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Old 07-06-2006, 07:34 PM   #1
Chelee
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Femara?

How soon do you start a drug like Femara after chemo? Right away...or do you wait till your body has recovered from chemo?


Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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Old 07-06-2006, 07:40 PM   #2
Cheryl E
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I started right away.
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Old 07-07-2006, 06:57 AM   #3
sarah
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I'd think right away unless you're doing radiation in which case, after that.
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Old 07-07-2006, 01:11 PM   #4
Barbara2
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I started right away.
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Old 07-07-2006, 02:09 PM   #5
Chelee
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I haven't been started on anything yet. Maybe its like Sarah said and I will start "after" Radiation therapy? I haven't started that yet...but sometime soon.

I wonder why you can't do femara or tamoxifen at the same time as Rads? All I have now is weekly herceptin.

Did others here do femara or tamoxifin while doing their radiation too...or AFTER their Rads?

Thanks all.

Chelee
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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Old 07-07-2006, 08:39 PM   #6
Andi
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I took tamoxifen during my radiation.
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Andi
-- ------------------------
Stage IIIC, 17 of 20 Nodes +, E+, Her2+++
Diagnosed 6/30/05
Lumpectomy 7/13/05
Dose Dense A/C x 4
Weekly Taxol + Herceptin x 12
Remainder of year Herceptin Every 3 weeks (completes 9/13/06)
Radiation completed 2/28/06
Currently on Tamoxifen
Dec 06 - Pleural effusion treated with pleurodesis
Now er/pr-, her2++
1/07 started weekly Navelbine plus Herceptin
Discontinued Tamoxifen
4/27/07 CTshowed progression
5/01/07 Began Tykerb/Xeloda + Zometa
5/22/07 Stopped treatment due to great progression
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Old 07-07-2006, 09:14 PM   #7
Bev
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My doc said after is normal, but during OK

My doc said hormonals after is normal but during is Ok. She gave me the script early and left it up to me. I felt like I had enough on my plate and waited til after but in hindsight I could have handled the hot flashes along with rads. It looks like people are doing them pre-surgery, so I think now I would do them during rads.
Tamox has been very easy for me and I'm almost reluctant to switch to an AI, even though it's suppose to be better. Uterine cancer versus osteoporosis, I just can't decide. It will all work out. What keeps me sane is I imagine that 2 years from now, if I have no problems, my mindset will be different than it is right now. I've gone from insane at diagnosis to oscillating between hopeful and insane 1 year later. So if all goes well, 1 year from now, I'll be mostly hopeful. I hope you will be too. BB
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Old 07-08-2006, 04:01 AM   #8
DeborahNC
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I was prescribed Femara after I finished Herceptin. My onc is on who waits to begin an AI.
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Old 07-08-2006, 06:22 AM   #9
madubois63
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I started Tamoxifen after chemo, but before radiation. Please be aware that the hormonal change can make you depressed. I became suicidal. My doc prescribed Zoloft and I was myself after two weeks again. I had a moment of clarity and realized I was myself again. Maryann
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Old 07-08-2006, 07:42 AM   #10
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I started Arimidex the day after my last rad.


Sassy
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Last edited by sassy; 08-22-2011 at 08:49 AM..
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Old 07-08-2006, 03:49 PM   #11
Chelee
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Sounds like some took their Tamox or AI after chemo...and some started after Radiation. Guess it depends on your onc doc. I will assume at this point that mine is waiting till I do my Rads and complete them.

MaryAnn, thanks for the warning. I have heard of women having problems with depression and other things with hormonal changes. That is something to be aware of ahead of time. Thanks!

Deborah, I see you didn't start till after your herceptin. Were you on herceptin for a year, or a lesser amount of time? I am curious since I am on herceptin for a year. Maybe I won't start tamox or femera till after my herceptin either?

Its interesting how different each ono doc is about when to start these? But some probably depends on each persons DX. Thanks everyone.

Chelee
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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Old 07-08-2006, 04:31 PM   #12
snoopy
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Started Tamoxifen 1 month after the end of chemo - was taking it whilst on Rads (and herceptin). Thought there was some published info to suggest that antioestrogens best started at end of chemo (I'll try and find it)
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Old 07-09-2006, 04:19 AM   #13
sarah
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I have never heard about waiting to take AIs until after finishing with Herceptin in fact I thought I read somewwhere here on this site that it was important to take AIs and Herceptin at the same time or it would increase the estrogen if only on Herceptin or the HER2 if only on AIs. I'm no onc so don't really know what's best but....I'm just over 2 years on Herceptin and I started AIs after radiation so just over a year on AIs. I'm wondering what to do when I'm told to stop one or the other! Do I panic and stop the other or.........????
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Old 07-09-2006, 07:58 AM   #14
Becky
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Herceptin and an anti hormonal are a great combination for a one-two punch. It does not matter if you are on an AI or tamoxifen. However, once the Herceptin year (or two) is over, one still has to stay on the antihormonal for a total of 5 years. That is when the dilemna comes in if you are on Tamoxifen versus an AI. Tamoxifen may not work well for those who are also Her2+ (especially if you are only moderately hormone positive. For example, I am 50% ER but PR neg. The literature says that I am not a good tamoxifen candidate. However, tamoxifen may work for some Her2+ patients).


An AI without Herceptin is always a good bet and works best for Her2+ patients (and works best for Her2 neg patients too - AIs have just been proven, over and over again, to be better than tamoxifen - but you have to be postmenopausal to take them). Hence, I had an oophorectomy to take them.

Kind regards

Becky
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Old 07-09-2006, 04:18 PM   #15
DeborahNC
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Chelee

I stopped Herceptin in June after 7 months. I want to see if this fatigue, iron deficient anemia and weight gain have anything to do with Herceptin use. My onc has said that I can resume at any time, if I either want or need to.
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Old 07-09-2006, 06:40 PM   #16
Chelee
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Becky, A one two punch sounds good to me. That is what I really thought my oncologist meant when she told me once I was off chemo...she would start me on femera. Its like she forgot? Since I am done with chemo...my next appt with her isn't for another 3 months. ARGH!

Its been 28 days since my last chemo. All I have been on is herceptin.

There doesn't seem to be one set rule for when to start tamox or a AI? After reading these posts...some did right away...some after? This is a confusing topic and one our medical team should be discussing with us in my opinion.

The BIGGER cancer center I went to recently for the 2nd opinion went over all my medical records and they really feel I am peri-menopausal. (So do I.) They say I should be on tamox and NOT femera? So I don't know what to think...or what I should be on? My current oncologist said I WOULD be on femera...PERIOD. But I have heard like you mentioned...that you HAVE to be POST menopausal for tamoxifen to work. I was having a period before I got put into chemo pause. So WHY would my onc want to put me on femera? I do believe I was getting real close to being menopausal...but I wasn't quite yet at that time. The minute I started chemo...it stopped.

I wish all the oncologist would get on the same page about this topic. I am going to search some more and read up some more on this. I am have my weekly herceptin tomorrow...I will leave a message for my onc doc about this. Too many decisions...and important ones at that.

Thanks to all of you that replied.

Chelee
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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