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JessicaV · 04-01-2015, 06:22 AM

Hi, When I saw my surgeon, he offered me neoadjuvant chemo. He told me that Neoadjuvant chemo can be done to shrink the tumour enough to make surgery easier, even just to shrink it enough to allow you to have the option of a lumpectomy instead of a mastectomy. So I don't think they expect neoajuvant chemo to make the tumour go away completely, though it is good if that happens. (That is called a complete pathological response.) A lot of women still have to have a lump removed, though one woman I spoke to said the lump kept getting smaller and smaller as they prepared her for surgery. It is still a good result and a sign that the chemo is hitting also any other tiny growths that may be there, too small perhaps to measure.

But I think to get proper answers, you really need to speak to your wife's oncologist, and should be able to go with her if she is happy for you to do so. Or maybe she could ask these questions at her next appointment even if you cannot come with her.

I don't know about how long it takes for primary breast cancer lumps to shrink but a friend with a dozen metastatic cancers the size of a golfball had them shrink about 30% in the first 3 months. Then they were the same size for the following test 3 months later. Then another 3 months later, they were all gone except for one 0.5cm lump. Three months later again, i.e. 12 months after she started treatment, they had all gone completely. For the first six months she had weekly treatment with paclitaxel and herceptin. Then she was put onto every 3 weeks.

This is a totally different situation i.e. secondary cancer not primary cancer, and different chemo.But it may give you an idea of how herceptin-based treatment can work. These HER2+ tumours naturally grow very fast. If the chemo stops them growing, or slows their growth, it is working to some degree. I do not think she or you would necessarily feel the difference in size if they had shrunk by a quarter or so, so would not be to disheartened.

I wish you both well, and hope the scan shows some good results. Oh, I forgot to mention, these chemo drugs are very toxic, and headaches are common. Drinking heaps of fluids and getting a daily walk in helps a bit, I was told to take panadol for mine, your oncologist may have other advice.

04-01-2015, 06:22 AM	#3
JessicaV Senior Member Join Date: Apr 2014 Posts: 206	Re: Question re chemo working Hi, When I saw my surgeon, he offered me neoadjuvant chemo. He told me that Neoadjuvant chemo can be done to shrink the tumour enough to make surgery easier, even just to shrink it enough to allow you to have the option of a lumpectomy instead of a mastectomy. So I don't think they expect neoajuvant chemo to make the tumour go away completely, though it is good if that happens. (That is called a complete pathological response.) A lot of women still have to have a lump removed, though one woman I spoke to said the lump kept getting smaller and smaller as they prepared her for surgery. It is still a good result and a sign that the chemo is hitting also any other tiny growths that may be there, too small perhaps to measure. But I think to get proper answers, you really need to speak to your wife's oncologist, and should be able to go with her if she is happy for you to do so. Or maybe she could ask these questions at her next appointment even if you cannot come with her. I don't know about how long it takes for primary breast cancer lumps to shrink but a friend with a dozen metastatic cancers the size of a golfball had them shrink about 30% in the first 3 months. Then they were the same size for the following test 3 months later. Then another 3 months later, they were all gone except for one 0.5cm lump. Three months later again, i.e. 12 months after she started treatment, they had all gone completely. For the first six months she had weekly treatment with paclitaxel and herceptin. Then she was put onto every 3 weeks. This is a totally different situation i.e. secondary cancer not primary cancer, and different chemo.But it may give you an idea of how herceptin-based treatment can work. These HER2+ tumours naturally grow very fast. If the chemo stops them growing, or slows their growth, it is working to some degree. I do not think she or you would necessarily feel the difference in size if they had shrunk by a quarter or so, so would not be to disheartened. I wish you both well, and hope the scan shows some good results. Oh, I forgot to mention, these chemo drugs are very toxic, and headaches are common. Drinking heaps of fluids and getting a daily walk in helps a bit, I was told to take panadol for mine, your oncologist may have other advice. __________________ 1997-2004 many cysts, many MG & U/S: polycystic breasts. Sept 2013 found lump,Cyst?? forgot lump. Dec 2013 GP check, Referred for U/S, MG,FNA. 7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail." Cancelled my psych clients for the week. 8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon. Cancelled my psych clients for the month. 13 Jan 14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan, 16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done. 19 Jan 14 discharged home with 1 drain. 22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment. 26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans. 30 Jan 14 HER2+ high amplification, 13 gene copies per cell. 21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up. Cancelled my psych clients for 6 months. Feb 14 First MUGA test: 71%, First C15.3 test: 20 7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and Claritin, reflux/indigestion helped by Somac. July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily. Sept 14 Second MUGA test: 69% Cancelled my psych clients for 2014 Dec 14 Third MUGA test: 70% Second C15.3 test : 20 Cognitive fatigue delays return to work. March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring. July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing Aug 2015 Heart good, no evidence of cancer, just Fatigue. May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets. Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.