~Mighty Oak's 2nd Ixempra Tomorrow & Update On Us~
 

Well, tomorrow is his second treatment and I cannot wait to see what the tumor markers represent. Besides the previous pain issues, not due to the Ixempra, things have been good for him. Although not the proper way to go about appetite control unless the last resort, he has taking 2mg of Decadron twice a day (no roid rage however~tehehe). This lasted only 2 weeks and was a choice made by him, not OncoMan, he will not continue this treatment unless direly needed again. His hunger is sometimes unsatiable, he has been awake and alive, pushing himself to the limits. I cried when he replied to me the other day, "I guess you know by now that I am doing pretty good on this treatment!" Yes My Sweet I did notice! So far no problems with hands and feet, nausea controlled, appetite controlled, pain controlled. This man is living right now, fully living again and I watch this in total amazement. Of course he has always continued to amaze me all along the way. I know he has had only one treatment so far but he and I are so full of hope and pray that this works the magic. It is somehow different this time, if that makes any sense. We are watching his blood work and we will give him Neulasta if needed. He had a small discharge or plug when he blew his nose and although no fever or other symptoms occurred we did get him on an antibiotic before something worse came about. This is just the second time he has had an antibiotic on this journey. Brain MRI was this last Monday and I will update when we find out the results. Please pray for a healthy brain, I feel everything else will work out with time.

Personally, I have been predisposed cleaning out my Mother-in-Laws house. It seems that each time I feel like I am experiencing the worst thing in life, something else is harder in a different way. I had to empty 74 years of her belongings without getting emotionally involved. How I did this I do not know, but I did stumble across little gifts along the way that she meant for me to come by in order to help. One of the most special things she left for me was her prized Amaretto Cheesecake Recipe that rivaled any pastry chefs....Mine now, along with the new cheesecake pans she left. The most precious things I found was a piece of paper that I saved, it had all the information about the Tykerb she was secretly trying to get for him as I worked on the same project. There were many other objects and prizes she strategically left but that would take a special post.

I am going to the house to get the last of the items and I will begin to mourn properly after I can focus better. Even as an Angel now I am still finding out beautiful and priceless ways of this woman. The Celebration of Life really allowed us to keep up with the family, the entire side of her family showed up. It is just Ed now, his family name will die with him unless there is a secret relative we do not know about. We do have plans on a family tree that I can pass down through the ages. All the pictures had smiles on each face and we were so happy to get some closure.

I have been so busy lately and do not mean to be distant but I have had to limit my log in time to 10 minutes at a time. I am still looking for work and really cannot wait to get started with Rose. We have several cancer survivor benefits and cookouts planned. Some friends are taking us out on the boat for a day far away from land and we have a plane ride scheduled with Ed's best friend in his new plane. Next weekend Ed and I will be spending the day in Newport, RI enjoying the nautical ambiance and seafood restaurants. A place we love to spend our summer days and although we cannot do the Cliffwalk or nature walks of the past, we will certainly share the most special things we can with one another.....time, laughter and love.

I love you all and missed spending the time I am used to spending here. Things are more settled now but I still have a million things to do and one of them is to stay in my jammins (pajamas in my talk) for two straight days and relax. And my back and neck are out of play again, go figure!!>>Believe51

PS: Ed and I have never had so many plans scheduled before, it is both weird and comforting. I do not know what this means but I am going with it without reservations. If the big guy cannot make it then we will reschedule, but life cannot ever be on hold anymore. We are once again rebelling against cancer, we are claiming our normalcy!!

found an old article abstract on the fact that megestrol acetate, a progestin like
 

drug used in many types of cancer against weight loss can have anti-cancer effects of its own against breast cancer. It is from 1991 and we may know more now about which breast cancer subtypes it may be appropriate for ie, ER+ vs ER-. PR+ vs PR- and have an inkling as to which it may be more or less likely to be beneficial for, have potential for worsening

My father took it effectively after weight loss from radiation therapy five years ago This past year they offered him the choice of it or a derivative of THC, the active ingredient in marijuana. He opted for it again. He was looking for a drug just to help him stop losing weight, help him regain weight, and have few side effects. Decadron has wide-ranging other effects, many of which he may not desire (osteoporosis, stomach ulcers, cataracts (if he takes them long enough) and some cancers have corticosteroid receptors and grow in response to decadron, prednisome and other "corticosteroids" (similar drugs) from my reading. Since he doesn't know if his
tumor is one of those, perhaps you might ask his oncologist if there might be a more specific drug for weight gain. Again there may be reasons that megestrol would be less safe for him (haven't checked out the literature as to whether it is safer in ER+PR+. vs other hormonal subtypes) but perhaps it would be more specific and less likely to result in side effects in the long run. Worth asking?

here is the abstract
 

Journal Article

A phase I/II study of high-dose megestrol acetate in the treatment of metastatic breast cancer

Howard L. Parnes2 , Jeffrey S. Abrams2, N. Simon Tchekmedyian1, Nancy Tait2 and Joseph Aisner2

(1) 1040 Elm Avenue, Suite 300, Long Beach, California, USA
(2) University of Maryland Cancer Center, University of Maryland Hospital, 22 S. Greene Street, 21201 Baltimore, Maryland, USA
Summary A dose-response relationship has been suggested for medroxyprogesterone acetate in the treatment of advanced breast cancer. To determine the tolerability and efficacy of increasing doses of megestrol acetate in the treatment of metastatic breast cancer, we conducted a phase I/II study among 57 patients. Three patients each received 480,800, and 1280 mg/d; 48 patients received 1600 mg/d. Of the 57 patients, 56 patients had had disease progression on prior hormone therapy, chemotherapy, or both. Twenty-seven patients had previously received standard-dose MA (160 mg/d). Among the 37 patients with measurable disease, high-dose megestrol acetate (HDMA) produced 6 (16%) complete responses (CRs) and 6 (16%) partial responses (PRs); 11 patients achieved stable disease (SD). HDMA resulted in improvement or stabilization in 12 of the 20 patients with evaluable, non-measurable disease. There were no responses among the 6 patients with liver metastases. Among the 27 patients who were previously treated with standard-dose MA, including 9 patients with primary treatment failure, HDMA resulted in 1 CR, 3 PRs, and 10 SD. Toxicities, which were mild and reversible, included fluid retention, hypertension, hyperglycemia, and mild congestive heart failure. Two patients had superficial phlebitis. The most profound side effect was weight gain which occurred in 43 patients (75%). This study suggests a dose-response relationship for MA in the treatment of advanced breast cancer. A randomized trial to determine the optimal dose is ongoing.
Key words breast cancer - hormone therapy - megestrol acetate - progestin therapy

Marie, I am happy to hear that Ed is doing well and eating. He must keep his strength up. It is great to hear that the two of you are getting some quality time together. It is those moments we share doing the things we enjoy that make it all worthwhile. I am sorry you have been left with the task of cleaning out you Mil's house. I know how hard that can be and it is a mixture of feelings. I am glad that you are nearing the end and will have time to go through the grieving process. Just remember that all those special moments are still in your heart and mind, and take comfort that she is at peace and painfree. I hope Ed makes out well with his seond treatment. God bless you both!

Thanks for the up-date, Marie. You've been on my mind alot lately. I read most of your post with a stupid little grin on my face. Such good news, and inspring. Hope you and Ed have wonderful times on your trips. Love, Bill

Will be with you in thoughts Marie for Ed's second treatment. Michka

You really lift my spirits high, Marie! I am filled with joy and hope reading about Ed and your fun filled schedule. May God bless you both with ever lasting happiness, peace and good health.

love,
shobha

Marie,

I read your posts all the time (though I am a habitual "lurker") and had to tell you how uplifting it is to read about how well Ed is doing. And good for you to make so many plans...I hope you get to do everything that you want to do! I like to make plans as if I am going to be here to participate in those fun times.

Well Marie you know I'm not really all that competitive, but I'll take Bill's stupid little grin and raise him tears streaming down my face! Not just the direction of Ed's well being, but also the little treasures your MIL angel is still finding ways to share.

Love you and Ed both to pieces,
Chris

Hi Marie, I haven't been around much lately due to family problems but just stopping by to send you hugs and hope all's well for Mighty oak:)

Marie,

Good, good, good----good vibrations! I've got it 'em for Ed's treatment. Enjoy all your plans!

Lovely post as always Marie! So very happy to hear Mighty Oak is living. This was a wonderful way to begin my day! Thanks, and God Bless!

Thanks for the update, Marie, and your ever-present positivity! My heart is warmed hearing of all the plans you and Ed have, and how hopeful you both feel these days. Keep up the good work!

Rebecca

believe 51--thought this might be of interest --in addition check out my post in your
 

previous update thread on appetite stimulation

hope this helps!
Unfortunately doesn't comment what percent were her2+

Ixabepilone Plus Bevacizumab Demonstrates Encouraging Activity Relative to Paclitaxel Plus Bevacizumab for Metastatic Breast Cancer: Presented at ASCO
[Doctor's Guide]
ORLANDO, Fla — June 5, 2009 — Ixabepilone plus bevacizumab given as a weekly or every-3-week schedule demonstrates encouraging activity relative to weekly paclitaxel plus bevacizumab in patients with metastatic breast cancer, researchers stated here at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO).
The overall safety profiles of the 3 phase 2 trial arms were similar, as well, said Hope Rugo, MD, University of California, San Francisco, San Francisco, California, on May 31.
The trial's primary objective was to evaluate objective response rates of ixabepilone/bevacizumab given weekly or every 3 weeks relative to paclitaxel/bevacizumab as first-line therapy for women with advanced breast cancer.
A total of 122 women (~59 years) with measurable disease and no prior chemotherapy for advanced breast cancer (locally advanced or metastatic) were included in the study.
They were randomised 3:3:2 to ixabepilone 16 mg/m2 IV (days 1, 8, and 15 then every 28 days)/bevacizumab 10 mg/kg IV (every 2 weeks); ixabepilone 40 mg/m2 IV (every 3 weeks)/bevacizumab 15 mg/kg IV (every 3 weeks); or paclitaxel 90 mg/m2 IV/bevacizumab 10 mg/kg IV every 2 weeks. Treatment was continued until disease progression or unacceptable toxicity.
Grade 3/4 neutropenia was reported in 11.1% of women in the weekly ixabepilone arm, 54.8% in the every-3-weekly ixabepilone arm, and in 21.9% of the paclitaxel-containing arm. Febrile neutropenia occurred rarely, at a 2.2% rate for the every-3-weekly ixabepilone/bevacizumab arm, and at 0.0% for the other 2 arms.
Overall response rates were 50% for weekly ixabepilone/bevacizumab, 71% for ixabepilone/bevacizumab every 3 weeks, and 56% for the paclitaxel/bevacizumab arm.
"Ixabepilone combined with bevacizumab as first-line therapy for patients with metastatic breast cancer given as a weekly or every-3-week schedule demonstrated encouraging activity relative to weekly paclitaxel and bevacizumab. Overall safety was similar between arms," Dr. Rugo concluded.

ASCO 2009: ABSTRACT #1029: Randomized phase II study of weekly versus every-3-week ixabepilone plus bevacizumab (ixa/bev) versus paclitaxel plus bev (pac/bev) as first-line therapy for metastatic breast cancer (MBC)
[American Society of Clinical Oncology]
Background: Pac/bev is superior to pac alone as first-line therapy for MBC. Ixa/bev has greater preclinical activity than pac/bev in human tumor models. The primary objective of this trial was to evaluate objective response rates (ORR) of ixa/bev given weekly or every 3 weeks relative to pac/bev as 1st line therapy for women with advanced breast cancer.
Methods: Women with measurable disease and no prior chemotherapy for advanced breast cancer (locally advanced or MBC) were randomized in a 3:3:2 ratio to Arm A (ixa 16 mg/m2 IV on days 1, 8 & 15 q28 days/ bev 10 mg/kg IV q 2 wks), Arm B (ixa 40 mg/m2 IV q3 wks / bev 15 mg/kg IV q 3 wks) or Arm C (pac 90 mg/m2 IV, schedule/bev as in Arm A). Treatment was continued until disease progression or unacceptable toxicity.
Results: Key efficacy and safety results from a pre-planned analysis of all randomized subjects after at least 24 weeks of follow-up are presented. Baseline characteristics were balanced between arms except for liver metastasis.
Conclusions: The combination of ixa/bev weekly or q 3 wks demonstrated encouraging clinical activity and safety comparable to 1st line pac/bev in E2100. Final PFS will be provided when data is mature. These results support ongoing clinical trials of ixa given weekly or q 3wk in 1st line MBC, and in combination with bev.

Marie,

Ed is in my prayers. And it seems as if he's tolerating the treatment well.

Joan

Marie,

Glad to hear from you. Let us know how the treatment went.

Amelia

Marie,

If he gains even near as much as I have on Decadron - weight gain will no longer be an issue - believe me. I am the total oppisite.

I always read your posts and keep an eye on how you are both doing. I will be watching as also have my second Ixempra treatment a week from this Thursday.

If I could perform magic I would pass on my weight to him gladly! But truly I just hope he continues to do well.

~Mighty Oak's 2nd Ixempra Tomorrow & Update On Us~
 

I am happy Ed is doing well and things are good at your house. Tell Ed to keep up the good work.

is there medical marijuana in RI? I used it during chemo and it made me hungry (growling stomach and all - it really worked - plus it made watching old TV shows very funny, some much needed comic relief for half an hour)

This man is very lucky to have you taking care of him.