Let's Talk About Chemotherapy - Chemo after surgery/good Pathology results (PcR)

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Chemo after surgery/good Pathology results (PcR)

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Forum Name: Let's Talk About Chemotherapy
Forum Description: A place to discuss Chemotherapy
URL: http://forum.tnbcfoundation.org/forum_posts.asp?TID=12770
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Topic: Chemo after surgery/good Pathology results (PcR)

Posted By: koala55
Subject: Chemo after surgery/good Pathology results (PcR)
Date Posted: Feb 12 2016 at 10:37pm

Hi,

Have just had breast conservation surgery and about 17 lymph nodes removed following 12 weeks of carboplatin and taxol (Carbo and Taxol 3 weekly and just Taxol on the other weeks). I was diagnosed with a 3 x 4 cm lump and at least 2 lymph nodes with cancer in October '15 - TNBC Grade 3 and possibly STage 2 - 3. According to pathology after surgery there were no cancer cells seen in removed tumor (what was left of it - it had shrunk considerably) and no cancer cells in any of the lymph nodes (previous biopsy had shown in at least 1 and 2 had lit up on PET scan at time of diagnosis). This is all good news.

My oncologist has suggested my next steps could be:-

1. standard treatment of 4 x AC (I am assuming this is Andriamycin and Cytoxan) to be given 3 days in a row with a two week break in between

or 2. two more 3 weekly rounds of the Carboplatin and Taxol before then moving to 1. (AC treatment).

The plan is to still have radium after this. I'm 60 years old and so far have tolerated the previous chemo quite well apart from extreme tiredness and lack of energy.

Just wondering what others may have done or suggest as I know all chemo comes with side effects and impact for the future. My treatment is carried out in Singapore as this is where I currently live. Thanks a lot.

Replies:

Posted By: gordon15
Date Posted: Feb 13 2016 at 9:39am

Great to hear the good news of PcR! You're asking if you should have a little more Carbo-Taxol, after the 12 ? I read somewhere that more chemo isn't necessarily better of the same one, there is some research out there on that, if 12 is the normal regimen depending on your tumor size/grade/etc of course.

From everything I've read, the AC is very effective, generally. The "A" can do really some damage to any cancer still floating around. My wife had it in 2008, and that non-TNBC cancer never came back. Sounds like a good plan to followup with the AC if you can handle it.

Posted By: koala55
Date Posted: Feb 26 2016 at 10:14pm

Hi Gordon,

Thank you for your reply. I did get a second opinion and will now just go for the AC combination and not add two more rounds of carboplatin/taxol. This will still be followed up with radiation so hopefully all bases will be covered. I'm hoping I can have the AC as a dose dense schedule across 8 weeks - so 4 doses.

Thanks again

Posted By: Dporter
Date Posted: Feb 27 2016 at 10:13am

I just got my pathology report yesterday. My case is similar to yours, I was diagnosed with stage 2 with no lymph node involvement. My neoadjunct chemo consisted of 12 weekly taxol treatments followed by 4 DD AC. I then had my lumpectomy. The surgeon took 1 lymph node and removed the area of the mass. He had to go back during the surgery and trim a little more on 2 margins. When the pathology came back, there was NO cancer remaining in any tissue, A complete pathologic recovery! I love the way that sounds.

I will be going for 4 weeks of radiation starting on March 21st. I and ready to get to the end of this long journey. Having said that, I know that there is a chance that it might come back, but I also understand that with a cPr, my chances of it returning are lowered a lot.

So Koala55, I believe in the drugs they pumped in me, and I am so thankful that I sought out the "best" cancer team to treat me! I hope all goes well with your aditional treatment. AC was rough for me, much harder than the taxol, but hang in there because it is only 4 treatments long!

I am praying that this week had good news for all of you, and that the weeks to come will as well!

Thanks for following my case!
Debbie

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Dx TNBC 7/15; age 52; stage 2, grade 3, BRCA negative; Taxol weekly x 12, DD AC x4 completed 1/19/16

Posted By: AmyL
Date Posted: Feb 27 2016 at 10:24am

What wonderful news Debbie! I hope you are recovering well from surgery. I knew that A/C was going to be tough, but WOW! Each day is a new adventure. Yesterday I was hit by the most profound exhaustion...dizzy when I stand up and move about. Hoping for a better day today. I know it will be worth it in the end, but that seems like a long way away!

Amy

Posted By: Jacklin
Date Posted: Feb 27 2016 at 1:06pm

Hi Amy,

When I started chemo there was a lady there who was having her last chemo treatment that day. Her advice was "listen to your body' and I'd like to share that with you too. I found that helped me tremendously, I didn't feel guilty or 'bad' having a nap whenever I needed it. What you are describing is very normal, I found that day 4 was the day I often had a 24-hour nap when I was on A/C. If that's what you need, then take it. Your body is working very hard right now and needs the rest. Praying that today is a better day for you.

Blessings

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Dx: Nov. 27/15, TNBC, left breast & lymph, BRCA -; Chemo: Dec 4/15 - Mar 4/16; 4 DD A/C, 3 DD Taxol; BMX/ALND: April 26/16; Stage 3C; Radiation: June 10-July 15/16; 1 cycle Xeloda: Aug 15 - 28/16

Posted By: AmyL
Date Posted: Feb 27 2016 at 5:37pm

Thanks for the wise words of encouragement Jacklin. I'm definitely going to try to embrace the advice. It's such a weird feeling to sleep for a few hours, then be just as exhausted when you wake up! I did spend a beautiful hour in the sunshine sitting on my deck with my daughter this afternoon. A rare treat in Colorado in February.

Amy

Posted By: Jacklin
Date Posted: Feb 27 2016 at 7:13pm

Good for you Amy, so glad you spent the time with your daughter. Especially when you're blessed with such good weather. Same for us here, I'm north of Toronto, Canada and it was above freezing today, but I was honestly too tired to go out for a walk. You are right, it is something we don't ever experience before chemo - that is, we usually have a nap and wake up refreshed. But now, the chemo is working hard in your body to kill the cancer cells, and also some of our non-cancerous cells, and that's why our bodies are so tired. Enjoy that beautiful sunshine!!

Peace,

Jacklin

Posted By: Dporter
Date Posted: Feb 27 2016 at 10:30pm

Thanks Amy,
AC knocked me off my feet! I was down for 3 days after a treatment. I would make it to the couch and had no energy to do anything and nauseous. The medicine didnt help a whole lot. The next 4 days Were a little better each day. I would feel much better then until my next treatment. I took them every 2 weeks. The best thing about the AC was that there was only 4 of them!
Debbie

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Dx TNBC 7/15; age 52; stage 2, grade 3, BRCA negative; Taxol weekly x 12, DD AC x4 completed 1/19/16

Posted By: Guests
Date Posted: Feb 27 2016 at 11:57pm

Ac is really harsh. I was glad they gave 2 weeks inbetween. They said it was cumulative so it builds up as it goes. I was so sick after 3.i was hospitalized for 7days. So take care to rest and drink lots of water. Dont turn down any help at home rest is really important. My prayers are with you. Just remember it is killing the cancer.

Posted By: AmyL
Date Posted: Feb 28 2016 at 3:32pm

What a difference a day makes! Much better today... Way less dizzy. It's almost like I can feel the Neulasta kicking in to make more red blood cells. I'm even well enough to put real clothes on and meet my husband for lunch after his golf game with my daughters. Another day of warm Colorado sunshine in the middle of winter. God is Good.

Posted By: Guests
Date Posted: Feb 28 2016 at 3:48pm

Did any of you feel really tired at the end of your Taxol treatments? Im so week and tired and its my 11th week. I didnt feel this bad at the beginning

Posted By: Jacklin
Date Posted: Feb 28 2016 at 8:07pm

Hi Romnessprite1,

I just completed 2 of 4 taxol and NEVER felt THIS tired during any part of chemo. I did feel a bit tired during A/C, but it's been building and it feels like I might never get my energy back again. I heard that taxol is much more tiring, so you're not alone in this. We both have 2 more to go - we can do this, right?

Blessings

Posted By: Guests
Date Posted: Feb 28 2016 at 8:12pm

Jacklin yes we can. We will just keep encouraging each other. Its raining here today and that really effects my mood too. I have a sunshine light that helps but its not the same. Hearing from peole os so important. Thanks for the note.

Posted By: Guests
Date Posted: Feb 28 2016 at 8:20pm

Cant type either lol. 😁 i drop stuff all the time too. Ive got that finger and thmb numb thing. Its so wierd. I laugh at myself because its like a silent commedy to see me try to do stuff. I feel like Lucy in the old black and wbite tv show. Haha. I looked goofy today too I put my wig on and it some how got pulled down too low on my forhead in the car. Didnt notice untill i saw my reflection in a window. It seems funny now but it didnt then.😵😁

Posted By: Jacklin
Date Posted: Feb 28 2016 at 8:21pm

Hi my friend,

Well, for us it was about 50F today, which is SO warm, usually it's about -25 or -30 so it was a beautiful day for walking. We've had very little snow this winter, for which we've been thankful when driving to chemo. The rain is good for the trees and grass, but I hear you, it can be tough to 'up' when it's dark and raining. So glad we've connected tonight. Are you treatments weekly? I sense they are since you said this was your 11th treatment coming up. Mine have been dose-dense, every 2 weeks so my next one is Mar 7. I had a bad reaction to the first taxol, but the dose was reduced by 15% for the last treatment and my hands & feet weren't nearly as bad. But the fatigue!! Oh my goodness, I've felt like I'm fight the flu and a cold since Thursday, just feeling icky. And no desire to get up and do anything either, just want to lie in my chair and rest/sleep. I'm here for you, just like you are for me. Hope you have a good night and sleep well. Hugs

Posted By: koala55
Date Posted: Mar 18 2016 at 2:52am

Hi Debbie,

So pleased you also got a good response. I am now into my second round of AC - every fortnight and it has been harder than the carboplatin/taxol but round 2 was easier than round one. I figure I have two more challenging weeks ahead of me following the next two doses then can move onto the last stage - radiation. It is a long road but getting there bit by bit.

Posted By: Guests
Date Posted: Mar 18 2016 at 11:32am

Hi Jacklin. How are you doing now? Im done with surgery yay! Next step is radiation. Recovering from double mastectomy and reconstruction is taking longer than I thought it would. But we can do this right?

Im looking forward to planting some flowers in my garden and going on picnics again. Im trying to see beyond cancer. I think Ive let it take over my life. When I look passed it its not as scarry. Its like a mountain pass I have to drive over to get to the next place.

Thank you all again for all the prayers and support.😁
Ginie

Posted By: Minigerkin
Date Posted: Mar 18 2016 at 12:11pm

Hi y'all,

Just finished my chemo on 1/28/16. Yay! But, I do have to agree, Taxol is very tiring. And, I just learned there will be a week (a couple of weeks after chemo completion), when our bodies will try to regain the strength it once had, and we'll experience nose bleeds, sinus issues, ringing in the ears, and muscle spasms. I had the daily nose bleeds and muscle spasms in my calves.

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Minigerkin

Posted By: Guests
Date Posted: Mar 18 2016 at 12:29pm

Hi minigerkin. I had my last taxol on feb29. Surgery on march 8. I found out some of my tired was an underlying problem my adrenal glands have almost stopped working so they put me on prednisone. It also made my blood pressure really low after surgery and nothing they tried worked. Finally after one of ladies here posted to me that she was praying for me. They discovered this problem. And im going again. Fighting one day at a time with all of you.😁

Posted By: Minigerkin
Date Posted: Mar 18 2016 at 12:43pm

Hey Ginie,

Good to hear from you! How is your recovery going? I keep you in my prayers. I'm so thankful the adrenal issues are under control! Stay strong! Hug

Minigerkin

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Minigerkin

Posted By: Guests
Date Posted: Mar 18 2016 at 12:51pm

Im trying to be patient!😵 its going ok. I just got to where i can walk on my own again. My blood pressure just came back to normal yesterday. My friends would lead me around. I would hold onto their shoulders and one day i started saying cha cha cha and we did a little kick like a sill dance hahahaha😁 is that chemo brain? Anyone. Maybe im just going nuts. But its better than being blue. I did that to and stiil do sometimes but i try to keep looking ahead beyond all of this. Planning to plant flowers this summer. Trying to picture this journey as a mountain pass we have to climb then there will be a beautiful view of whatever the future holds.
So keep climbing Girl Friends we are going to make it!

Posted By: Minigerkin
Date Posted: Mar 18 2016 at 1:09pm

I do agree, this is just a mountain, and it's a challenge for us to climb up and OVER! We are almost there! On Wednesday, it was almost 80 degrees here in Virginia and I began to feel sick. I had to go outside to breathe and I became nauseous, and legs so weak, my son had to help me indoors and lay me on the couch. Of course, laying on the couch was so frustrating that I began to cry and hating myself for being so weak. Then at the radiation appointment the next day, I tell the nurse and she thought it was a cardiac issue. It's not, I think it was a panic attack. Cry

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Minigerkin

Posted By: Guests
Date Posted: Mar 18 2016 at 1:39pm

Oh. Minigerkin. Im sending you big cyberhugs. Its ok to cry. Here is my shoulder cry it all out. You are not a weakling. You are stonger than you think or you wouldnt have even made it this far.Just let yourself cry and Im crying right here with you.
Then we will help each other one step at a time.

Posted By: Minigerkin
Date Posted: Mar 18 2016 at 2:00pm

I try to keep optimistic, but it's not an easy thing to do.... Thanks for the cyberhugs, they felt good! Yes, we'll definitely need to pump each other up, when we are feeling blue!

Hugs!

Minigerkin

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Minigerkin

Posted By: Jacklin
Date Posted: Mar 18 2016 at 3:48pm

Hi Ginie,

Thank you for asking how I'm doing. I'm doing well today, thank you. It's been a tough week, but through it all God's sustaining me and giving me strength to keep moving forward, taking 1 step at a time. I will hopefully finish chemo next week and have set a surgery date, BMX, for April 29. Sounds like you are a step ahead of me in terms of treatment. Know that I continue to lift you up in prayer each and every day.

Hugs,

Jackie

Posted By: Jacklin
Date Posted: Mar 18 2016 at 3:50pm

Dear Minigerkin, sorry to hear/read about your bad trip outside. Please feel my arms around you, giving you a big hug. Let your tears fall because I've got a tissue for you too and would love to wipe your eyes for you. I'm here for you, along with so many others. Just take a deep breath too, one breath in, one out. Take another deep breath. There, does that feel a bit better? I hope so. You're in my thoughts and prayers, just take things 1 step at a time, ok?

Hugs, hugs and more hugs,

Jacklin

Posted By: Minigerkin
Date Posted: Mar 18 2016 at 4:34pm

Jacklin,

Thank you so much for the support and the inspiration. I try so hard to be strong and the center core of my family (as I was before TNBC). It's tough to admit I can't do it all. I have on child still at home and it's been difficult for him to see me in this condition. It breaks my heart. I am so thankful to have you and others to help me up when I'm down.

Hugs! Minigerkin

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Minigerkin

Posted By: Guests
Date Posted: Mar 18 2016 at 4:49pm

Jacklin thank you. I got you covered in prayer too. Enjoy the weeks off between no more chemo and bmx. I wish I would have waited a liitle longer between it was only 8days. I just thought i just wanted to get it over with. My recovery might have been better if i waited.Ask who your anesthesia Dr. Is. I have a trial that any of us can do. Its a thoracic spinal tap. I felt no pain and they only used light anesthrsia so the recovery from that was better too. The study is about the effect anesthesia has on recurrence. Ask about it.
Keep smiling. Im here for ya sista.

Posted By: AmyL
Date Posted: Mar 19 2016 at 6:52pm

I'm praying daily for all of you ladies! Stay strong, focus on the positive things in your life. I find that my perspective on life has changed since my diagnosis. I cherish time with my family and conversations with my best friends. This week my daughter and son-in-law are coming home for Easter ( stationed in Texas in the Air Force), my other kids are on spring break and home all week and even though I will get A/C #3 on Monday, I'm only thinking about being surrounded by all my kids and being enveloped in their love and celebrating a blessed Easter! I wish the same for all of you!

Amy

Posted By: Guests
Date Posted: Mar 19 2016 at 7:58pm

Im looking forward to Easter too. My daughter is 18and my son is 23. Both still home with us. They have been so helpful and supportive. I know they need support too but i dont know how to help them. We have no extended family. We all have close friends though. My son has a longtime girl friend who he loves dearly and she has helped im sure.
We have always kept them informed of what the Drs. Have told us i even talked to my son about research. He ia a science guy. He gavenme a lecture about using my arms too much today. I lifted the milk out of the fridge and shouldnt have.😁 we both laughed when we realised he was parenting me for a change.
How have your loved ones handled this sisters?

Posted By: Jacklin
Date Posted: Mar 19 2016 at 8:39pm

Good evening everyone,

Thank you for your prayers and hugs, it means so much to me.

We have 4 children (ages 31, 27, 24, 23) and this Easter will be the first time in 15 years they're all home (I suspect it might have something to do with my illness) and I'm so excited about it. And, all 3 grandchildren will be here too, so it'll be a real time of celebration for us as a family. 3 of them live 6 hours away so I appreciate them all driving home. I'm praying that my last chemo, which will be on Thursday, will not interfere with our weekend together - knowing the way the ondansetron (steroid) works, I'll be wired higher than a kite anyways.

Our children have handled my illness relatively well. The oldest 2 are born from my heart and they've had the most difficult time with it because they lost their Mom to ovarian cancer when they were very young. The youngest 2, my biological children, have thanked me for our openness about what the dr's all say and both said it has helped them through this all because they knew exactly what was going on at all time. The youngest one is the one who has struggled the most, maybe because she's my baby-she's often come home (6 hour drive) to spend some time with me and it has helped her to see how Mom is/isn't functioning. She said she noticed that my fatigue levels are higher each time she comes home, no surprise.

I think my illness has hit my husband the hardest. For the 2nd time his wife has cancer and he's the caregiver. Just today he opened up about how hurt he is that his friends have not called him, they've bailed and he's feel very isolated. He's terrified of losing a second wife but knows that it's not his decision and we're both leaning on God through this all.

We're having all of my husband's family getting together on Good Friday for a family dinner (not at our home, I can't do it this time). Again, every single family member is coming and this is a first time ever that everyone will be there, all 49 of us! My parents are both dealing with late-stage Alzheimer's disease, so they don't know that I'm sick. I visited them today and it was tough because I'd love to share with them, but they were only there physically, I've lost them a long time ago; nasty illness.

I've babbled on long enough about my family. How are you families coping?

Know that I continue to lift you all up in prayer, each day. Blessed Easter to you all.

Jacklin

Posted By: Guests
Date Posted: Mar 20 2016 at 12:35am

I think it is the hardest for my husband as well. He works at a hospital and his co workers have been great but he isnt really friends with them. He has nobody but me and the kids.
Thanks for sharing with us Jacklin. I believe God will provide what they need. Thiss certainly has brought us closer together in our marriage so far.

Posted By: Jacklin
Date Posted: Mar 20 2016 at 12:40pm

So I have to ask, what can we do, as wives, to get better support for our husbands? As a woman, I am quite open and share with others quickly, but I sense that most men aren't as open and don't have as many friends. My hubby isn't open to seeing one of the social workers at the cancer centre, he feels he doesn't need it, but he is having troubles with the isolation.

Suggestions anyone?

Posted By: Guests
Date Posted: Mar 20 2016 at 12:57pm

I sometimes would see couples in the infusion room together. I was never so bold as to ask. But maybe we have identified a need that we can start to fulfill. Maybe see if your husband would be willing to help other men in the same situation. Helping others is the best way i know of to help yourself. It is kind of a sneaky wife trick i use after 26 years of marriage.😋
It didnt work this time with mine😏 but it might work with yours.

Posted By: Jacklin
Date Posted: Mar 20 2016 at 1:12pm

Thanks Gini, I'll see what I can do to facilitate that type of situation. Never thought of using the infusion room as a starting point.....hmmm, will check it out on Thursday for sure.

Hugs,

Jacklin

Posted By: Minigerkin
Date Posted: Mar 20 2016 at 5:49pm

Hi Y'all,

This is a stupid question, but I need your advice/suggestion/tips. At what point after your chemo treatments did you begin to pluck eyebrows and shave/wax legs and pits?

Thanks!

Minigerkin

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Minigerkin

Posted By: praying2016
Date Posted: Apr 26 2016 at 9:38am

Hi ALL

sorry about all of our tnbc dx... and sorry that we would meet in such circumstances.

I have question about PCR and recurrence, if you can help!

I am new here.. DX in decembre 2015, IRM showed some suspecious nodes, my MO beleives i had at least 3 affected nodes, started chemoherapy on 11dec, had surgery 15 march; report came back CPR.

my question is what is our rate of recurrence and what signs apart from imagery every three months.

when they say the rate of recurrence fall, by how much?

Thanks and prayers to all of us!

-------------
Dx 39
2 daughters 3 & 6
Ki67 70%
PCr
Dx 12/5/2015, IDC, Left, 4cm, Stage IIIA, Grade 3, 3/14 nodes, ER-/PR-, HER2-
Chemotherapy 12/13/2015
Surgery 3/15/2016 Lumpectomy
Radiation Therapy 5/15/2016

Posted By: Guests
Date Posted: Apr 26 2016 at 3:51pm

Hi. PCR means the chemo killed all of your cancer. It means that you will probably not have a recurrence. They still keep checking just in case. Congratulations this is very good news for you. The percentages of recurrence are not very accurate. Every site I checked quoted different percentage depending on what study they were doing. They all agreed on the fact that pcr most of the time means no recurrence.

Posted By: gordon15
Date Posted: Apr 26 2016 at 5:48pm

I agree, from everything I have read recurrence chances could be from 15-50% but a 100% PCR is great, I've been reading a lot about it and it says the cancer stem cells sometimes are still active, or resistant, and that's why it's not a PCR, or a partial response. They are trying to find in clinical trials to attack these.

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wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017

Posted By: Guests
Date Posted: Apr 26 2016 at 5:55pm

Thanks Gordon. Im glad for the reasearch since i didnt have pcr. I wander if xeloda attacks those stem cells?Im going to try it.

Posted By: gordon15
Date Posted: Apr 26 2016 at 6:05pm

My wife didn't have a 100% PCR with neoadjuvant chemo, it reduced it by 75%, she has(had?) metaplastic/squamous/ stage 3A (actually I think it's 3C, despite them saying the chemo killed it in the lymph nodes, to me, it was in at least 4 nodes, not sure if that's to make us just feel better)
Anyway, the oncologist said it's "possible" the cancer that became resistant in the 4.5cm tumor, reduced to 1.5 cm was the "metaplastic part"
But maybe that's the stem-cell part?
Since my wife is finished, for now with treatments, it's not good for me to bring up the issue (yet)of since they sent out the tissue after surgery and did genectic testing (6 genes, all neg for mutations) why can't they come to a determination on the part of the tumor that's resistant, is this metaplastic/squamous, or stem cell part? Of course, this is WAY beyond my pay-grade, and perhaps expecting doctors and researchers to be God.

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wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017

Posted By: Guests
Date Posted: Apr 26 2016 at 6:27pm

They will eventually. At least they are studying it now. Its hard to be patient though. Studies take so long and cost a lot takes time to find enough people who fit the criteria. The more rare it is the harder it is to study. Im wiling to paticipate in any study that can help them find answers. The ones about using our immune system to fight cancer are very encouraging. Because it wont matter what kind of cancer. They use a part of your tumor. Expose your own t cells too it and then put them back in your body. They kill the cancer they were exposed too. I was reading about it on ncbi.nlm.nih.gov last night.