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Old 04-24-2008, 06:17 PM   #1
Ruth
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Unhappy Friend in need...questions

One of my mom's friends from way back (they were Girl Scout leaders together) was diagnosed with BC approx 3 years ago. It was a large tumor and several lymphnodes involved. She went through treatment and radiation and seemed OK until now. I am confused a little bit and seem to be in touch with how this all goes but this really confuses me. This wonderful lady went to Myrtle Beach a few weeks ago and had a blast. Everything seemed fine until she got home and became very, very tired. She thought it was related possibly to the pollen count that is so high here in Georgia. Mom told her that after it rained and she still didn't feel good that she needed to go see her Dr. right away. It sounds nutty about the rain but it usually works. Well, it rained soon after she came home and she still felt horrible. She went to see her Onc. and he immediately put her in the hospital, drained her lungs which were full of fluid and ran loads of tests. Her tests came back very, very bad. The BC had spread everywhere. So intense that they were only going to give her "comfort chemo" as they put it. When is chemo ever comfort? Then she just went back to see the Oncologist a couple of days ago and they decided her potassium was so low that no "comfort chemo" either. Comfort chemo was to be Gemzar I found out. Now they are talking about hospice care. How can this happen so fast? She was feeling fine weeks ago. My Mom wants to help her. I want to help her but I am at a little bit of a loss here. I understand that if her blood work is not stable enough they can't give her chemo but can't they help her to get her bloodwork stable? Any suggestions or thoughts would be much appreciated.

Hugs ~

Ruth
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Diagnosed 6/03 nursing daughter
Dose dense A/C 4x
Modified rad mast 8/03
IDC; 3 cm; 10+/16 nodes; ER/PR-; Her2+++
Weekly taxol w/Herceptin (off label) 12x's
40 weeks Herceptin
Radiation 33x
Reconstruction w/ implants 05 & 07
NED
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Old 04-24-2008, 06:42 PM   #2
Bill
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Ruth, I'm sorry to hear the news about your Mom's friend. I've never heard that phrase before-"comfort chemo.", maybe someone else here has. From your post, I can't tell what part of her bloodwork is unstable, but if her bilirubin is too high, there are very few chemos. they can give her without quickly creating a high toxicity level within her liver. Maybe it's something like that. My heart goes out to you all. Love and prayers, Bill
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Old 04-24-2008, 10:12 PM   #3
madubois63
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I, like Bill, have not heard of "comfort chemo." I think your friend needs to see another oncologist at a larger center for a second opinion. I truly believe in third opinions too. Sounds to me like the cancer spread to her lungs (hence the fluid) among other places. But, there is no more "everywhere" anymore. I was told it was everywhere, but it was in my lungs and liver. Bad enough but not EVERYWHERE. I had to have my lungs drained several times because the body has a way of trying (but failing) to attack the cancer cells. The irritation somehow makes extra fluid causing her to feel tired and short of breath. She needs to see an pulmonary doctor or I suggest a thoracic surgeon for that. She can have her lungs "sealed" with a talc that will adhere the lung to the breast wall leaving no room for the fluid to come back. I had that done twice. It's called pleurodesis. The draining of the lung is called thorocentesis. The oncologist should be giving her potassium (IV or pill form). I have had IV potassium many times (it doesn't stay in her system very long and needs to be replenished. Sounds like her electrolytes are out of whack, also making her very tired. If this happens for too long, it can damage her heart and put her at major risk for a heart attack. She needs to be hydrated very well. And If her blood counts are very low, she should be having blood and/or platelet transfusions. Then there are shots of neupogen, epogen and/or other medications she can easily have to raise her red blood count and white counts so she can get the chemo. There are easy fixes that it doesn't seem like this onc wants to waste on her. Please help her get a new onc right away. This is pissing me off the more I think about it!! Next, she needs an MRI scan of her brain. That will decide if your friend needs Tykerb (chemo that passes the blood brain barrier) or radiation treatments. Most chemo's do not pass the BBB because the molecules are too big. Tykerb is one of the newest medications that DOES. She also needs to find out if she carries the HER2 gene. If it wasn't done on her original pathology, the doc (new or old - preferably new) can request to have a Fsh test. Tell your friend to get copies of ALL her past and future reports for her own files. I know it seems like this happened quickly, but I doubt this doctor was taking regular scans to watch for reoccurance. This has probably been happening for a while. Once the fluid started build up in the lung, that was probably when she started to feel the worst. She needs to stay out of crowds and be VERY clean about everything. The last thing she needs right now is to catch a cold. If you and your mom want to do something to help, pay for a crew to REALLY clean her house or do it yourselves. Doesn't seem like much, but it can really mean saving her life. I carry antiseptic wipes and clean my forks and knives in a restaurant, wipe down the handle of the carriage at the market, don't touch doorknobs and Lysol my own at home all the time, wipe down everything in my car especially the door handles and steering wheel. Every little thing helps. Your a great person for caring and trying to understand whats going on...Hope I helped a little! Keep us informed...
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Maryann
Stage IV Inflammatory BC 1/00
Mod Rad Mastectomy 24nod/5+
Adriomycin Cytoxin Taxol
Tamoxifen 4 1/2 yrs
Radiation - 32 x
Metastatic BC lung/liver 10/04
thorocentesis 2x - pleurodesis
Herceptin Taxatiere Carbo
Femera/Lupron
BC NED 4/05
chemo induced Acute Myeloid Leukemia 5/06
Induction/consolidation chemo
bone marrow transplant - 11/3/06
Severe Host vs Graft Disease of liver
BC mets to lung 11/07
Fasoladex Herceptin Zometa Xeloda
GVHD/Iron overload to liver
Avascular Necrosis/morphine pump 10/10
metastatic brain tumor
steriotactic radiosurgery
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Old 04-24-2008, 11:06 PM   #4
BonnieR
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Maryann, I just want to say how impressed I was with your post. I can only imagine what a blessing it will be to Ruth's friend...
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Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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Old 04-25-2008, 09:24 AM   #5
Ruth
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Maryann,

Oh my did you make my day. I also couldn't believe it was everywhere and the Dr told her in the hospital she had two months. I mean come on. She was so upset because her daughter is in the process of adopting another child and was so frightened that she would never see this happen. She received Gemzar, potassium (IV) and fluids yesterday. She has only received A/C and T so I also think that she has so many more options. I'll talk to my Mom and check on HER2 status today and get copies of reports. She is definitely not a person that reaches out for help. She is an fantastic artist and lived alone for many, many years. I feel like I'm butting in but she is so trusting of everyone and doesn't question. I'm thinking her acceptance of the situation is leading her team of Dr's to think she is ready to go out. She is just a mellow person.
I think it is in only her liver and lungs. "Comfort chemo, 2 months and EVERYWHERE" are things that make me so mad!
Thank you, thank you, thank you!
Ruth
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[/SIGPIC]~~~~~~~~~~~~~~~~~~~~~~~~~~~

Diagnosed 6/03 nursing daughter
Dose dense A/C 4x
Modified rad mast 8/03
IDC; 3 cm; 10+/16 nodes; ER/PR-; Her2+++
Weekly taxol w/Herceptin (off label) 12x's
40 weeks Herceptin
Radiation 33x
Reconstruction w/ implants 05 & 07
NED
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Old 04-25-2008, 11:28 AM   #6
Jade
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'comfort' chemo

My dad died from lung cancer 8 years ago. It was 'everywhere' and had literally eaten away his ribs so that the x-ray showed three ribs missing. It was also in his brain and a large area of cancer was protruding from his head. My understanding is that 'comfort' chemo is offered when there is a mass that is pressing on a nerve or area which is causing additional pain, discomfort and complications for the patient. The chemo is not given as a hope for a cure, but rather in an attempt to control the rapidly growing cancer to avoid unnecessary additional suffering.
Hope this helps,
Love,
Jade
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Dx Nov.04 - Stage 1, Grade 3, widespread high grade DCIS, Paget's disease of nipple, 8mm tumor invasive DC (ductal carcinoma), ER/PR-, HER2+++
Nov.04 - left mast., clear margins, 6 of 6 nodes clear
Feb.05 - began EC chemo, 4 rounds (every 3 weeks)
Aug.05 - began Herceptin every 3 weeks for 1 year
Aug.06 - ended treatment
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Old 04-25-2008, 06:59 PM   #7
madubois63
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Ruth - Glad to make your day. Don't feel like your butting in. Remember, your mom and her friend come from a time when no one questioned the DOCTOR. You have to help your mom's friend become assertive and TELL the docs what to do. She needs to let everyone know she is NOT ready to check out!!!
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Maryann
Stage IV Inflammatory BC 1/00
Mod Rad Mastectomy 24nod/5+
Adriomycin Cytoxin Taxol
Tamoxifen 4 1/2 yrs
Radiation - 32 x
Metastatic BC lung/liver 10/04
thorocentesis 2x - pleurodesis
Herceptin Taxatiere Carbo
Femera/Lupron
BC NED 4/05
chemo induced Acute Myeloid Leukemia 5/06
Induction/consolidation chemo
bone marrow transplant - 11/3/06
Severe Host vs Graft Disease of liver
BC mets to lung 11/07
Fasoladex Herceptin Zometa Xeloda
GVHD/Iron overload to liver
Avascular Necrosis/morphine pump 10/10
metastatic brain tumor
steriotactic radiosurgery
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Old 04-25-2008, 07:15 PM   #8
juanita
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Sorry that I can't be of any help except to offer you my prayers.
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dxd 9-04, lumpectomy,
st 1, gr 3, er,pr-, her2 +,
2 tac,33 rads,6 cmf
1 yr herceptin,
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