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Old 06-13-2009, 02:07 PM   #1
StephN
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Question MARIE - What about necrosis???

Dear Marie -

I am having trouble believing that all the spots on Ed's scan are all tumors. He has had WBR, Gamma and taken Tykerb. This would be an all time record as far as this group for all these treatments to fail like that.

I am thinking about my own case as well as others of us like Barbara H and Jojo who supposedly had new spots in old treated areas and come to find out through open surgery that they were DYING tissue and NOT new lesions. 100% necrosis!

Remember that the MRI can NOT differentiate between actual tumor and necrotic tissue. SO, with that in mind, I am thinking that if there is a place with some kind of new scanning equipment that COULD give a better picture of what the spots ACTUALLY are, that would be my first step.

Especially since you are not reporting that Might Oak has symptoms at this time. With THAT many lesions, I have to think that he would show some outward sign that they are cancer lesions.

Maybe Dana Farber has such a new system. Dr. Winer would know about that.

I am going to live in "HOPE" that many of these "spots" are just "spots" of dying tissue.

I can take this route of thinking, since my two gamma knifed spots seemed to disappear and then one year later show up again. I still have one 5-6mm spot that continues to sit there unchanged through scan after scan and it is read as "scar."

Thinking SCAR, SCAR, SCAR!!!
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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
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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 06-13-2009, 03:24 PM   #2
Believe51
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Steph, I would love to believe that this is what happened, unfortunately these are new spots we are talking about. The MRI he goes for is one which measures the changes from all other MRI's, both the necrosis and new mets. This is what is happening as much as I still do not believe it. The GammaMan himself almost broke down on the phone when he told me that there were too many to count and that our hands are tied.

As far as the Tykerb, it did not work at all. Herceptin should have protected him better but it failed for him almost from the get-go. Ed has been fighting brain mets for 2 straight years and that is a great record and one we wish to beat.

Male breast cancer is so different, so much more aggressive and harder to treat. Being Her2+++, and the Inflammatory element added, nothing else can be put in the mix to make this a worse, more aggressive cancer. I hope I do not sound hopeless because still part of me is full of a glimmer.

It looks like Ed has that all time record of things failing him. Even information regarding Tamoxifen for males is proven now not the standard or even recommended measure of care. I am trying to say "scar tissue" but these spots we certainly not there for the last scan. They are covering his brain in all spots and if we cannot stop them, 3 months or so he will start having symptoms. In the mean time we need to control the brain swelling.

BUT.....we are going to go for more elaborate scans to be able to seek further treatment. The only hope we have is to redo WBR and that appears not to be an option. I am so appreciating all of the advice and opinions that we have received and again, I work hard to remain positive.

This is not the end of his story and I try to say that if he is being called away, God must have better plans for him than having him beat this and remain with me. Sorry to sound so negative, the reality is where I have to live in as I pop in and out of living with hope and miracles.

Please add any advice, as petty as one may think it is, to these posts. I need everyone to write what they think of feel, even those quiet members that may want to speak. Keep these things coming for us, it is how we are surviving right now.

Thanks Steph, you are an amazing Warrior and I so appreciate your journey, knowledge and inspiration. You are the greatest.>>Marie
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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 06-13-2009, 03:42 PM   #3
ElaineM
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Wink MARIE - What about necrosis???

Marie and Steph
I don't know if 3 D scanning would be an option for Ed, but I saw it demonstrated on T. V. recently. It looks like it is easier to see everything more clearly than on regular MRIs or CAT scans. I wonder if we can find out where it is available. Maybe there is someone on this board who has tried it and can share the experience with us?
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Old 06-14-2009, 07:27 AM   #4
Lori R
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Dear sweet Marie,
I am so sorry that you are dealing with yet another round of challenges. I am sending you all the positive energy I can gather to support you as you and Ed "push the envelope" of treatment.

First of all....I am with StephN and others to really confirm that you know what you are dealing with and make no "assumptions". Is open brain inspection an option? I realize quite invasive but at least you'd know.

I thought on the site there was mention of injecting chemo directly into the brain. (I am sorry, this is probably the wrong choice of words but I hope you know what I mean).

Are there any clinical trials that Ed could participate in?

I am with you.....keep on asking the questions, don't accept NO....As so many on this site have already proven, the Drs. don't know all. This cancer has NO IDEA who they are dealing with!! Keep on swinging!!!
Lots of Love....Lori
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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
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April - Rads for 6 weeks
2009
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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 06-14-2009, 07:36 AM   #5
Jackie07
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Marie,

I would think Ed's team will be able to figure out what steps Ed can take based on the new information.
Scans are complicated stuff. I was frightened when told to get an ultrasound after the CT of my liver. The explanation from the doctors were so confusing I had to go to the Web to get some clarification.

Will continue to pray for both of you. Take care.
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Old 06-14-2009, 10:29 AM   #6
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Marie - what about Temodar?
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

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Old 06-14-2009, 12:31 PM   #7
ElaineM
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Wink MARIE - What about necrosis???

Hi Marie,
I keep thinking about this and want to share it. It may not make any sense, but wouldn't Ed have very terrible headaches if there are too many brain mets to count?
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Old 06-14-2009, 12:35 PM   #8
Believe51
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On my list for a while Brenda but was not a good choice at that time and I think this is a viable aid now this has happened. Open brain inspection is not on Ed's list and I smile because I have always had the master list and Ed's list reflected the same options. Intercranial port, maybe but Herceptin did fail for him systemically. It is a chance that it will help or a chemo itself. Right now it is 'scaling' these options vs. quality of life for Ed. His total weight loss through this journey is 75 pounds and counting. Hard as it is I must admit that the quality of his life has been sacrificed for some time now.

Believe me, we are not going to accept much negative response from these doctors, someone will answer with options. Those options again must suit approval for Ed. The bottom line though, is that his brain has numerous mets that are new. All Gamma Knives and WBR did work in the past and well at that. WBR for a second time projects a few months to your life from what I am researching myself. For the first time I must say we almost feel defeated but the powers of science are out there. He is willing to do clinical trials and has been for a while now, but the brain was controlled and the body was starting Ixempra.

I will travel to the ends of the world with him to visit hope. There is someone that is out there that can give us options or take a chance on treating him. There is someone, somewhere that will offer....and then I will step aside and watch what Ed feels and pray that he chooses something he is comfortable with.

I cannot wait for tomorrow even though I do feel I will not like many things that are being presented to me. Tuesday we have an appointment with OncoMan and I plan on taking my list.......A list I started here, one compiled with suggestions from you Warriors, last ditch efforts and many long shots. I have information from other research of brain mets and brain cancer also. The more p.o.'d I get with cancer, the more I want to fight back. In the back of my mind I have to remember that 33 months is a long amount of time having the elements of his cancer. We want more, our story is not over. He has fought with all his might and shall continue to beat back the beast in a situation that looks impossible this time. Love to all.>>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 06-14-2009, 12:48 PM   #9
ElaineM
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Wink MARIE - What about necrosis???

Marie and Ed
Keep up your fighting spirits !!!!!!!!
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ElaineM
12 years and counting
http://her2support.org/vbulletin/showthread.php?t=48247
Lucky 13 !! I hope so !!!!!!
http://her2support.org/vbulletin/showthread.php?t=52807
14 Year Survivor
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Old 06-14-2009, 01:37 PM   #10
Believe51
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You know it Elaine. And by the way, I rambled so much that I forgot to answer you. These mets are seeded everywhere and will soon to pose issues. Time is of importance because it is working against us at the moment.

I have started him on my favorite drug (not~Wink), Decadron, to keep brain swell down. I think it is important to keep an eye on the worse mets and know their areas so I will be aware of what side effects will affect him. He has had previous mets in areas that would cause paralysis and such. I am worried about the last freedom Ed has, driving.

If you look at him now, one would say he looks great. Of course he looks great, he is still full of fight and hope, energy is good and all pain managed as good as it can be. Appetite is better but weight cannot be gained and very hard to maintain.

We are gearing up for the fight of our lives. You all are keeping my hope alive and inspiration flowing.......my greatest thanks.>>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 06-14-2009, 02:08 PM   #11
Rich66
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Just so I understand, why no traction with Rexin-G?
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Old 06-14-2009, 05:10 PM   #12
Barbara H.
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Thinking of you.

Hi Marie,
My computer is acting up and my name no longer appears when I log on to the website. I put in what I thought was my password and it didn't work.

However, I needed to try and post because my heart goes out to you and Ed. I know that you plan to see Dr. Winer at the Dana Farber. I also suggest that you try an get an appointment with Peter Black. He did my surgery and is excellent. He is also very compassionate.

I don't have any suggestions for you, except that I have had three brain surgeries as a result of my brain met. The other two turned out to be necrosis, and Dr. Black was quite sure that was a possibility when others did not offer me that hope.

Best wishes on this continued journey. Please know that my thoughts are with you even when I don't post. I read everything you write.

Best regards,
Barbara H.
P.S. I finally got back into the system.
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Old 06-14-2009, 08:40 PM   #13
Believe51
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Have no fear Rich, Rexin-G is on the list. Another project in the works.

And Barbara, I value your continued support when it comes to DFCI. I will be looking into things tomorrow.>>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 06-16-2009, 06:49 AM   #14
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Join Date: Feb 2008
Location: Georgia
Posts: 1,486
Marie,

This is the first chance I have had to log in this week. I will be praying for the Mighty Oak and thinking of you. Please let us know what happens at the doctor's appointment.

Amelia
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