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Question:
#1831
10/15/2002
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I was diagnosed with Breast Cancer August 30th & "just" had a Lumpectomy &
Sentinel Node Biopsy October 11th.The results came back Her2-Negative,Estrogen Receptor-Negative,Lymph Nodes-Negative.What type of treatment(s) do you think the Oncologist will recommend for me? I am a 38 year old women,and relatively overall healthy. |
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it will strongly depend on the tumor diameter, type of breast cancer, and its grade. you are young and we want you to die of old age... if the tumor is larger than 1cm the oncologist will probably recommend some form of adjuvant chemotherapy just to be sure that this disease doesn't revisit you hopefully ever again. Most commonly just 4 cycles. Get an appointment soon to discuss your options regarding this |
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Question:
#1832
10/13/2002
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I am a 42 year old female with stage IV breast cancer. It has also invaded the supraclavicle node, but all other tests, bone scans ect.. came back clear. My onc says that my cancer will not respond to chemo or tamoxifen and that radiation is the only option for the moment. Should I get another opinion. I am Canadian and stand in long line ups for any appointment. |
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yes, pursue another opinion. we are talking about your life here. Settling for one person's opinion isn't enough. Leave no stone unturned... |
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Question:
#1833
10/10/2002
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I finished chemotherapy the 17th of Sept. I am experiencing muscle, bone and joint pain. My Dr. said this could go on for months. It is disableling. Do you have any suggestions? I have tried all over the counter pain medications. I had a couple percocets left, that is the only thing that stops the pain. Please advise.
I start radiation treatment the 1st of November. |
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unfortunately, it is a common side effect from chemo-- joint and bone pain and yes i can go on for a long time. some patients report relief with moist hot packs; anti-inflammatory drugs that are over the counter, as well as staying off joints that hurt the most (ie, not standing in place for a long time). In time this will subside |
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Question:
#1834
10/06/2002
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My 55 year old wife has been diagnosed with a 2.1 cm invasive lobular tumor near the nipple via a biopsy. A second surgery removed more tissue, but some margins were within .1 mm. During the surgery lympth nodes were removed, they are negitive. We will consult with a radiation onocologist to determine what needs to be done with the breast but I gather it will be more surgery to get clean margins and/or a mastectomy.
My wife is to start six cycles of chemo (CAF) next week followed by tamoxifen. She has ER 90% positive receptors. I saw a recent JCI article on a study that said women in my wife's situation do not benefit from chemo but should have the tamoxifen.
Should she have chemo?
We live near Baltimore, should we visit John Hopkins? |
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Yes, DO visit Hopkins for answers about chemotherapy vs hormonal therapy. She is young and though nodes are negative (which is good news) she has stage II breast cancer. You can have her pathology re-reviewed too, which is part of our consultation automatically-- this will help in ensuring that she needs another surgery. It's good that she is hormone receptor positive too! Often times with node negative disease chemo isn't offered unless tumors are greater than 1.5 cms--- hers is 2.1 cms plus whatever margins may still be remaining though. So call 410-955-8964 ext 4071 and ask for a consultation about chemo. Let Judy (whose number this is) know that Lillie (that's me) referred you. She will help get your wife scheduled. Information is power-- we want both of you to be informed people and participate in the decision making about treatment... |
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Question:
#1835
10/06/2002
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My daughter has Invasive Ductal Carcinoma, poorly differentiated, High Grade.
Nottingham comined Histolgic Grade: lll.
Tumor size largest dimension" 2.2 cm.
Microcalcifications: present.
Lymphovascular invasion: present and extensive.
Additional Findings: Extensive Cancerization of Lobules and some associated High Grade Ductal Carcinoma in _ Situ.
The AJCC pathologic stage is T2, at least Nl a, MX.
Her tumor is HER 2 nu.
She is being given Chemotherapy
The medicine is Adriamycin and Cytoxin.
What do you think of her chances of survival, and is this the right chemo to use on her?
I have family that lives in Baltimore. Johns Hopkins Hospital is number one.
I thank you .
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No doubt you are worried for her... Consider first of all contacting Mothers Supporting Daughters with Breast Cancer (410-778-1982 or www.mothersdaughters.org) to get support for yourself as well a more education about this disease for you. They will match you with a mother volunteer who had a daughter with the same clinical profile. Adriamycin and Cytoxan are commonly used, along with one of the taxane drugs. If she hasn't seen someone with us at Hopkins you might consider having her get a second opinion since you have family here. Her clinical presentation is worrisome due to the angilymphatic invasion. I trust that her scans are negative. Feel free to call me at 410-614-2853 for help in getting her seen by a medical oncologist who specializes in breast cancer and women with this type of prognostic factors. Aggressive therapy, optimism, and lots of love are a poweful combination against this disease. It's clear that she has lots of love. Let's investigate the other areas to ensure the best outcome for her. |
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Question:
#1836
10/04/2002
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I am 41 yrs old and I have stage IIb breast cancer. I had a right mastectomy with axillary clearance on 12-9-02.The histopathology report confirmed infiltrating ductal carcinoma with 32 out of 49 lymph node positive for tumour. I am also estrogen receptor and progesterone receptor negative and the HER2gene is amplified. No metastasis to liver and lungs by CT Scan.I have a high risk for recurrence and would like to know what is the best chemotherapy regime to go on to have the best chance for cure. |
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What you are requesting really requires a personal medical oncology consultation. We'd be happy to provide that by calling having you call for an appointment at 410-955-8964, ext 4071. Glad that your scans are negative. Feel free to call so we can help you. |
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Question:
#1837
10/04/2002
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Age 50. Lumpectomy-stage 1 invasive DC ER+ 97%/PR+35%. premenopausal, sentinel node biopsy was all clear.CT/bone scans clear. 4 cycles AC.
after 2nd round SGPT 30 SGOT 33 Bil .3
after 3rd round SGPT 39 SGOT 31 Bil .2
before 4th round SGPT 61 SGOT 52 Bil .5
Is it chemo related, or do I have serious liver problems to explore??
Radiation starts next week on breast.
onc offered no info. |
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Could be either. Your doctor will probably want to take blood counts again in another 1-2 weeks to see if the levels drop back to normal. It is a bit unusual to see chemo do this but is possible. Ask when he/she plans to redo the blood work and then determine if you need an internal medicine consultation. Congrats on being done your chemo-- you are coming down to the finale for adjuvant treatment! great! |
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Question:
#1838
10/04/2002
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Should I get a second opinion whether i need chemo after my lumpectomy since my lump was 1.5cm, high grade, ER+, PR-,her2+, lymph nodes- ? I am confused whether chemo will be beneficial to me after all the current research that i have read. Is it poss that i can get an opinion from an oncologist at Hopkins? |
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You certainly can get an opinion from a Hopkins medical oncologist who specializes in breast cancer. Just call 410-955-8964 ext 4071. That's Judy Pitt. She will help arrange it. Even with negative lymph nodes, especially if a woman is premenopausal, usually chemotherapy regemin of some sort is recommended. Which drugs to choose and what course of treatment is important to determine and for you to feel confident in that choice. Depending on how positive the ER was may also play a factor of (of tamoxifen vs chemo or tamoxifen and chemo or just chemo or just tamoxifen!) Seeing an expert is a smart thing to do so go ahead and call. |
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Question:
#1839
09/27/2002
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I had a lumpectomy followed by radiation. My lump was found accidentially (4-5 mm) attached to the back wall of a 3.5 cm cyst. I was told the risks of chem were about the same as the benefits as i have a 4-8 % chance of recurrence. I am presently taking tomaxifen. Should I have take the Adjuvant chemo? I also stopped HRT sa Some cells were estrogen positive (less tha !0%). Should i re think my decision re adjuvant chemo? I had sentinel node biopsy that was negative for nodes as well. |
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The decision to take chemo or not to do so can be a tough one. The patient needs to weigh the pros and cons of it and decide personally their comfort level in not choosing to do so. Usually with very small invasive tumors that are less than 5mm chemo is not recommended unless there are other prognostic factors that are worrisome like vaascular invasion for example. Your gut will tell you which direction to go |
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Question:
#1840
09/24/2002
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I have been diagnosed with invasive lobular cancer of the left breast & mastectomy is planned. I am probably just now going through menopause (age 53)-so do not know where I would fall in categorizations of pre and post-menopause for the purposes of determining treatment outcomes. As such, I have found some recent research that shows tamoxifen alone to be as effective for post-menopausal women as chemo & tamoxifen combined- not apparently true for pre-menopausal women. Would a blood test to determine hormone levels put me in one category or the other -and, if I am found to be post-menopausal, what is your view on this research finding questioning the efficacy of chemo. Thank you. |
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If you have had a menstrual period in the last 12 months you would not be classified as post menopausal yet.a key factor for chemo though is the size of the tumor and whether or not lymph nodes are involved. you are a young woman, whether still having periods regularly or not, and depending on the hormone receptors, her2neu status, size of the tumor, grade of cells and other prognostic factors--- these would all weigh in regarding the need or recommendation for chemotherapy or not.Talk with your doctor about these factors listed above. |
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Question:
#1841
09/15/2002
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I AM TAKING DOXIL & TAXOTERE FOR MY CHEMOTHRRAPY. I HAVE ADVANCED BREAST CANCER.DO YOU THINK THIS IS A GOOD CHOICE. |
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Both of these drugs are powerful in killing breast cancer cells. There are also other chemotherapy agents that your doctor may also decide to try in the event that your tumor cells don't respond as well as they'd like to see. Don't give up hope. There are lots of treatment regimens. Hang in there, stay focused on your goals for the fugure, find something to laugh about everyday, and know that you are taking action against this disease to the best of your ability. Talk with your oncologist more regarding how he/she chose this treatment regimen for you too. It's important that the two of you function now as a team. Your inquiring about whether these drugs are a good choice tells me that you are concerned. Let your doctor know this concern too. scans and blood work will be done as a way to monitor their effectiveness |
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Question:
#1842
09/15/2002
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My mother is undergoing chemotherapy. She was told that her blood sugar is up to 500. She cannot be prescribed anything until Monday. In the meantime, can she do anything or take anything for this? |
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Your oncologist would have given her an emergency number to call in the event that urgent questions or medical issues arise over a weekend or during the night. Check with her regarding this and pursue medical help in this manner. 500 is too high to just sleep on it... |
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Question:
#1843
09/13/2002
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My mother had recently a breast surgery.and removed her left breast completly.
Her surgeon advises chemotherapy for her for 6 sessions every 3 weeks.after the first time she got bold and also feel a bad ache in her kyte.
all of her lab results items were positive,i mean that result after the surgery on her breast tissues for chemotherpay,i don't understand these items,,,i want just to know if it is good to be positive or negative results were good.(her doctor said this is good,,but as far as i know usually positive means bad in lab results..maybe her doctor wanted to encourage her)
again thank you a lot.
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If you click on the pathology icon on the home page of our website you can learn a great deal about what pathology results mean. www.hopkinsmedicine.org/breastcenter
Hormone receptors that are positive is considered a good thing. Lymph nodes that are positive for cancer are considered not to be good. Her2neu that is positive is considered to be a concerning finding. Read the section we have on this though as it will help you more and ask the doctor to explain in laymen's terms for you what each test result means. you need to be informed patient/family member so that you can be confident about her care. |
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Question:
#1844
09/13/2002
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My mother was diagonosed with breast cancer. She is currently taking chemotherapy. Recently, she has noticed severe leg and pelvic pain. Her oncologist cannot seem to find a reason for this. Is this a side effect of the chemotherapy? |
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sometimes. patient can complain of joint pain and bone pain as a side effect of chemo. If she is having problems eating some blood work might be done to ensure it isn't an electrolye imbalance ( low potassium levels for example can cause leg cramps and pain.) Talk with the doctor about ways to relieve the symptoms and celebrate the completion of each chemotherapy treatment she has under her belt. She will be done before you know it. |
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Question:
#1845
09/02/2002
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To whom it may concern: I have a 38 year old sister with stage III breast cancer. She just had her first chemotherapy treatment. Feeling so nauseated, we're finding it hard to find anything for her to eat and drink. Her doctor says she can't have any citrus type foods, bananas, or tomato(acid)type food. Is there a diet we can prepare with her or a special diet that she can follow? Thank you for your time. |
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Nausea is the primary side effect of many chemotherapy agents. In most cases, doctors will prescribe an anit-nausea drug like zofran or kytril that have proven quite effective in preventing and/or controlling this GI problem. So explore that option with the medical oncologist as well as offer clear liquids and full liquids until the symptoms subside. Smelling mint sometimes helps as well as sipping on cola syrup available over the counter from a pharmacy. Nausea, when it occurs, usually subsides on its own after 3 days. Do talk with the doctor about medication to be taken in advance of future treatments to help prevent this from happening as severely again. |
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Question:
#1846
08/16/2002
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How do I know if the chemotherapy I’m taking is working? |
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For women having neoadjuvant chemotherapy for the purpose of shrinking the breast tumor, breast imaging (mammography and ultrasound) can measure the before and after effects, with the hope that the tumor diameter is measurably smaller. For women having chemotherapy after surgery, and is receiving it as a safe guard and not because there is evidence of the disease having spread to other organs, it is harder to determine. Clinical trials that have been conducted on the specific chemotherapy agents you are taking are your best way to judging its effects and benefits to you. Medicine lacks a crystal ball, so faith is key. For women who have metastatic breast cancer, scans are done showing evidence of the disease in the bones, liver and /or lungs and additional scans are done once the patient has had several course of chemotherapy treatment to measure the effect it has had on these organ sites that showed evidence of cancer being present. |
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Question:
#1847
08/16/2002
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Why do some women get chemotherapy before their surgery and others afterward? |
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Chemotherapy given prior to surgery is referred to as neoadjuvant chemotherapy. It is designed to help shrink the breast cancer tumor in the breast to be smaller and in doing so make the surgery more manageable. Sometimes this is done for very large tumors; other times it is done for women who are desiring breast conservation surgery and presently their tumor compared to their breast volume makes it difficult to achieve. Also, depending on the nature of the patient’s course of therapy and the pathology findings, the patient may need additional chemotherapy after surgery as well. |
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Question:
#1848
08/16/2002
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Do all chemotherapy drugs cause you to lose your hair? |
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No, not all. Some do; some do not. Do not use this as your basis of deciding whether to take chemotherapy or not though. Your hair will grow back and be healthier than it ever has before. Review with your doctor the other possible side effects, and pros and cons of taking chemotherapy to make your decision about this treatment. |
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Question:
#1849
08/16/2002
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How does the doctor decide if you need chemotherapy or not? |
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First, let’s plan on the doctor discussing his/her recommendations with you and the two of you deciding what is the best plan of care for you. The doctor will use the staging information from pathology to help in making these decisions. The size of the tumor, whether lymph nodes were involved or not, specific prognostic factors like your hormone receptor status, Her2neu results, grade of the tumor cells and some other pathology findings serve as the base for determining this. Your general health, age, lifestyle, and other medical findings also influence these decisions. For example, two women could have the exact same pathology findings and be given different recommendations--- a healthy 31 year old with stage II b breast cancer would be advised to take a specific regimen of chemotherapy; a chronically ill elderly woman of 82 probably would not. |
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Question:
#1850
08/16/2002
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What is the difference between radiation and chemotherapy? Do you get one instead of the other? |
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Chemotherapy is systemic treatment, usually in the form of drugs that act to destroy cancer cells that may be anywhere in the body. Radiation is referred to as local treatment and is designed to radiate a specific part of the body, for example, radiation therapy after lumpectomy is a standard of care. |
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