off with the eyelash, lol.  btw im 38, your questions and concerns are exactly the questions I had.  sometimes I may not sound like I have any sense when I respond because I have so much to say and cant't type fast enough, lol.  Also, I didn't lose my eyebrows or eyelashes until the very end of my 5th treatment.  If you wear eyeliner on the top lid and bottom people won't be able to tell that you've lost them. At least that what friends have said to me.  Strangers can't even believe that this is my 2nd round of chemo, that was my goal. Still being young I want to look healthy and like I still care about myself otherwise the cancer is winning!  Don't ever back down even on your worse day.  Usually after the 4th day after chemo I feel 80%.  Just keep in touch with this website through your journey.  Help and support will always be here!  Best of luck!

Hi Sandra,

Sending lots of positive and caring thoughts to you for your Tuesday appointment.
Hope you get all the information and support you need from your physician.

Although it sounds counterintuitive, most feel better after chemo starts.
The waiting and unknowing is hard.

I like to remember a statement from Dr. Jerome Groopman, MD.
Found this statement by Jerome Groopman, MD in his book: "Anatomy of Hope" helpful.......usually
have to read it twice to understand it.
" Each disease is uncertain in its outcome and within that uncertainly we find real hope, because a
tumor has not always read the textbook, and a treatment can have an unexpectedly dramatic
impact. This is the great paradox of true hope. Because nothing is absolutely determined, there
is not only reason to fear but also reason to hope."
He also says: "Hope is a belief and expectation."
Here's to hope for you that all is and will be well for you.

With caring thoughts and lots of good hopes,

Grateful for today..................Judy

Hi Sandra,

What great good and positive news in your Nov 8 posting.

I happened to see your post on TNBC Talks Forum on: 5-fluorouracil (5-FU).
Wasn't sure if the members who have been posting on this forum topic would see your post on 5-FU.
Thought they would also like to share the additional good news of your CT and bone scan being all clear.

Copied from your post on 5 Fluorouracil (5-FU) today 4;42:
"Hi folks,
I start my chemotherapy on November 25th. My MO recommended 3 cycles of FEC100 followed by 3 cycles of Taxotere - at 3 week intervals. She also said I'll be given 4 different kinds of anti nausea meds?! I thought that sounded like a lot, but from what I'm hearing here, I may just need it.
Good news is that my CT scan and bone scan came back all clear. And my kidney and liver function tests were excellent, yay. That was such a relief. Vit D levels were very low, though, so am on supplements for that. I need to ask the MO, at my next appointment, what other supplements I can take.
Thanks for all your good advice to date. It has been very helpful. "


I know when I go to post I sometimes have to stop and think which of the various forums (that I had
previously posted on) do I now want to post on.
I appreciate that everyone on the forum is flexible where one posts.
Hope it is OK with you that I referred to your other posting on this forum........just wanted the members on this forum to know the good news about your CT and bone scan.



Have you seen the post by dmwolf of jan 12, 2011     5:40
It's about whether the taxane is given first or last.
You might want to read the entire post / all the replies (it's on the Welome New Members forum).
           (There's 8 pages).
You might want to ask your MD's opinion of the retrospective study........
note: study looked at taxol ( paclitaxel) (a taxane) and you said you will be on
             taxotere ( another taxane)
Post by dmwolf of jan 12, 2011     5:40            
Newbies: you might want to discuss this study with your doctor as you work together to come up with a treatment plan.
Chemotherapy Sequence Affects Early Breast Cancer Outcomes
Elsevier Global Medical News. 2011 Jan 7, B Jancin
SAN ANTONIO (EGMN) — The sequence in which paclitaxel and anthracyclines are given for treatment of early breast cancer makes a big difference in long-term outcomes.

That's the conclusion reached in what is believed to be the largest-ever retrospective study of the clinical impact of the sequencing of taxanes and anthracyclines. The study involved 3,010 early breast cancer patients who were treated during 1994-2009 and entered into the prospective online database at the University of Texas M.D. Anderson Cancer Center, Houston.

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.

Starting with paclitaxel rather than an anthracycline-first regimen led to better long-term results in the settings of adjuvant chemotherapy and primary systemic (or neoadjuvant) therapy.

The adjuvant chemotherapy analysis included 1,596 women, three-quarters of whom received paclitaxel followed by anthracyclines. The 5-year relapse-free survival rate with this regimen was 88.8%, compared with 79.5% when anthracyclines were followed by paclitaxel. The 10-year relapse-free survival rates were 81.8% and 73.5%, respectively.

Five-year overall survival was 93.1% with paclitaxel followed by anthracyclines, compared with 83.2% for the reverse. The 10-year overall survival rates were 83.9% and 65.6%, respectively.

In a multivariate analysis that was stratified for potential confounders, including age, clinical stage, hormone receptor status, tumor grade, and era of diagnosis, the anthracyclines-first sequence was associated with a 67% increased risk of relapse (P less than .0001) and a 2.5-fold greater risk of mortality (P = .001), according to Dr. Alvarez, a medical oncologist at M.D. Anderson.

Among 1,414 patients who underwent neoadjuvant therapy, the 5-year relapse-free survival rate was 79.0% with the paclitaxel-first regimen vs. 61.2% with the anthracyclines-first regimen. Ten-year relapse-free survival occurred in 61.7% and 50.5%, respectively, of these patients.

Overall survival was 84.2% and 66.2% at 5 and 10 years, respectively, in patients who received paclitaxel followed by anthracyclines, compared with 71.3% and 53.4% in those who got anthracyclines first.

In a multivariate analysis, the anthracyclines-followed-by-paclitaxel sequence of neoadjuvant chemotherapy was associated with an adjusted 49% higher risk of relapse (P = .01) and a nonsignificant 28% increase in risk of all-cause mortality (P = .17), compared with the paclitaxel-first strategy.

The mechanism that accounts for the increased efficacy of taxane-first regimens for treatment of breast cancer is unclear, according to Dr. Alvarez.

With caring and positive thoughts,

Grateful for today........Judy

Hi Sandra,

Glad to hear you were referred for see a genetic counselor (check counselor is certified).
This year (according to post previously by Steve) the NCCN ( National Comprehensive Cancer Network
advised BCRA testing for TNBC patients if under 60 years of age. Once you receive all the information
about BCRA testing, you can decide about being tested.

The responses to the article " Chemotherapy Sequence Affects Early Breast Cancer Outcomes " as you
will see from the posts on the other forum are varied.    Some MDs are doing the taxol first.   Some MDs are continuing the taxol as last. Would have really preferred not to have given you information that may not have a black and white answer........however, thought it better to know about this article before you start chemo......so you can discuss it with your MD.    Some places do not changes protocols until there is a
prospective clinical study. The ACT vs T-AC was a retrospective study.

Believe some one posted about the following article but cannot find it right now.
Also, I still have trouble using the hyperlink on the forum......sometimes I get it to work and
other times it fails   (it's me and not the hyperlink).
So I need to print article and not use the hyperlink.
You may want to discuss this article with your MD.
REMEMBER: This is a RESEARCH article.    Not proven by a clinical study.
After the article was in Oncogene, 3/15/2010,   Taxanes (taxol and taxoterel protocols still being use.
Article:
Research May Provide Potential Target For New Therapies To Limit Metastasis Of Primary Breast Cancers
Main Category: Breast Cancer
Also Included In: Biology / Biochemistry
Article Date: 15 Mar 2010 - 2:00 PDT

Researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer Center have discovered that "microtentacles," or extensions of the plasma membrane of breast cancer cells, appear to play a key role in how cancers spread to distant locations in the body. Targeting these microtentacles might prove to be a new way to prevent or slow the growth of these secondary cancers, the scientists say.

They report in an article to be published online March 15, 2010, in the journal Oncogene that a protein called "tau" promotes the formation of these microtentacles on breast tumor cells which break away from primary cancers and circulate in the bloodstream. While twisted remnants of tau protein have been seen in the brain tissue of patients with Alzheimer's disease, this is the first report that tau could play a role in tumor metastasis by changing the shape of cancer cells. These tau-induced microtentacles can help the cells reattach to the walls of small blood vessels to create new pockets of cancer.

"Our study demonstrates that tau promotes the creation of microtentacles in breast tumor cells. These microtentacles increase the ability of circulating breast tumor cells to reattach in the small capillaries of the lung, where they can survive until they can seed new cancers," says the senior author, Stuart S. Martin, Ph.D., a researcher at the University of Maryland Greenebaum Cancer Center and associate professor of physiology at the University of Maryland School of Medicine. Michael A. Matrone, Ph.D., is the study's lead author.

Healthy cells are programmed to die - a process called apoptosis - after they break off of epithelial layers that cover internal organs in the body. They also can be crushed if they are forced through small capillaries. However, cancer cells are able to survive for weeks, months and even years in the body. Once they are trapped in small blood vessels, the cells can squeeze through microscopic gaps in the vessels' lining and spread to organs such as the brain, lung and liver.

"We hope that through our research, we will be able to identify drugs that will target the growth of these microtentacles and help to stop the spread of the original cancer. Drugs that reduce tau expression may hold potential to inhibit tumor metastasis," Dr. Martin says.

He notes that metastatic cancers are the leading cause of death in people with cancer, but methods used to treat primary tumors have limited success in treating metastatic cancer. In breast cancer, metastases can develop years after primary tumors are first discovered.

Tau is present in a subset of chemotherapy-resistant breast cancers and is also associated with poor prognosis, but Dr. Martin adds, "While tau expression has been studied in breast cancers for contributing to chemotherapy resistance, the protein's role in tumor cells circulating in the bloodstream hasn't been investigated. And that's the focus of our research."

In this recent study, the University of Maryland researchers analyzed breast tumor cells from 102 patients and found that 52 percent had tau in their metastatic tumors and 26 percent (27 patients) showed a significant increase in tau as their cancer progressed. Twenty-two of these patients even had tau in metastatic tumors despite having none in their primary tumors.

Dr. Martin says more studies are needed to determine if tau is a clear predictor of metastasis. Given the complex nature of tumors, there most likely are other factors involved in causing cancers to spread, he says.

"Metastasis is a very major concern for people diagnosed with cancer, and the discovery of these microtentacles and the role that tau plays in their formation is a very exciting development that holds great promise for developing new drugs," says E. Albert Reece, M.D., Ph.D., M.B.A., acting president of the University of Maryland, Baltimore, and dean of the University of Maryland School of Medicine.

The University of Maryland, Baltimore, has filed patents on the microtentacle discoveries of Dr. Martin's lab group and is looking to partner with biopharmaceutical companies on new drug development. The researchers identified these cell extensions while they were studying the effects of two drugs that prevent cell division, or mitosis. Most chemotherapy drugs target cell division, aiming to slow or stop tumor growth.

Dr. Martin says his team found that a popular chemotherapy drug, taxol, actually causes cancer cell microtentacles to grow longer and allows tumor cells to reattach faster, which may have important treatment implications for breast cancer patients. Their studies are continuing.

"We think more research is needed into how chemotherapies that slow down cell division affect metastasis. The timing of giving these drugs can be particularly important. If you treat people with taxol before surgery to shrink the primary tumor, levels of circulating tumor cells go up 1,000 to 10,000 fold, potentially increasing metastasis," he adds.

The study being published in Oncogene was funded by grants from the National Cancer Institute, the USA Medical Research and Materiel Command, and the Flight Attendants Medical Research Institute.

Source:
Karen E. Warmkessel
University of Maryland Medical Center


One other thing you might discuss/clarify with your MD: dose dense chemotherapy.
Some chemotherapy is given every 2 weeks (dose dense) and some given every 3 weeks.
Sorry if I missed how frequently your chemo is being done.
Know you said FEC x3 and Taxotere x3.
Your oncologist can explain further about every 2 weeks versus every 3 weeks.

If I have given you to much information, apologies.
I found such an overload of information during treatment time. Yet I wanted to know as much
   as possible.
Please know my intent is to help and not overwhelm.

I love the black and white situations/choices.
Life is not always black and white.

With your chemo planned for Nov 25, you have time to prepare your body and mind for that part
of your treatment plan which is your "insurance" for healthy cells in you. Again, waiting is challenging!

With caring and positive thoughts,

Grateful for today..............Judy

                                                        

Hi Sandra,

You are doing everything A++++++.
You are so right about how important it is to be confident and comfortable with the choices you have made thus far.

Hopefully I try to give information that seems important to know.
Then, with similar clinical status and with the same information, different people can come to different decisions with each decision being the best one for that person.........sorry I did not express this in my
prior posts.

I did not realize you had already discussed every 2 week vs q 3 wk chemo with your MD.
If I had realized that, I would not have brought it up again.
Just wanted to be sure you had discussed it.
Again, every one is different and the best decision is the one you make with your MD.
(That very long and wordy article that I had included was RESEARCH info if you wanted to
share with your MD if your MD was wondering what SOME thinking is about the ORDER of
chemo meds.    Again, both order of meds (taxane first and taxane last) are being done at the
major cancer centers in the USA......so whatever you and your MD plan is best for you and backed
up by others.)

Please know that I did not intend to question any of your decisions.

So good to hear about all you do......such healthy activities.....walking your dogs, connecting with
nature in the garden, getting sunshine.....and most important having time with your kids in the park.

With continued positive thoughts,

Grateful for today.................Judy

I'm ready to start my second round of FEC this week and am feeling thoroughly sory for myself. The last two weeks have been great. I was back at school and getting on with the job like I'd never left. After initially being intrigued by my headgear the kids have been great and I actualy feel normal (whatever that is). Unfortunately I have developed another seroma which is dragging me down and I've been told they won't drain it because of the risk of infection and I can't swim because of the risk of infection and although all the hair is still on my head (maybe that not so cold cold cap actually worked!) my eyes are very itchy and I'm wondering if I'm losing my eyelashes first?

6 rounds of FEC then 3 weks of radiotherapy. I was originally going to have 4 rounds of something else with lots of steroids but pleaded insanity (I'm asthmatic and whenever they have put me on oral steriods I have felt like I was having a nervous breakdown!).