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Question:
#1771
04/05/2003
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Q: |
i have a friend who is 62 just diagnosed with stage 2 possibly 3 breast cnacer her2...she is being treated with taxotere and herceptin...she has a very sore esophagus and chest pain...and cannot seem to eat very much..she has lost 10 lbs in the last week....what can we do |
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A: |
First it is good to hear the love and support she has around her. thanks for being there for her. Eating an actual "meal" is unrealistic now... small portions, frequently, is more comfortable to try to manage-- soft foods- nothing spicy. See if her doctor can prescribe something to help with oral ulcer irritation. there are several medications avaiable for this to try. Hot food may irritate her most, so stay with room temperature when feasible. If wieght loss persists her doctor needs to know it and may bring her in for IV hydration. |
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Question:
#1772
04/02/2003
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Q: |
How successful is chemotherapy is shrinking lobular breast cancer before
surgery? I had a large tumor(stage 11)
not attached to the bones or muscles and
I went to see three surgeons who all
recommended mastectomy. An oncologist I saw said she was more comortable with the surgery first instead of trying chemo because it was
lobular. I was very much hoping to avoid chemo and radiation. But after
surgery I was told the tumor was very
close to the skin and the surgeon recommended both. My surgery was a week
and half ago. Thank you in advance for
helping. |
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A: |
sometimes it shrinks it and sometimes it doesn't. it really varies from person to person quite a bit-- the only way to know for sure is to do it. If the tumor is a stage 2-- (between 2 cms and 5cms) you would have been looking at chemo really no matter what-- either before surgery or after surgery. Women can endure anything when we know it has a beginning and an finite end... though not a pleasant experience, it is very doable. consider it your way of helping ensure that you die of old age and not of this disease... |
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Question:
#1773
04/02/2003
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Q: |
I'm 39, had a lumpectomy in late 2002. Tumor was 1.6 cm, stage 1, grade 3, ER positive, Her2Neu positive. I've had 4 treatments of AC, with plans to do radiation and then tamoxifen for 5 years.
My oncologist has waivered on whether I need additional treatments of Taxol before I start radiation. He can find no studies that say this will help, but is leaving it up to me to decide. Can you justify the additional treatments of Taxol, or where can I find more information? |
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A: |
hhmm. sounds like you would benefit from a formal second opinion consultations regarding this. So seek out a breast center in your area that is part of a comprehensive cancer center so that you can get another opinion hopefully from a medical oncologist who specializes in breast cancer and has access to all the clinical trial information. There are many factors that go into making such decisions about who would benefit and would may not. so take the time to check it out formally. |
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Question:
#1774
04/02/2003
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Q: |
My Mother is 74 years old and in good health. She recently underwent a lumpectomy and node removel. 1 out of 20 nodes were postive. There was no vascular invasion. ER and PR positive. Herz negative intensity of 0. Tumor was 1.8 cm with ductal and lobular components. Nuclear grade II/III. All margins were clean. Her doctor recommended CMF but after her heart tests came back he said she could also choose AC or AC with taxol. The choice was left to her. What is the survival benefit of the AC treatments over the CMF in women over 60 years? Is CMF used at all for node positive cancers anymore? With one node positive should we use the more aggressive treatments? We will move on to HRT and radiation reatments after the chemo is complete. |
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A: |
Rather than the choice/decision being placed on you and your mom, take the time to get another formal consultation from another medical oncologist. AC is more commonly used than CMF today but it doesn't mean that CMF isn't effective. Decisions about taking any chemo agents need to be made with care and considerable discussion with the patient. so seek another opinion for more input. This will help in the final decision making so that you can determine with adequate medical direction and guidance what direction to take for drug choices and frequency. |
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Question:
#1775
03/14/2003
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Q: |
After chemotherapy for breast cacner, how can I manage the problem of amenorrhea? Is the HRT treatment suitable ? |
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A: |
once a woman has had breast cancer it is usually not recommended that she take HRT again. If the problem is menopausal symptoms then consider asking your doctor about what he recommends for control of hot flashes, night sweats and such. Rarely do women complain about their periods being gone, just the symptoms that accompany their absence. |
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Question:
#1776
03/14/2003
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Q: |
My wife recently was diagnosed with two different forms of breast cancer. The tumor size was miniscule but she had a mastectomy and is preparing for a 2nd mastectomy on the healthy breast due to a strong family history. She had no node involvement and her margins are clear. The oncologist wants to put her through Chemotherapy anyway. His rationale is that she is 93% cancer free and would be 96% cancer free after chemo. I don't think 3% is enough justification to go through the pain of chemotherapy. What is your opinion and aren't there drugs like Arimidex out there as forms of treatment that don't have the side effects that chemo has? |
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A: |
It is important to weigh the benefits with the risk/side effects/complications. some women will take chemo for a 1% gain; others want a number that is much larger. it is time to get a second opinion from another medical oncologist who specializes in breast cancer in order to make this decision with her input. |
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Question:
#1777
03/13/2003
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Q: |
i am a 33 year-old african american woman diagnosed with breast cancer in Nov 2002 i have had a masectomy and am now going through chemotherapy i am taking the act for my chemo i just want to know what caused black or purpelish spots to appear on my tongue i have had 3 treatments and only have one more my doctor has never seen this can you tell me what it is my blood work came back fine and he has no explaination of this i have a photo to send of needed. |
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A: |
This is a known side effect from chemotherapy though it rarely occurs. It is more common in African American women and it will go away but takes a while. Though frustrating to have, it isn't harmful. There are also some antibiotics that can cause similar unusal side effects like this. |
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Question:
#1778
03/10/2003
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Q: |
I am on CMF for a double mastectomy I had breast cancer 9 yrs ago and radiation, then the cancer returned in 2002 in the same breast almost in the same spot near the left nipple after doing another lumpectomy, I decided on the double mastectomy in 94 they also removed all the left arm lymph nodes and they were negative, this time they took six lymph nodes from the rt arm and they also were negative but becuz it came back and was i.i centimeters they wanted to do chemo cytoxan pill and mf injected 2 weeks on and 2 wks off, but in my second month I developed the flu and had terrible diarrhea for 3 days the dr gave me Levaquin for 10 days, but on the 4th day I could not breath without my left side making me collapse, so I entered the emergency ward and they found that I had many blood clots in my left and rt lung, but now here is my question to you I have the greenfield screen in my lower vena cava and that is what protected me, but after a ct of the stomach to see if it was working which it is and a Dopler ultrasound, of my legs which showed that no blood clots came from there they are very confused and have no answers to give me, except that I will be on coumaden for the rest of my life and that I must have chemo continued Mar 11 which is my start up date. My Husband thinks that the clots came from my treatments and not from anything else, I am now scared to continue my regular life as an aerobics instructor or for that matter to continue my great outlook when I am living without an answer to this problem. I am 55 years old and feel very old right now HELP and thank you for any input on this set back. |
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A: |
sorry you have had such a bad time... it is hard to say the cause of the clots-- could be from a variety of causes. bottom line is that you need to deal with it, no matter what the cause. Consider seeing a blood specialist for a second opinion so that you can talk through what your options and long term treatment may be. hang in there. |
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Question:
#1779
03/05/2003
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Q: |
I had a segmental mastectomy last week and anxillary node disection. The lump was 3 x 3.5 cm and one margin was not clear, it still showed dcis. I had 13/15 positive lymph nodes. ER/PR negative, HER-2 positive. They have classified this as stage III.
The surgeon wants to do a complete mastectomy now.
My question, since so many of the lymph nodes were positive, should I look at doing chemo first and then the mastectomy. Also, should I look at doing a double mastectomy even though the other breast is clear.
I'm not concerned about looks at this point. I want to survive. |
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A: |
of course you want to survive... it can be hard to think about anything else when in the throws of breast cancer treatment. Usually one form of treatment is completed befor proceeding on with the next so it is more common to finish the surgery and then proceed with chemo. Some scans will be done to evaluate lungs, liver and bone too which helps with the planning of chemo regimens. Depending on how dirty of a margin and how much breast tissue remains helps to determine if mastectomy is necessary or lumpectomy is achievable and can still give a good cosmetic outcome. The risk of cancer in the other breast needs to be discussed with your doctor-- the type of breast ancer it is, your age, how hard your breasts are to image in mammography influences whether bilateral mastectomy is something to seriously persue. Additionally, the need for reconstruction with mastectomy is usually delayed until after chemo and radiation when many nodes are involved. If recon is considered, then sometimes women will elect to do bil mastectomies if planning to do flap surgery since the abdominal tissue can only be harvested once. hope that helps. hang in there. |
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Question:
#1780
03/05/2003
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Q: |
I am currently in my third year of taking tamoxifen. I am premenopausal with regular periods. The breast cancer that I had was positive for both estrogen receptor and hur2 neu. I heard of a study that found that for survivors with my cancer history tamoxifen may not be indicated after 3 years of dosing and that it may infact encourage cancer growth if the tamoxifen is continued beyond 3 years. What information can you offer me about this as I want to discuss it with my doctor? Thank you. |
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A: |
I haven't heard anything regarding these specific findings. the standard of care is still tamoxifen for 5 years. check with the NCI for more information perhaps. |
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Question:
#1781
03/05/2003
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Q: |
My mother is 76 yrs old. She has been dianosed with Stage II breast cancer. 1 out of 20 nodes positive. There was no vascular invasion noted. She is ER and PR positive. Herz/neu (Herceptest) is negative staining intensity of 0. For chemo her doctor recommended either AC or CMF. He left the choice up to her but said he felt she would do better on CMF. What is your input on the two types of chemo for a women her age? Also, how bad are the side effects with CMF? Are there any other chemo treatments available which we should speak to the doctor about? He is also not recommending a bone scan unless she has any obvious pain. I want to do what is best to insure she will live for many years to come. |
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A: |
Depending on how healthy someone is in their 70s influences whether chemo is recommended as a consideration for treatment. The doctor can review with you the pros and cons of each chemo regimen. some women tolerate one better than another but it can be very patient specific and sometimes hard to predict.Most women usually report that cmf was a bit easier but took longer. Bone scans are sometimes done as routine in some institutions and in others it is dependent on whether nodes were involved or the size of the tumor. even when there are negative nodes the cancer can find its way elsewhere in the body and there is usually more concern of this risk when tumors are bigger than 2cms. talk with the doctor more.. consider a second opinion. she is blessed to have the love of her family which is definitely part of a successful treatment plan. |
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Question:
#1782
03/04/2003
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Q: |
what do you know about a trial drug called Paclitaxel for treating breast cancer |
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A: |
check with the cancer information service hotline at 1-800-4-CANCER. they can give you information about this. |
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Question:
#1783
03/03/2003
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Q: |
There seems to be a LOT OFCONTROVERSAY REGARDING CHEMOTHERAPY FOR STAGE ONE BREAST CANCER. dO YOU HAVE AN OPION ON THIS. |
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A: |
the controversy isn't so much over stage 1 but the diameter of the tumor within the stage 1 category. For tumors bigger than 1.5 cms then it is fairly common to recommend chemo, factoring in a few other factors such as age, other prognostic factors from pathology results, other medical conditions that patient has, etc. For tumors that are less than 1.5 cms there is more controversy--- sometimes it gest down to how much of a risk taker the patient is-- some patients want to doe everything no matter what-- others want to do the minimum; others ride the middle of the road. it is always valuable to get second opinions when there is difference of opinions what to do. |
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Question:
#1784
02/28/2003
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Q: |
My Mother just had a lumpectomy and a Sentinel Node biopsy. The doctor found the sentinel node at level I to be positive for metastasis so he performed a axillary node dissection and removed level I, II and III. The pathology report just came back. All other 19 nodes were negative for metastasis. Here tumor measured 1.8 cm. It was invasive mammary carcinoma with ductal and lobular components. Nuclear grade II/III. Ductal carcinoma in situ (DCIS) solid type with intermediate nuclear grade. There was no vascular invasion noted. She is ER and PR positive. Herz/neu (Herceptest) is negative staining intensity of 0. All margins were clear. The doctor put her at a early stage breast cancer stage II and recommended a "mild" chemo and Tamoxifin and sent us to a oncologist. My Mom is 76 years old. She has high blood pressure and bone pain from post polio. Otherwise she is in good health. We are scheduled to see the Oncologist next week but would like your input on the chemo. What is "mild" dose chemo? |
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A: |
not sure what mild chemo means either-- so ask him to be specific. perhaps drugs that are not as toxic to the heart is what he means? hard to say-- so be informed and ask him to explain. |
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Question:
#1785
02/28/2003
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Q: |
my 26 year old neice was just diagnosed with infiltrating ductal carcinoma in situ with lymphatic vessel infilitrate present, grade III. she was induced to have her baby early so that she could begin receiving chemo. she hasn't had any lymph node biopsies, no bone scans, no ct...nothing to determine degree of metastasis (if any). there's not even a pathology report back yet. how can they know that chemo is the first step? the tumor grew very quickly. isn't there something she could be taking or treatment she should be having while they're waiting to get all of her tests run? how aggressive should we be about pushing for them to start some kind of treatment immediately? thank you thank you thank you. she has two beautiful babies that need her to live.
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A: |
they determine the need for chemo based on tumor size for now. if large and growing fast then the mission is to shrink it down to a more reasonable size and make it more operable. Then later do the surgery. this form of chemo is called neoadjuvant chemo and is commonly given for young women because we worry that their disease is more aggressive. she will benefit from lots of love, prayers, help with her baby to give you more time to rest and be with family and help around the house to let her focus on getting well again. |
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Question:
#1786
02/28/2003
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Q: |
Hello. I am in the middle of chemotherapy. Lumpectomy 10/4/02, margins not clean, tumor sized at between 3 & 5cm. Pathologist was not able to give specific size due to extensive angiolymphatic invasion. er/pr/her2 all negative, 2 sentinel and one axillary node positive, out of 17 total. No extracapsular invasion, grade 3 tumor. I will be having mastectomy after chemo. My concern is this: I just started my second phase of chemo. I finished 4 AC. I went to the onc today for my 5th infusion and he stated he was going to start me on Taxol. I wanted to know what the difference was in the benefit of Taxol over Taxotere. I told him that I had read the latest study where Taxotere was administered after AC and it was found that Taxotere after Taxol povided a 50 greater response rate. I basically let him know that I really would like to have Taxotere and he agreed to it. I belong to an online support group and in reading one of the post, someone stated that Taxotere is given to women with positive receptors and that Taxol is given to women with negative receptors. Also, I am in first line treatment and I read that Taxotere is given as a second line treatment. Now I am wondering if I was wrong in desperately wanting and getting the Taxotere. Leave it to me to mess myself up! Can you give me your opinion? Will the taxotere work on negative receptors and lastly, what is the significance in it be given as a second line tx, versus a first line tx? Thank you. |
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A: |
there are a variety of clinical trials that utilize taxol and taxotere-- sister drugs to one another. Ask your doctor about enrolling you in one of these clinical trials. this way you will be confident that the treatment you are receiving is as good as standard if not better (which is the purpose of the clinical trial). don't rely on information posted by an online support group. Go straight to the doctor overseeing the clinical trials and review the documentation associated with that trial. you will then feel more confident about which drugs to be taking because you are part of a scientifcally proven trial that will be of benefit to you as well as others in the future. |
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Question:
#1787
02/28/2003
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Q: |
When is Taxotere used and why? Also, how frequently is normal for tumor markers to be drawn? My doctor does them only every 6 months. |
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A: |
taxotere is in the taxane family and is one of the numerous chemotherapy agents used for breast cancer. The decision to use it vs another chemo regimen is decided by a medical oncologist based on pathology informatin and prognostic factors learned from the surgery done to remove the cancer itself. tumor markers--- there isn't a set time frame really-- some doctors don't ever do them; others do them annually; some do them more frequently. there is no full proof test for looking at recurrence. that is the bottom line. there can be false positive results with tumor markers too which is why some doctors don't do them at all. |
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Question:
#1788
02/19/2003
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Q: |
What is the recommended time post neoadjuvant chemotherapy (6 cycles of CEF) for surgery? |
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A: |
usually about 2 weeks but can be as long as 4 depending on how quickly the patient's blood counts bounce back. |
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Question:
#1789
02/19/2003
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Q: |
I am a 45 yr old woman diagnosed with BC in Oct'02 (right breast). I chose to have a bilat mast, due to family history. My path read: a 1.1 cm moderately differentiated invasive duct carcinoma. Solid and cribriform intraductal carcinoma with intermediate nuclear grade is also present. Vascular channel invasion is seen. Tumor is er/pr receptor positive. It lacks Her-2/neu over expression and has a high proliferation index. My right sentinel node biopsy showed metastatic carcinoma in one of four lymph nodes. The full axillary dissection of 17 nodes were without evidence of metastatic carcinoma. Grade 1, Stage 2. I underwent 4 cycles of A/C chemo (completed on Jan 23) and will soon begin Tamoxifin for 5 years. Would you agree that my chemo treatment was the correct one for me? Why do some women have A/C and then taxotere? Not that I want any more chemo, I just want to be sure I got enough. Also, is Vascular Channel Invasion the same as Angilymphatic? Thank you. |
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A: |
vascular channel invasion is the same as angiolymphatic invasion. yes. Te drug choices very from oncologist to oncologist. Often times there is no magic formula but a choice of several different ones to choose from. You may want to consider a second formal consultation with a medical oncologist who specializes in breast cancer to discuss taxotere. it is not uncommon for this drug to be recommended when there is nodal involvement but not always. each patient's situation needs to be "weighed in" to determine this. |
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Question:
#1790
02/14/2003
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Q: |
What is recommended time post mastetomy surgery to begin chemo? How strict is this timeframe as suggested by data? |
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A: |
it actually varies though on average 4 weeks post op. some start as early as 3 weeks and some as late as 10 weeks. 4 is a good window of time to allow the wound to heal which is important since your white blood count may go down from chemo effecting healing to some degree and making patients more prone to infection risks |
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Question:
#1791
02/11/2003
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Q: |
I am 45 and premenopausal. In August of 2002, I had a lumpectomy for infiltrating DCIS in my left breast. The tumor was .3 cm, ER+, PR+, Her2Neu1+ amplification ratio of 1.18. My follow-up treatment was tamoxifen and six weeks of radiation. In January of 2003, a follow-up mammogram found a second primary site in the right breast. I chose to have a double mastectomy followed by reconstruction. The DCIS tumor in the right breast measured 1.6. The sentinel node tests for both surgeries were negative (thankfully!) However, after the mastectomy surgery, I developed a blood clot in my right arm so my oncologist took me off tamoxifen. I am currently on coumaden. My oncologist works with a team of several other oncologists. They have presented some varying options as to what my future treatment should include. One feels that oophorectomy would be as effective as taking chemo. Others say 4 cycles of chemo (CA) is the way to go. Still another says I should do the chemo in addition to the oophorectomy. I know my prognosis is excellent; however, I would like another opinion as to which course you would recommend. |
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A: |
hhmm. Seek out a medical oncologist who specializes in breast cancer. There are many factors to consider in making this decision and you need to be physically seen, medical records reviewed, even you pathology verified for accuracy and your prognostic factors and medical history evaluated to make a good recommendation for you about this. it is rare to do removal of ovaries unless there are additional circumstances like a family history of breast and ovarian in your family.you mentioned the DCIS tumor was 1.6 cms. DCIS doesn't require chemo at all as it is noninvasive disease. sounds like maybe you are talkingabout having had both DCIS and infiltrating ductal maybe? in any case, these are big decisions to make,sos schedule an appointment with a third doctor-- a medical oncologist who specializes just in breast cancer.. not a general oncologist. |
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Question:
#1792
02/11/2003
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Q: |
4-00 found lump in right breast. gyn did biopsy - lab report benign. scar on breast began to grow. l2-02 another biopsy, was malignant but mamograms compared and showed not changed much. I had mastectomy on 1/6/03. i got second opinions from md.anderson, houston on both pathology reports. the one in 00 in error. also the one in 02 differed from the one at local hospital. locally they called it a stage 2, microamount in sentinal lymph node. m.d.anderson says stage 1 none in lymph nodes. the oncologist here recommened 4 chemo of adriamycin & cytoxan - 5 yrs of tamoxifen and perhaps radiation because the cancer grew to the top of the skin. surgeon says all is removed and oncologist recommending chemo but says only 10% chance will return. would you recommend chemo? |
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A: |
Gee, you really owe it to yourself to get a formal medical oncology consultation. this isn't the kind of thing that can be determined in an email for sure.. going to another comprehensive cancer center as a tie breaker is in order. you are dealing with a serious disease that apparently had some time to progress based on delay in definitive diagnosis. your age and prognostic factors of your pathology will weigh heavy too on what is the best course of action for you regarding additional treatment. so take the time to see a medical oncologist and radiation oncologist elsewhere who specializes in breast cancer. |
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Question:
#1793
02/11/2003
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Q: |
I am looking for a study for a patient who has had a mastectomy. 19 nodes out of 27 tested positive. All negative receptors. Would any of the studies John Hopkins offer benefit this patient? |
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A: |
I assume you are referring to clinical trials for women with large volume of positive nodes. There are many clinical trials for patients-- other prognostic factors also play a role in selection criteria though. for a list of clinical trials that may apply, call 800-4-CANCER |
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Question:
#1794
02/04/2003
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Q: |
I was diagnosed with stage 1 invasive ductal carcinoma at the age of 36. It is hormone positive and hur2 negative. There were no lymph nodes involved. I am undergoing 33 radiation treatments an then tamoxifin for 5 years. Two different doctors said that chemo was not my best choice but was wondering if that was the right choice. I had a lumpectomy and the size of the tumor was 10mm with clear margins. Thanks! |
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A: |
your tumor is right on the border of "yes chemo/no chemo". you are young though.. some doctors would say do everything based on your age; others would say that based on tumor size and positive prognostic factors (like ER positive and her2 neu negative) that hormonal therapy is sufficient. Go to a medical oncologist who sees and treats lots of young women like yourself and get a second opinion. Sometimes women base the decision too on how much of a worrier they are-- worriers will want to do everything possible to prevent revisiting this disease again; those who worry less will usually opt to do less treatment not seeing the measurable benefit. |
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Question:
#1795
02/04/2003
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Q: |
59 years old. Had mastectomy, right breast,6 foci tumor, largest 1.5cm. ER negative, Her2 positive overexpression; one node positive at a .2cm microscopic level.Question is chemo. One oncologist recommends AC and Taxol; another AC and taxetere; a third AC, Taxetere and herceptin. Is it true that taxetere is more toxic but offers no more survival than taxol? Is there more risk than advantage in taking herceptin? Have post treatment one day after chemo with IV hydration shown to lessen side effects? |
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A: |
hhhmm. I'm afraid this really requires a formal consultation with a medical oncologist to answer the question. what you have decribed though are several clinical trial options available to you. As clinical trials, the objective is to provide you at a minimum standard of treatment and possibly treatment that might be even better than standard but we don't know that yet-- thus this is part of the research to figure it out.some patients do better with taxol; others with taxotere-- no good way to know ahead of time.. keeping yourself well hydrated as well as talking with your oncologist about the prophylactic use of anti-nausea drugs would be a good thing to do before getting started. Not all women get sick-- many work during chemo, just taking the day of and the day after off. Consider joining a support group too or asking the doctor to match you with a patient who has recently completed the same treatment regimen that you will be selecting so you have a "partner" to talk with as you continue this journey.. |
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Question:
#1796
01/31/2003
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Q: |
I have completed 5 rounds of chemo so are for early breast cancer. I have had a sinus infection for the past week and a half. My dr cancelled chemo last Friday and this past Monday because of the infection. He also put me on a different antibiotic. I am scheduled for chemo this friday, but im still congested in the nose and chest and still dont feel well. My question is, how long can I put off this last dose of chemo??
thank you. |
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A: |
Don't worry about the delay. your safety is important-- you need to be infection free if at all possible before proceeding with chemo which will drop your white blood count that is needed for fighting infections. Don't focus on the delay... you are doing the right thing in waiting. |
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Question:
#1797
01/30/2003
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Q: |
YOur site looks like just what I've been searching for. My mother, 65, was diag. last Dec 2002 with Breast Cancer. She did not do self exams, after needle biopsy was told it was invasive ductal cancer, and appeared to be around 2.0cm. Her mammogram was neg. She elected to have a modified masectomy Jan 03, 2003. Now she's deciding about chemo. My understanding is pathology was pos. invasive ductal cancer, 6 of 6 lymph nodes neg. (good thing), but the cancer was encapsulated with pre-cancer in-situ. Actual cancer measured 2.1 cm, estrogen neg receptor, and "very high Her2/nu positive", lymphatic invasion present, staged grade 2. Moms, type 2 diabetic, minor heart problems. Though the nodes were neg..all I'm reading doesn't give her a great prognosis. Her HMO doctors, keep passing the "buck" of information to the next doctor, and we can't get a clear answer. Are her results as bad as they sound? We were told that if she was est. + success rate was in excess of 60%, but since she's neg. it drops to 5-15%. Those aren't encouraging. She's described as borderline high risk for mestasis...with all this should we consider the agressive chemo? or stick with the less aggressive/ but longer treatment? thankyou for your time and consideration to my question.... |
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A: |
She is fortunate to have a loving daughter looking out for her. She'd benefit from getting several opinions from medical oncologists who specialize in breast cancer before a final decision is made. There is risk of the disease possibly being elsewhere based angiolymphatic invasion. The stats quotes of 15% sounds very low based on the stage being a stage 2 and no negative... hhhmm. all the more reason to pursue other formal medical oncology consultations. If she is other wise healthy (heart and lungs) she hopefully will do well with chemo. there are some tests that are done to help assess her heart status (MUGA test) which will be useful prior to starting treatment. Part of her additional treatment has already begun- receiving lots of love from her family. We can never underestimate the benefit of this... |
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Question:
#1798
01/29/2003
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Q: |
I'm 62 year old female. Diagnosed with lobular breast cancer in 1993. Received a mastectomy followed by 6 months of CMF chemo. Also took tamoxifen, but had to discontinue at the end of 2 years because of highly elevated liver enzymes. Have had good checkups in the intervening years until this month. Now I have infiltrating ductal CA in the remaining breast. My question: will my chemo be prescribed as if I am a brand new patient or will my prior history and chemo regimen automatically exclude me from some drugs? What about other hormone therapies--do they also have the tendency to affect the liver? |
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A: |
A decade has passed.... sorry that the dog returned to bite you again. Some chemo drugs can be given again; others they avoid repeating. The good news is that there are now more chemo drug choices than there were in 1993. There are other hormonal therapies too other than tamoxifen that might be considered and be kinder to your liver. Wait and see what your full pathology shows you after your surgery and your medical oncologist can then put together a game plan to keep you well and cancer free going forward. |
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Question:
#1799
01/23/2003
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Q: |
My 43 year old fiance was diagnosed with stage 1 grade 2 breast cancer, er-Kip67,(tumor size .9cm)There are differing opinions on the chemo regime. One doctor recommend TAC two others recommend CMF. What is your opinion. Thank you. |
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A: |
You may be well served getting a third formal opinion. Both are common chemotherapy options offered. The recommendation may be based on the oncologist's personal experience and access to clinical trials too. Your tumor is small and nonaggressive. god for you! |
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Question:
#1800
01/22/2003
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Q: |
I am 37 newly diagnosed with multifocal invasive ductal carcinoma. Tumor was 2cm; ER,PR positive and HER2 negative. No nodes tested yet. Am waiting to see a surgeon regarding mastectomy.I have seen 2 oncologists who both recommend chemo. One recommended 6 courses of FAC (no taxol or taxetere due to possibility of permanent neuropathy like side effects). He also said to never let anyone give me a bolus of Adriamycin (should infuse over 72hrs) as the bolus will cause permanent heart damage. Do you infuse it over 72hrs as well? I am thinking about coming there for treatment, but doesn't seem realistic as i live in the Dallas/Fort Worth area and have children in school.Also, if i came there, how long of a treatment time would i be looking at? Would i need to stay there in the area, or fly back and forth every month for treatment.Do you have oncologists in this area that would work with you to follow me here in case of any problems if i came home in between treatments? Thank you! |
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A: |
hhmm. we would not be infusing over 72 hours... you would be recieving it IV over a couple of hours and then go home. We recommend that women having chemo receive their chemo within a 1 hour radius to where they live-- this is for a variety of reasons including maintaining your family life, being near home in the event of an emergency, having doctors close by who know you well and can follow you easily long term. DO consider getting a second opinion though locally at a large cancer center in your area. Be seen by a medical oncologist who specializes just in breast cancer. Muga tests are usually given prior to administering adriamycin and serve as a good barameter for letting the doctors know if a patient may be at risk of heart toxicity from this drug. take care dear. |
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