The update I posted on Treatment

[Sheila]

Just wanted you to know the update I posted...you all give me strength and hope! Thank you....


Re: Scanxiety Confirmed, Progression Shown
A quick update and thank you for all your support and information...the Avastin is approved, and I will begin tomorrow, so far no other agent. My muga last Thursday showed a major drop of 15 points, and now below 50....dont know if it was because I had it 2 days after my 3 week herceptin, the combo of the Tykerb/Herceptin, or the mass of lymph nodes in my chest pressing on my pulmonary artery...now I have to see a cardiologist...I asked about surgery or radiation, and was told i could get a consult, but it was probably a no....and now with Avastin, the surgery would be a no.
Just wish they were adding a chemo in...this has been a very trying week as my Dad was life flighted to a major heart institute in Illinois Saturday after suffering a heart attack...he had angioplasty and is doing amazing....he is so worried about me which makes all of this even harder.....so, cardiologist appt this week, Avastin tomorrow at 7am in Chicago...get the kleenex, let the nosebleeds begin....trying to stay focused and positive.
__________________
"Be kinder than necessary, for everyone you meet

[Rich66]

Glad your Dad is hanging in there.

Will you be staying on the Herceptin?

Might be worth asking for Avastin weekly.:
http://her2support.org/vbulletin/showthread.php?p=221218#post221218

[StephN]

Dear Sheila -
Glad you are getting a consult with a rad onc. Hope they can do cyberkife and give you some relief. Find the top person in your area for this.

I was also wondering the frequency of your Avastin. Can they give a weekly dose?

With a drop in your Muga is the Herceptin off the table for now?

I know you are in Fight Like Hell mode!
{{{hugs}}}

[chrisy]

Sheila, I'd like to see some chemo component added in as well...maybe even your old friend Xeloda! I know you've been on and off that many times, but it worked really well and since it's been a while maybe it is worth checking out again. The cancer might have forgotten about that one.

I'll also keep my fingers crossed that maybe the rad onc will have some ideas.

You sure don't need the added stress of your dad's issues...but maybe you two can get a family discount. It does seem that there should be an explanation for the muga drop that is unrelated to the herceptin or even tykerb/herceptin together. There is a lot going on there that could have affected the results. Maybe you could get a retest, or an echo.

Hang in there, Sheila.

[Gerri]

Shelia,

I'm happy to hear that you got approval without having to jump through hoops. Sure hope Avastin works for you again.

So sorry to hear about your dad but glad he is doing okay. Sounds like you got your fighting spirit from him!

Fight on - we are all in your corner!

[Laurel]

Sheila,

Happy you got the Avastin approved easily this time and I sure pray it is mighty effective! Sorry about your pop, but I bet he is a fighter like his daughter, so no worries about him. You baby yourself, Girlfriend, you've earned the right to focus on you. How long do you think it will be until you know if the Avastin is doing the trick?

[Barbara H.]

Hi Sheila,
Sorry that you have had such a tough week. It's bad enough to have to give up Tykerb, but more concerning is your latest Muga score. I assume that you are taking CoQu10. Hopefully, you can get your score back up in the normal range. I think that T-DM1 might be an effective treatment in the future, but your muga score needs to improve. Please know my thoughts are with you. It's unbelievable to me that those nodes can be so resistant to all the therapy you have taken.
I am also sorry to hear about your Dad.
Thinking of you!!
Barbara H.

[lizm100]

Sheila-

since I'm not very knowledgeable in all the different treatments available (I know that many on this forum are all) all I have to offer is prayers and positive energy. Stay strong and keep positive thougths.

Sending (((hugs))) and a box of kleenex (as you stated you will need) your way. You are an amazing person.

Liz

[Mary Anne in TX]

Hi Sheila! I'm thinking as positive as these ol' brain cells have the power to think for you! When I got kicked out of the Neratinib Trial I went to a cardiologist and after some tests, he said I could take whatever chemo Dr. K suggested. He said I had a wiring problem that wouldn't be impacted by the chemo. I'm believing that you will get the ok to continue with whatever will zap those node mets to outer space and get you back to comfy and peaceful. Much love to one very amazing woman! ma

[Carolyns]

Hi Sheila,

Thank you for keeping us posted. You are always in my prayers.

Love, Hope, Peace, Carolyn

[karen z]

Sheila,
Thanks for your update and glad that the Avastin was approved quickly. Please keep us updated as you have your consult(s) and review all options. Very sorry to hear about your dad.

[Jackie07]

Sheila,

Thanks for the update. We will keep both your Dad and you in our thoughts and prayers.

[michka]

Sheila, I am happy you are able to start Avastin. I hope your nose will not bleed this time. Tell us how you feel. Hugs. Michka

[Chelee]

Shelia, I'm glad you didn't have to fight to get the Avastin. Although I do wonder why they aren't throwing something else in the mix as you said? Maybe they want you to see the Cardiologist first due to the drop in your muga?

I know it won't be easy with all you have going on...but when you get a chance I would go ahead and get that "consult". Even though I know what a pain it is...epecially with all you have to deal with right now. I think it would be a good idea...but I'm sure I don't have to tell you that of all ppl.

I'm so sorry to hear about your Dad. That's just too much...my heart really goes out to you. You will both be worried sick about each other, but it does sound like they took good care of him. I am glad he is doing ok under the circumstances. I sure wish you didn't have to deal with all this...but I do want you to know I will be keeping you & your Father in my thoughts & prayers.

Chelee

[Shobha]

Sheila,

Adding my prayers and positive thoughts for you! Avastin has worked well for a couple of my friends in my local support group. Wishing you the same great results.

hugs,
shobha

[chrisy]

Hi Sheila,

Hope your first Avastin went well and that it is a nasty shock to the cancer. Very nasty.

Call me if you need me to send you kleenex.

[MJo]

Interested in hearing more about your experience with Avastin. Last night in my support group a woman was talking about how excited her doctor is about Avastin's potential. Sorry you had added stress of your dad's illness. Isn't that the way life works sometimes! Go figure. Sending positive thoughts....

[WolverineFan]

Shelia,

I am so glad to hear that you were approved for Avastin. I'm also glad you are getting in to see a cardiologist this week, am terribly sorry to hear about your dad. I know this is such a stressful time for you, but stay focused and continue to fight strong as you always do. I am thankful your dad is doing well, and will keep both of you in my prayers.

[ElaineM]

I hope your Avastin treatment went well and it will be the thing the cancer can't fight. Have you considered co enzyme Q 10 to bring up your muga score? I also hope your Dad is doing well. Keep putting one foot in front of the other.

[Rich66]

Mol Cancer Ther. (http://javascript%3cb%3e%3c/b%3E:AL_get%28this,%20%27jour%27,%20%27Mol%20Cance r%20Ther.%27%29;) 2009 Jul;8(7):1867-77. Epub 2009 Jul 7.
Increased antitumor activity of bevacizumab in combination with hypoxia inducible factor-1 inhibition.

Rapisarda A (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Rapisarda%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Hollingshead M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Hollingshead%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Uranchimeg B (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Uranchimeg%20B%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Bonomi CA (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Bonomi%20CA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Borgel SD (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Borgel%20SD%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Carter JP (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Carter%20JP%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Gehrs B (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Gehrs%20B%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Raffeld M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Raffeld%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Kinders RJ (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Kinders%20RJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Parchment R (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Parchment%20R%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Anver MR (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Anver%20MR%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Shoemaker RH (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Shoemaker%20RH%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Melillo G (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Melillo%20G%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract).
SAIC-Frederick Inc, National Cancer Institue at Frederick, Frederick, MD 21702, USA.
Inhibition of hypoxia inducible factor-1 (HIF-1) is an attractive therapeutic strategy to target the tumor microenvironment. However, HIF-1 inhibitors may have limited activity as single agents and combination therapies may be required. We tested the hypothesis that HIF-1 inhibition in a hypoxic-stressed tumor microenvironment, which could be generated by administration of antiangiogenic agents, may result in a more pronounced therapeutic effect. The activity of bevacizumab, either alone or in combination with the HIF-1alpha inhibitor topotecan, was evaluated in U251-HRE xenografts. Tumor tissue was collected at the end of treatment and changes in tumor oxygenation, angiogenesis, proliferation, apoptosis, HIF-1alpha levels, HIF-1 target genes, and DNA damage were evaluated. Bevacizumab decreased microvessel-density and increased intratumor-hypoxia, but did not induce apoptosis. Moreover, bevacizumab alone caused a significant increase of HIF-1-dependent gene expression in tumor tissue. Addition of a low dose of daily topotecan to bevacizumab significantly inhibited tumor growth, relative to mice treated with topotecan or bevacizumab alone (P < 0.01). The addition of topotecan to bevacizumab was also associated with profound inhibition of HIF-1 transcriptional activity, significant inhibition of proliferation, and induction of apoptosis. Importantly, DNA damage induced by topotecan alone was not augmented by addition of bevacizumab, suggesting that increased cytotoxic activity did not account for the increased antitumor effects observed. These results strongly suggest that combination of anti-vascular endothelial growth factor antibodies with HIF-1 inhibitors is an attractive therapeutic strategy targeting in the hypoxic tumor microenvironment.


See if you can add Steph N's secret weapon, Milk thistle (http://her2support.org/vbulletin/showthread.php?p=218176#post218176)3.1.4. Flavonolignans
A flavonolignan is a compound containing a flavonol linked to
a lignan molecule. Silibinin is the major active constituent of sylimarin,
a mixture of flavonolignans isolated from Silybum marianum.
In a recent study, using athymic nude mice implanted with
human colorectal carcinom HT29 cells, it was found that oral
feeding of silibinin suppressed tumor cell growth [84]. Silibinin
inhibited tumor proliferation, reducing also microvessel density.
Silibinin administration was associated with a decrease of both the
nuclear localization and protein concentration of HIF-1a. The
mechanisms responsible for these effects are unknown.

[tricia keegan]

Keeping you in my prayers Sheila and good thoughts for your Dads recovery also. xx