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Old 04-17-2009, 08:37 AM   #1
Lori R
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Unhappy Well Poop - Liver Met Back

Hi gang,
I received the results of my 6 month PET/CT a week ago and the liver met identified in 11/07 is back.

I believe it was Chrisy who said that when her liver met came back that the sad part about the recurrance is that she was holding on to a sliver of hope that she would somehow beat the odds. I know I certainly was.

I had a liver biopsy yesterday to confirm the original characteristics of the tumor (originally er-/pr- and her2+) We'll see if it's stayed the same. Glad to have the confirmation for appropriate next steps.

The current thinking is that since the taxotere was tolerable and did a pretty good job the first time around that I would go back on another round. (potentially 10 cycles ---YIKES---I was ready to be done at 6 but I am sure I can manage)

I am also checking into Radio Frequency Ablation to quickly blast the tumour.

Does anyone remember the sister on the site that had used Cyberknife. I believe the procedure was performed in California.

Rich...I have a call into the University of Michigan vaccine trial but I think that I am not a candidate as I have not had an anthracycline.

T-DM1 sisters - I looked into available trials here and there is one but I would have to travel and the randomized second arm was not taxotere. I am afraid of changing horses.

My daughter is 16 and a sophmore in highschool. A consideration (hopefully not short sighted so challenge me on this one...I appreciate all of your honesty) is trying to not disrupt these precious years for her by being gone too much for treatment.

SOOOO sad right now, a little scared...but certainly not willing to give up the fight.

Any words of encouragement, advice etc. appreciated.

So glad I could come here for support....love Lori
__________________
2007
Oct - Diagnosed - Stage IV
5 c.m. IDC - Left Side er/pr- Her2+++
Node + 2/14 - Single Liver Met
Double Mastectomy
Nov - Begin T+H
2008
Feb-Complete 6 cycles- T&H- NED
March - Continue - Herceptin Only
April - Rads for 6 weeks
2009
Continue Herceptin - Continue NED
April - Recurrance- 3 cm. Liver Met
May - Cryosurgery
June - November - Abraxane + Herceptin
Aug - PET/CT - CTC = 0 Back to NED
2010
January - Continue NED
July - Recurrance - 3 cm Liver Met CTC=1
August - Cryosurgery #2
August - November Navelbine
November - Back to NED - End Navelbine
2011
Feb - Recur - 4 cm Liver Met - Same Left Lobe
March Surgery it is -Couldn't get a clean margin
July - Confirmed continued liver involvement
August - Begin Herceptin + Tykerb
October - Mixed results from H+T
Add Abraxane + H + T - Nov - April
2012
January PET Scan - It's working!!
April - Back to NED
July - Recurrance
August - Begin TDM-1 Trial (Taxol + TDM-1)
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Old 04-17-2009, 09:50 AM   #2
WomanofSteel
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Lori, we are in the same boat. I too have a 16 year old at home, so I know how you feel. I just started on navelbine. If you had luck with the taxotere,I would stick with that. There are lots of different drugs out there and we will be fine. Hang in there girl! Let's make those cancer cells beg for MERCY!
__________________
dx aug 03
invasive dcis 1 cm
er/pr/her2+
bcs 8/4/03
bcs 8/21/03 0/16 nodes
tx 4x ca 36 rad tam
postmenopausal 06 aromasin
sept 07 biopsy node in neck
muga/pet/cat/bone mets to lungs nodes and liver stage iv
tx hki-272
tx not working switched to taxol herceptin
Taxol not working switched to navelbine
navelbine is causing bad neuropathy
starting gemzar
gemzar quit on me now on Ixempra due to increasing number and size of liver mets
another progression starting tykerb/xeloda
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Old 04-17-2009, 09:55 AM   #3
bashmaz
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Cyberknife for liver mets

Hi Lori,
I think it is Esther (from California) who had cyberknife for liver mets. She also posts on BCmets.org under luv2ski. She's been away for a few weeks - vacation?

Good luck in your treatments - I know how you feel about being close to home during your daughter's last few years in high school. My daughter is a senior and now that she is going away to college this fall she has become quite the home-body and wants to hang out with me a lot.

Marianne
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Old 04-17-2009, 10:42 AM   #4
mmoons
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Sending you comfort

Oh Lori-

I am sure you are sad and scared.......but you also sound so strong. Amazing! You are an inspiration and I bet your daughter is so very proud of you. I am sending you warm thoughts and lifting you up prayer today.

I wish I had the words to really express my heart to you. Please stay stong. I love what Woman of Steel wrote......bring those bad cells to their knees!

Maureen
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Maureen


My loves

IDC & DCIS, HER2+++ Diagnosis: October 1, 2008
  • Tumor: 6.8 centimeters, never showed on mammograms
  • ER-/PR-
  • November 2008: Sentinal Lymph node surgery. 6 out of 9 lymph nodes with cancer
  • Stage IIIc
  • Lapatinib Clinical Trial start: November, 2008
  • Surgery: May 5, 2009
  • Started Herceptin: May 19, 2009
  • Started Radiation (33 rounds): June 10, 2009
  • September 2009: Moved to Michigan to be closer to family
  • 12/09 - still on Herceptin until May 2010
  • August 2010: Port out, port out, port out port out port port port out port ooooout...da da da dant! (to the music of the Pink Panther)
Blog: http://moonsfamily.blogspot.com
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Old 04-17-2009, 10:45 AM   #5
Rich66
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In addition to cyberkife, you could look into liver directed therapies at Swedish hospital there in CO:
http://www.swedishhospital.com/Custo...0-7D345CD59DC5}

I don't think you have to be Swedish but I would learn a little just in case it opens some doors.

This was an interesting article, similar to others I have seen, which might be applicable to your case:

1: J Vasc Interv Radiol. 2009 Mar 26. [Epub ahead of print] Links
Radiation Lobectomy-A Minimally Invasive Treatment Model for Liver Cancer: Case Report.

Siddiqi NH, Devlin PM.
Division of Vascular and Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St. Louis, MO 63110.
Chemotherapy-resistant colon carcinoma metastases to a patient's right hepatic lobe progressed after right lobar radioembolization with yttrium-90. The metastasis-free left lobe had adequate volume as a future liver remnant. Repeat right lobar radioembolization with supratherapeutic activity of (90)Y caused shrinking of the tumors and the right lobe with no adverse outcome. With an adequate tumor-free future liver remnant, one hepatic lobe bearing a large tumor burden may be administered supratherapeutic activity of (90)Y, risking lobar ablation for greater probability of tumor eradication. This is analogous to hepatic lobectomy. This case is presented as a proof of principle.
PMID: 19328722 [PubMed - as supplied by publisher
I seem to remember an MD Anderson raticle discussing how getting rid of the offending lobe was giving great results.I think they were using Trans arterial Chemo.

There is a forum of patients dedicated to Yttrium 90 issues:
send an e-mail to yes@discussthis.com to join.

Isolated hepatic perfusion is starting to make a comeback. Dr. Alexander seems to be the US guru. I think it's totally off-label for BC liver mets:

1: Front Biosci. 2009 Jan 1;14:1771-84. Links

TNF-based isolated hepatic perfusion.

Bellavance EC, Alexander HR Jr.
Department of Surgery, University of Maryland Medical Center, Baltimore, MD 21201, USA.
Unresectable primary and metastatic cancers confined to the liver often determine the prognosis for patients with primary hepatic cancers, colorectal cancer, ocular melanoma, and neuroendocrine tumors. Although many locoregional therapies have emerged as options for patients with unresectable liver malignancies, these treatments frequently have limited clinical benefit. Isolated hepatic perfusion (IHP) has emerged as a regional therapy effective in inducing tumor regression in isolated liver metastases from multiple histologies. Tumor necrosis factor alpha (TNF) is a biologic agent well suited to isolated therapy because of its single-dose efficacy, synergistic effect with hyperthermia, and effects on tumor neovasculature. When combined with chemotherapeutic agents in IHP, TNF may improve response rates in patients with hepatic metastases of some histologies. However, there are additional toxicities associated with the administration of TNF and further studies are needed to determine whether TNF confers a clinical advantage in IHP.
PMID: 19273161 [PubMed - indexed for MEDLINE]


With all that said, perusal of liver metster profiles in this forum seems to support what worked for you in the past. Taxotere/Herceptin with or without Navelbine seems to be a powerful combination. It's not like it stopped working. So..you might be in a good position to use local therapies along with chemo that's benefitted you before.
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Old 04-17-2009, 10:50 AM   #6
Shobha
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Lori,

I am sorry to hear your news but I have a strong feeling that you will beat this very quickly. From what I have reading on this forum, many of our brave sisters have beaten it and I pray that God will guide you to the right drugs too.

Lots of prayers and hugs,
shobha
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DX: 06-30-2007 - left breast -stage IIIB, Her2/Neu 3+++, ER weakly positive, PR-
Taxol+herceptin weekly for 3 months
FEC+herceptin every 3 weeks for 3 months
BRCA 1 and 2 - Negative
Jan 2008 - Bilateral mastectomy, prophylactic Rt. side.
Radiation for 5 weeks
Completed my yr of herceptin on 07-14-2008
Brain MRI - 3/2/09 Clean
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Old 04-17-2009, 10:54 AM   #7
Mary Anne in TX
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Lori! You'll pick just right on what to do.
Just remember that the kids today are part of the technology generation.....they can talk, twitter, text, sky dive....oops anything anywhere. I'm just betting that your 16 year old, while she needs you day to day, most of all needs you to fight to be there for a very long time! I'm betting she will be supportive of you whichever you choose to do! Remember, she's your daughter!!!
Wishing you many hours of peace over the next few days!
With love, ma
__________________
MA in TX.
Grateful for each and every day....

Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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Old 04-17-2009, 03:13 PM   #8
kk1
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Hi Lori;

Sorry to hear your news, I've traveled that same road a few times now, and also have a 16 year old daughter. I always find the following site very useful when I am trying to figure out which bat to take out for my pesky hide and seek liver met.

http://breastcancer.evidencewatch.com/ search for liver met and you will find many articles on the latest options.

Tomorrow will mark 5 years since DX with liver mets so hang in there you can beat this back.
__________________
KK1
April 2004 de novo metastatic left breast 1.5cm her2++,er+/pr+ with 2 small liver mets
weekly taxotere,herceptin, xeloda
Sept 2004 NED-3 herceptin, zoladex,aromasin
Dec 2006 recurrence in liver
Feb. 2007 liver resection left lobe removed-herceptin, zoladex, switch to Arimidex
NED 16 months added zometa
May 2008 new lesion in liver 15mm Tykerb/Xeloda/Herceptin
July 2008 stable...yeah!
Sept 2008 NED again !!!
Jan 2009 fell off the wagon again spot back in the liver and fell out of menopause.
Feb 2009 RFA and 2nd liver resection to remove spot ---back on the NED wagon again continue Tykerb, Herceptin.
March 2009- oophrectomy added Femara and bi-annual Zometa
May 2009- scans clear but suspect lung nodule
June 2009- Lung VAT wedge resection to remove nodule---fungus ball not cancer!! phew
Aug 2009- NED
Nov 2009-scans again clear YAHOO!
March 2010- scans clear continue Tykerb, Herceptin, Femara, Zometa Q6mo
Nov 2009-Nov 2019 scans clear done every 6 months


Feb 2020 - Fell out of the NED wagon hard! single liver lesions and large infect cyst. 3 weeks in ICU.
March 2021- 5 cycles perjeta, herceptin, navelbine. lesion stable.
June 2021 - 3rd liver resection to remove single liver lesion. Continued perjeta, herceptin.
Nov. 2021- PET scan show 5 hot nodes near liver. 9 cycles Kadcyla
June 2021- PET scan shows progression. nodes size unchanged but even more SUV uptake.

July 2021- start ENHERTU
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Old 04-17-2009, 05:33 PM   #9
chrisy
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Lori,

Well POOP
I guess you've correctly described MY feelings on this as well!

Sounds like you are getting lots of good advice and options. If it were me and I was dealing with a single met, I'd look at the local options - yes, it is Esther/luv2ski who had the cyberknife done on her liver met, it's not commonly done but she did it at Stanford.

I'm not familiar with the option Rich has posted, but it sounds close to you and worth looking into, especially if you know swedish. Or maybe you just need to like big fluffy pancakes...

Finally, I'd like to offer this thought on the chemo options. I agree with what you say about not changing chemos - going back to the "winning horse". On the other hand, you've had such a good response to Herceptin you would be a great candidate for a DM1 trial. I wouldn't rule that out.

My doctor at UCSF who is one of the cutting edge researchers in BC is a very big advocate of using targeted therapies and avoiding chemo as much as possible. Keeping your body and immune resources strong is so important.

Lori, I'm bummed that you are having to deal with this, but it is what it is,so now your goal is to MANAGE it...as I know you will.

Hang in there, keep us posted!
__________________
Chris in Scotts Valley
June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 04-18-2009, 03:46 AM   #10
Joan M
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Lori,

I'm sorry to hear about the return of your liver met. Perhaps you should think about RFA since you have no other mets.

The treatment has been used a lot in the liver to good result. Also, it may give you some time to be off from chemo, as you would be NED after the procedure.

I had RFA in the lung. In my case I developed complications related to coughing up blood from a fungus/mold infection that took hold a few months later. However, I also had brain surgery two months after the RFA and was on steriods which can promote an infection.

But that is no reflection on liver RFA. Also, despite the lung complication, the cancer has not returned in the lung. (I had a lung wedge resection two years ago and a year later there was a recurrence, which is why I had the RFA.) And I have no other spots on PET/CT.

Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 04-18-2009, 08:13 AM   #11
Lori R
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Thank you all soooo sooo much for the words of encouragement and advice. I am sure each of you knows the lonely feeling of fighting this disease while trying to keep a positive face for family and friends.

It is such a relief to have a place to come and "let it all hang out".

I am excited by all of the advice and I will spend the next few hours following up to continue to challenge (er....drive my onc crazy) my Dr. in her thinking and game plan.

Rich...I used to be blonde so maybe I can act like I am Swedish. I'll have to try to develop a Swedish accent for when I contact them!!!

Chrisy....We are absolutely on the same page in regards to going back on Chemo that would destroy my immune system. The first round of Taxotere really did a number and I had to take the neulasta shots to keep afloat. Maybe my body is sensing that something is in the works as after being incredibly healthy, I just came down with a whopper head cold. Hmmmmm.

I don't know what I would do without this site...WOS and KK1, thank you for letting me know that I am not alone in trying to support a teenage daughter. It sounds as if your daughters are as generous and loving as mine. Aren't we lucky.

I love you all and feel much more at peace knowing that I have such a fantastic support team. HUGS!!!! Lori
__________________
2007
Oct - Diagnosed - Stage IV
5 c.m. IDC - Left Side er/pr- Her2+++
Node + 2/14 - Single Liver Met
Double Mastectomy
Nov - Begin T+H
2008
Feb-Complete 6 cycles- T&H- NED
March - Continue - Herceptin Only
April - Rads for 6 weeks
2009
Continue Herceptin - Continue NED
April - Recurrance- 3 cm. Liver Met
May - Cryosurgery
June - November - Abraxane + Herceptin
Aug - PET/CT - CTC = 0 Back to NED
2010
January - Continue NED
July - Recurrance - 3 cm Liver Met CTC=1
August - Cryosurgery #2
August - November Navelbine
November - Back to NED - End Navelbine
2011
Feb - Recur - 4 cm Liver Met - Same Left Lobe
March Surgery it is -Couldn't get a clean margin
July - Confirmed continued liver involvement
August - Begin Herceptin + Tykerb
October - Mixed results from H+T
Add Abraxane + H + T - Nov - April
2012
January PET Scan - It's working!!
April - Back to NED
July - Recurrance
August - Begin TDM-1 Trial (Taxol + TDM-1)
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Old 04-18-2009, 10:17 AM   #12
Rich66
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You could rent the muppet show series and study the Swedish Chef. He managed to communicate with a 3 or 4 word vocabulary.
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Old 04-18-2009, 10:18 AM   #13
jones7676
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I was sorry to hear your bad news but very glad to see all the help and info you are receiving here. I hope your successful treatment occurs real soon and that you get the treatment that is just what you need!
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Barb

10/03 Radical Mastectomy 3 cm tumor - 1/17 Nodes Stage II B, Her 2 +++ ER-/PR- 11/03 4 AC 4 Taxol 12/05 Stage IV - Lung met , Bone mets - Carbo, Taxotere, Herceptin 9/06 - 2 cm brain tumor 10/06 - Tumor removal surgery - Herceptin Halted 12/06 gamma knife tumor base.1/07 Navelbine/Herceptin 4/07 Rads to R femur 5/07 Stereotactic - new 2 cm brain tumor 4/07 Start Xeloda 5/07 Tykerb added 7/07 Brain MRI clean 10/07 .055 cm brain met found. 12/07 Stereotactic -1 cm brain tumor Start Tykerb 11/07 Abraxane/Herceptin 5/08 Cisplatin, Gemcitabine/Herceptin 6/08 Stereotactic to 1cm 9/08 Stereotactic repeat (growth). 11/08 Pet Scan Good but new tiny met on L lung/dead Brain surgery (no cancer cells found/scar tissue) 1/09 Chemo restarted 2/09 Pet Scan Bad - R larger very active/active L active lymph nodes both sides of chest MRI- mets slight increase 2/09 Start Doxil/Tykerb Treatment
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Old 04-18-2009, 10:33 AM   #14
Believe51
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Location: RHODE ISLAND (Ed getting me a latte on 2nd Cancerversary Cruise 2008) 'BELIEVE': To accept as true or real, To have faith in, To presume ALWAYS BELIEVE
Posts: 2,999
Talking

Lori, I was bummed out hearing of this news but then read your post. I feel the fight in your voice and it is with that fight you will combat this new pest. You go girl, gather that ammo to beat down the beast. You will examine all weapons of war and chose the tools to acheive it. I will be in the side lines awaiting your updates and then I am sure we all will gather to applause your success. For now you are looking the beast in the eyes and promising it that it is not welcomed at Lori's party. Keep the faith during this as hard as it is and surely keep staring it down. You can do this. Sending the most healing thoughts possible.>>Believe51
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9/7/06Husband 50yrs=StageIV IBC/HER2+,BoneMets10/06TaxotereX10,'H'1X wk,Zometa,Tamoxifen4/12/07Last Tax5/18/07Pet=Rapid Cell Activity,No Organ Mets,Lytic Lesions,Degeneration,Some Bone Repair5/07ChemoFail6/01/07Pleural Thoracentisis=Effusions,NoMalignantCells6/19/07+7/2/07DFCI
6/25/07BrainMRI=BrainMets,Many<9mm7/10/07WBR/PelvisRad37.5Gx15&Nutritionist8/19/07T/X9/20/07BrainMRI=2<2mm10/6/07Pet=BoneProgression
10/24/07ChemoFail11/9/07A/Cx10,EndTam12/7/07Faslodex12/10/07Muga7512/13/07BlasticLesions1/7/08BrainMRI=Clear4/1/08Pet=BoneImprovement,
NoProgression,Stable4/7/08BrainPerfect5/16/08Last A/C8/26/08BrainMets=10(<9mm)9/10/08Gamma10/30/08Met=5mm12/19/08Gamma5mets5
12/22/08SpinalMets1/14/09SpinalRads2/17/09BrainMRI=NoNewMets4/20/09BoneScan5/14/09Ixempra6/1/09BrainMRI=NumerousMets6/24/09DFCIw/DrBurstein6/26/09Continue
Ixempra/Faslodex/Zometa~TM now lower7/17/09Stop Ixempra By Choice9/21/09HOSPICE10/16/09Earned His Deserved Wings And Halo=37 Month Fight w/Stage 4 IBC, Her2+++,My Hero!!
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Old 04-18-2009, 12:36 PM   #15
DanaRT
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Dear Lori,
I certainly understand the need to remain close to home and not disrupt your daughter's high school years. I have a 16 year old daughter too. More than anything I didn't want my family and daughters to worry about me. I tried very hard to be as normal as I could be~ which isn't very normal.

Lori, Sounds like your lining up the best treatment and you will win this combat once again. Praying for strength and wishing you good health.

Love,
Dana
__________________
-Dana-

]
Diagnosed - Nov. 2, 2007 at 45
Lumpectomy - Nov. 13, 2007
Tumor 1.2 cm
Stage 1 Grade 3
ER/PR - Her2 +++ (3.8)
Taxotere/Carboplatin/Herceptin- 6 rounds
Neulasta
Radiation 33 treatments - will be done 6/6/08
Herceptin through 12/08
12/07 MUGA 61%, 4/08 MUGA 60%, 7/08 MUGA 64%
three wonderful daughters, a terrific husband,
Life is Good
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Old 04-19-2009, 05:11 AM   #16
Sheila
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Lori
It seems to be the time of year for mets for many of us...you have gotten so much good advice...Chrisy is a veteran at liver mets...the go to girl.....it sound like your onc, has a plan...that is the beginning....prayers that it will rid you of that met quickly and thoroughly!
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"Be kinder than necessary, for everyone you meet
is fighting some kind of battle."



Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 04-19-2009, 12:19 PM   #17
Rich66
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Studies to watch:


Biological Therapy in Treating Women With Breast Cancer That Has Spread to the Liver
This study is ongoing, but not recruiting participants.
First Received: March 8, 2006 Last Updated: February 27, 2009 History of Changes
Sponsored by: Mount Sinai School of Medicine
Information provided by: National Cancer Institute (NCI) ClinicalTrials.gov Identifier: NCT00301106
Purpose RATIONALE: Biological therapy using a gene-modified virus that can make interleukin-12 may help the body build an effective immune response to kill tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of a gene-modified virus that can make interleukin-12 in treating women with breast cancer that has spread to the liver.


Condition Intervention Phase Breast Cancer
Metastatic Cancer
Biological: adenovirus-mediated human interleukin-12
Phase I






Interleukin-12 in Treating Patients With Metastatic or Recurrent Breast Cancer
This study is ongoing, but not recruiting participants.
First Received: March 7, 2000 Last Updated: February 6, 2009 History of Changes
Sponsors and Collaborators:
Cancer and Leukemia Group B
National Cancer Institute (NCI)
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00004893
Purpose
RATIONALE: Interleukin-12 may kill tumor cells by stopping blood flow to the tumor and by stimulating a person's white blood cells to kill breast cancer cells.
PURPOSE: Randomized phase II trial to study the effectiveness of interleukin-12 in treating patients who have metastatic or recurrent breast cancer.



Breast Cancer
Biological: recombinant interleukin-12
Phase II
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Old 04-19-2009, 09:57 PM   #18
Believe51
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Location: RHODE ISLAND (Ed getting me a latte on 2nd Cancerversary Cruise 2008) 'BELIEVE': To accept as true or real, To have faith in, To presume ALWAYS BELIEVE
Posts: 2,999
Sending you a cyber hug and telling you that I am thinking of you. I know it there is alot of information but you will be amazed how you can filter though it all. I am sure you will find what you need, you are certainly off to a leaping start.>>Believe51
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9/7/06Husband 50yrs=StageIV IBC/HER2+,BoneMets10/06TaxotereX10,'H'1X wk,Zometa,Tamoxifen4/12/07Last Tax5/18/07Pet=Rapid Cell Activity,No Organ Mets,Lytic Lesions,Degeneration,Some Bone Repair5/07ChemoFail6/01/07Pleural Thoracentisis=Effusions,NoMalignantCells6/19/07+7/2/07DFCI
6/25/07BrainMRI=BrainMets,Many<9mm7/10/07WBR/PelvisRad37.5Gx15&Nutritionist8/19/07T/X9/20/07BrainMRI=2<2mm10/6/07Pet=BoneProgression
10/24/07ChemoFail11/9/07A/Cx10,EndTam12/7/07Faslodex12/10/07Muga7512/13/07BlasticLesions1/7/08BrainMRI=Clear4/1/08Pet=BoneImprovement,
NoProgression,Stable4/7/08BrainPerfect5/16/08Last A/C8/26/08BrainMets=10(<9mm)9/10/08Gamma10/30/08Met=5mm12/19/08Gamma5mets5
12/22/08SpinalMets1/14/09SpinalRads2/17/09BrainMRI=NoNewMets4/20/09BoneScan5/14/09Ixempra6/1/09BrainMRI=NumerousMets6/24/09DFCIw/DrBurstein6/26/09Continue
Ixempra/Faslodex/Zometa~TM now lower7/17/09Stop Ixempra By Choice9/21/09HOSPICE10/16/09Earned His Deserved Wings And Halo=37 Month Fight w/Stage 4 IBC, Her2+++,My Hero!!
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Old 04-20-2009, 08:48 AM   #19
jml
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Similar Dx...did RFA, did Liver Resect - liver NED since 12/05

Hi Lori~
First & foremost, I'm sorry you're wrestling with a stubborn liver met. I know how disheartening it is to deal with the recurrence.
I have a similar story to yours & I hope my experience & my journey is helpful to you.
I was dx'd Stage IV @primary dx too (5/02). I had single liver met, but after failing navelbine+herceptin, the disease progressed to "innumerable, immeasurable" lesions. Fortunately, Taxol+Herceptin cleaned up my liver & I was NED for a year!
In 9/04, a single lesion recurred. We did short cycles of TH & the lesion would resolve, I'd go off chemo, but then it would pop back up.
I researched RFA & consulted with an Interventional Rad.When the lesion recurred in 1/05, I had RFA. But it was only partially successful because the lesion was located adjacent & very close to the main portal vein. The proximity to the vein creates a "heat sink" effect - carrying the heat from the RFA away from the lesion during the procedure & preventing the lesion from heating up sufficiently to kill off all the cells. So, while some of the tumor was blasted away, it did leave a crescent shape of viable cells that eventually just grew back.

So back on chemo - Abraxane
+ Herceptin, but no response.Then TCH & complete response again.
In the meantime, I started consulting with a liver surgeon.He followed me through the year, then in 11/05 when the lesion recurred again, he said he felt confident a liver resection would be curative, unlike the RFA. (Incidentally, he said that he would have never expected the RFA to be completely successful/curative because of the location & heat sink effect. He suggested the IR should have known this & should have been completely honest with me about the best potential outcome. He's right, the IR never stressed the importance of the heatsink...)
In 12/05, I had a right partial hepatectomy - they removed the R lobe of my liver, which is 55% of the organ. My surgeon did a full exploratory internal sonogram of the liver while I was in surgery to make sure there was in fact only a single lesion. He said if he found small lesions he could RFA them internally, but if there were too many, he would have had to abandon the procedure.
By the grace of God, there was in fact, only 1 lesion. They removed the R lobe. I was in ICU overnight, then on the regular floor the next day. Believe it or not, I was up & walking (thanks to the epidural) & dc'd from the hospital after only 4 days.
I don't mean to imply that the surgery was easy -b/c it wasn't. I have a big incision that runs 1" below my sternum to 1" above my bellybutton. And the 1st few weeks post-op were tough - incision pain, really weak. Taking a shower was exhausting.
BUT with each passing week, I could feel myself getting stronger.By week 3, I was able to travel to LA to be with my family.
The good news is, the liver resection was curative and my liver has been NED ever since.

Unfortunately, I have wrestled with recurrences in the supraclav nodes (2x) & mediastinal nodes(1x) since, but that's the unfortunate cirucmstance of a Stage IV'er. As far as I'm concerned, a recurrence in a lymph node is less threatening compared to a vital organ.

I'll mark 7years as a Stage IV'er in a couple of weeks. Surviving this disease, through all the surgeries, radiation & 105 chemos-to-date is definitely worth celebrating.
Now I have the "7 Year Itch" & I wish, hope & pray to move past this disease. But ultimately, if I have to live with this disease, I will do so vigilantly, but peacefully.

Sorry this is soo long, but, I do hope the info is helpful to you. Most of all, I urge you to get as much info as you can about RFA, you candidacy for a Liver Resect, and consult w/an IR and a Surg Onc & always get 2nd opinions!

Please feel free to send me a note via pm & if I can be additional help.
Successful treatment for any one of us is a victory for all of us. We will help you find yours too!

Keep the Faith, Lori~
Jessica
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Old 04-21-2009, 04:11 PM   #20
miss di
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I had Cyberknife to liver in Nov. 08. The actual procedure is painless, there was some pain with the fiducials you have placed around the tumor, but that was it. lots of scans before for placement, etc. I had mine done in Wisconsin, but I know they do it in CA.
As far as I know (have PET on Fri) the CK got over 95% of tumor.

Web site is cyberknife.com and you can ask questions and find facilities.

Good luck to all,
Di
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