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Old 06-04-2007, 01:11 AM   #1
supermehra
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Location: New Delhi, India
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Thumbs down Liver & Sternum mets after FAC, Herceptin, Xeloda, Tykerb

Hi,

This is on behalf of my mom:

HER2+++ er/pr-
Rt. Breast Primary 2001 Oct.
Surgery followed by FAC
Mets to Sternum 2004
Treated with Taxol, Herceptin (6 months only) + Rad
Single Brain Met 3cm June 2006
Treated with Gamma Knife (didn't work)
Then surgery Apr 2007 with great success
Started Tykerb 3 weeks ago + Xeloda (500mg x 6) 2 weeks ago

PET Scan last week now shows multiple Liver mets & large lesion on the Sternum has grown back (this is the site of original met). Brain is all clear!

I have been reading the posts and people have talked about Zometa, Taxatere even Xeloda for Liver... any advice?

Have people had success with surgical removal from Liver - particularly when there are multiple mets?

Hanv't met the ONC he's at a conference in London, back in a couple of days... we are out in India.


Any help appreciated....

Thanks,
Suman
(that's mom's name, mine is Sachin)
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Old 06-04-2007, 06:38 PM   #2
anne2
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Here are few other meds that I have heard might help:

Zometa- for bone mets
Avastin and Xeloda trial
Carboplatin and Taxotere (I think)
Sounds like your onc is pretty progressive so I am sure he will put your mom of something helpful.
Take care,
Anne
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Old 06-06-2007, 06:17 AM   #3
supermehra
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Location: New Delhi, India
Posts: 22
And Liver mets?

Anne, thanks for this. Question on liver mets - Avastin & Xeloda trials is for liver?

Anyone know what the stadard treatment course for liver is?

Thanks,
Sachin
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Old 06-06-2007, 10:34 AM   #4
Adriana Mangus
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Location: California
Posts: 668
Liver resection

Dear Sachin:

It is possible to have a piece of the liver removed, I just had an appointment with onc yesterday and he mentioned that surgery is posible in most cases, and the rate of success is high -90%.. I have mets to sternum as well, since 2003, have been on Navelbine, then Xeloda-did not work-now I am back on navelbine. Just three weeks on Navelbine, reading went down..I wouldn't worry to much about liver, there are a lot of treatment available. Read some of the postings, a lot of our "sisters" are doing well after mets to liver.

Sending you positive vibes and BIG hug to your Mom.

Thank you for being such a good daughter, we really appreciate all the help we can receive, specially from our daughters...
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 06-06-2007, 11:14 AM   #5
Adriana Mangus
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Join Date: May 2006
Location: California
Posts: 668
Question

Sachin: Did your mom had radiation to the sternum following conventional treatment for bc.?
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 07-13-2007, 08:03 AM   #6
Rupali
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Posts: 148
Bringing this back to the top.
Ladies, please advice what is the best route to take for liver mets.
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Old 07-13-2007, 11:31 AM   #7
StephN
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Location: Misty woods of WA State
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Sachin -
Hope your Mom is on a treatment by now, as we did not hear back from you.

Resection of liver depends on numerous factors. In my case it was not possible to consider as there were too many tumors (like swiss cheese or buckshot) plus two quite large ones. Even when most of the tumors were no longer visible, the last stubborn ones were at the main hepatic vein and surgeon felt that since I was responding to the chemo that it was better to keep trying with that route.

The drugs that worked for me were a combination on clinical trial of Taxol, Navelbine and Herceptin. It took 27 weekly treatments to put me into remission and NED.

I also changed my diet to be easy on my liver and drank detox teas.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 07-13-2007, 12:36 PM   #8
Esther
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Give the treatment some time. Xeloda has generally been good in treating liver mets, and if she is a responder to the Tykerb, this may be a winning combination for her.
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Old 07-13-2007, 07:40 PM   #9
supermehra
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Adriana,

Yes, Mom had 21 days of radiotherapy for the sternum. It had cleared up and was clean for some time - 2 yrs. It seems to react well on chemo. After 3 cycles of Xeloda+Tykerb she is now free of chest pain - so perhaps its working!

THanks
Sachin
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Old 07-13-2007, 07:54 PM   #10
supermehra
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Location: New Delhi, India
Posts: 22
Thanks all. The update is like this:

1. Tykerb now nearing 3 months; Xeloda 3 cycles complete
2. The therapy is 21 day per cycle where she has 2 weeks xeloda and then one week break; tykerb continues uninterrupted.
3. Overall she is much better - moving around and looking happier... very concerned, but happy that she has her freedom back... the brain met had put her in bed for a year.
4. Sternum pain has subsided - scan due end of the month, hoping it will be clear.
5. Liver mets were small - 4 in total with largest around 4mm. Has inflicted both lobes and probably few more that we cannot see yet on the PET. With any luck xeloda+tykerb may work magic

Have a few other questions:
1. What blood tests can one perform as an early warning or monitoring in our case? Onc here has not asked us to do any and 3 months between scans is too long?

2. If xeloda+tykerb work on the sternum, any thoughts on adding (or NOT) other bone met durgs?

3. Havn't seen anyone talk about remedy for xeloda side-effects... is there any natural/herbal stuff that helps even a tad?

Thanks again for all your support.
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