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06-29-2009, 03:54 PM
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#1
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Senior Member
Join Date: Sep 2005
Posts: 290
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Advice Needed from Propeller Heads
Dear Friends at HER2Support,
I have been asked by my earlier mentioned friend to make a very important decision for her, and I must admit I am feeling a little weak in the knees about it.
As I may not have mentioned in the original post, she is contemplating enrolling in a clinical trial using a vaccine that has already shown promise in sensitizing the immune system to attack HER2+ BC cells. She needs to make this decision before she has her surgery. Now here comes the rub. It turns out that she had a prior lumpectomy four years ago for DCIS that was HER2+(+3)ER-/PR-, and the usual course of radiation therapy. Now she has a new case of DCIS that is also HER2+(+3) ER-/PR- in the same breast.
Conventional wisdom would automatically suggest a mastectomy for that breast. However, it has been suggested that she might consider having a second lumpectomy on the same breast that was involved four years ago.
The vaccine was in fact designed to stop HER2+ DCIS in it's early stages and prevent it from recurring. The vaccine will be given for six weeks prior to surgery, whether she chooses lumpectomy or mastectomy. Additionally, SNB will be performed at the time of either surgery. No repeat radiotherapy will be given.
I guess you can all see my concern at not following the standard protocol for a recurrent DCIS. I just don't know what to advise her. It would be great if she didn't need to undergo the mastectomy, and had another lumpectomy instead. If she does choose the lumpectomy after the vaccine, she would need to have a mastectomy later if there is a recurrence. She has no particular fear of either surgery (she is a tough cookie) but doesn't want to have to go through another surgery later if she doesn't have to do so, as it would be "inconvenient" as she says with her own brand of cold calm reasoning.
So, what do I advise she do? Does she roll the dice and have a lumpectomy, or take no prisoners and have the whole breat removed? Again, the vaccine has shown great promise in preventing HER2+ DCIS recurrences. I suppose I could advise her to go ahead and get the vaccine course, and see what imaging shows right before the surgery. If there is a clear response, it would add just a little information to her decision. I hate to ask you guys to help me make the call for her, but I need to know relatively soon. Thanks again for your help.
Sweating like the pig that I am,
Tom
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06-29-2009, 05:10 PM
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#2
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Senior Member
Join Date: May 2008
Location: Hershey, PA. Live The Sweet Life!
Posts: 2,005
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You're not the only swine...
Dear Sweating Pig,
No propeller head here. I do like playing the odds, though, so here goes! Nothing clear on Her2 DCIS. If it were me, I'd want Herceptin, but that isn't an option for stage 0's yet. I would want something to treat the Her2. This vaccine at least offers that. The no radiation part bothers me a bit as it is standard protocol and well documented that it greatly decreases recurrence. However clearly it is not a part of the trial protocol.
Okay, Tom, here is how much of a pig I am. I'd roll for the vaccine. If I got anxious later on, I'd simply have the mastectomy! That way I'd have been treated for Her2 DCIS AND had the offending breast removed. Should go a long way to ensure my existence on this earth.
Yeah, I know, that isn't the unselfish answer, but you cannot argue with the wisdom, ethics yes, wisdom no.
__________________
Smile On!
Laurel
Dx'd w/multifocal DCIS/IDS 3/08
7mm invasive component
Partial mast. 5/08
Stage 1b, ER 80%, PR 90%, HER-2 6.9 on FISH
0/5 nodes
4 AC, 4 TH finished 9/08
Herceptin every 3 weeks. Finished 7/09
Tamoxifen 10/08. Switched to Femara 8/09
Bilat SPM w/reconstruction 10/08
Clinical Trial w/Clondronate 12/08
Stopped Clondronate--too hard on my gizzard!
Switched back to Tamoxifen due to tendon pain from Femara
15 Years NED
I think I just might hang around awhile....
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06-29-2009, 05:20 PM
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#3
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Senior Member
Join Date: Feb 2008
Location: South East Wisconsin
Posts: 3,431
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Especially with the history, I would be very concerned about the accuracy of the work-up imaging in this decision. Each modality has its strengths and weaknesses. Maybe there's a way to employ as many as possible? I would also be concerned about making the decision for her. Careful about the pig/sweat remarks. PETA may be monitoring.
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06-29-2009, 05:40 PM
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#4
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Senior Member
Join Date: May 2008
Location: Hershey, PA. Live The Sweet Life!
Posts: 2,005
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Oh no! Not PETA!
Oh no! Not PETA!
Tom, you may find this helpful. It was posted today by Hopeful (I think).
http://www.asco.org/ASCOv2/Meetings/...stractID=30353
__________________
Smile On!
Laurel
Dx'd w/multifocal DCIS/IDS 3/08
7mm invasive component
Partial mast. 5/08
Stage 1b, ER 80%, PR 90%, HER-2 6.9 on FISH
0/5 nodes
4 AC, 4 TH finished 9/08
Herceptin every 3 weeks. Finished 7/09
Tamoxifen 10/08. Switched to Femara 8/09
Bilat SPM w/reconstruction 10/08
Clinical Trial w/Clondronate 12/08
Stopped Clondronate--too hard on my gizzard!
Switched back to Tamoxifen due to tendon pain from Femara
15 Years NED
I think I just might hang around awhile....
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06-29-2009, 07:59 PM
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#5
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Senior Member
Join Date: Sep 2005
Location: Central Coast, CA
Posts: 3,207
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Tom,
You know I'm not a propellerhead but at least I'm not in PETA.
Speaking from a personal opinion, if it were me I would go for the vaccine but also go for the mastectomy. You just don't want to mess around with Her2+ even if its "just" DCIS.
What is her doctor recommending? Ultimately of course it is her decision but if he/she is suggesting a second lumpectomy perhaps it is because it is a very small area.
Rich also makes a good point, the more surgery in the area the more challenging it is to get good images.
How does your friend "feel" about this?
__________________
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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06-29-2009, 08:30 PM
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#6
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Senior Member
Join Date: Oct 2005
Location: New Jersey
Posts: 3,154
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Tom,
We know that her2 likes to travel and dr's. are now treating DCIS more aggressively than in the past.
Radiation is now part of treatment when just a few short years ago was not.
While the vaccine sounds promising...when it comes to Her2 I use the barn theory....once the barn door is open
well you know the rest of the story.
I would opt for the mastectomy and not hold much faith in the vaccine....I recently spoke with my dr. regarding
the topic of vaccines and he feels we are not there yet.
She certainly can try the vaccine but I would not use it as a treatment option since it is not proven just yet.
Wishing her the very best - please let us know how she is doing.
Kindest Regards,
Jean
__________________
Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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06-29-2009, 08:46 PM
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#7
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Senior Member
Join Date: Feb 2008
Location: South East Wisconsin
Posts: 3,431
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06-29-2009, 11:46 PM
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#8
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Senior Member
Join Date: Apr 2007
Location: LA LA Land
Posts: 1,607
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Well, who asked me? I am neither a pig lover nor a pig hater. BUT sweating? YUCK. I agree with Rich - watch out for making other people's decisions.
To me, she IS having a recurrence. Hello? Same breast, same dna. Maybe because my propeller is not spinning, I am missing something. If it were I, off with the boob! Mastectomy, maybe some reconstruction. And...her doctor should cleverly position this as a recurrence and get her herceptin. This recurrence is an opportunity to get herceptin. There are woman on this board who went from dcis to stage four in one big jump. Tell your lady friend that she should be aggressive. What about diet/lifestyle changes? Her body is "making" cancer and I would take this second showing very seriously. Before it escalates. Hope this helps you!...good luck and blessings,
Flori
__________________
1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda. Finally stops spreading.
2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
1/2006 Rads again, to scar line. NED.
3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
12/07 Herceptin.Tykerb. Markers go stable.
2/8/08 gamma knife 13mm stupid brain met.
3/08 Herceptin/tykerb/avastin/zometa.
3/09 brain NED. Lungs STABLE.
4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
9/09 MARKERS normal!
3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
Dec 2010 Brain NED, lungs/sternum stable. markers normal.
MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
May-Aug 2011 Tykerb Herceptin Xgeva.
Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
12/20/12 add in PERJETA!
March 2013 – 5 YEARS POST continue HAPZ
APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
December '13 BRAIN MRI ned in da head.
Jan 2014: CONTINUING on HAPX…
FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
4. scattered lung nodules, up to 5mm in size = stable, no increased activity
5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
October 2014: hold avastin, continue HPX
Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
Continue HPX. Adding back Avastin
Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX. I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
Markers drop post rads.
2/24/16 HAP plus X - markers are down
SCIATIC PAIN DEAL BREAKER.
3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
APRIL 2016 - 9 YRS MBC
July 2016 - continue HAP plus Xgeva.
DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad. Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
APRIL 2017 10 YEARS MBC
December 2017 - Progression - gonna switch it up
FEB 2018 - Kadcyla 3 cycles ---->progression :(
MAY30th - bronchoscopy, w/foundation1 - her2 enriched
Aug 27, 2018 - start clinical trial ZW25
JAN 2019 - ZW25 seems to be keeping me stable
APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
MAY 2019 - progression back on herceptin add xeloda
JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved or improved results. Markers near normal. I'm stunned but grateful.
10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
Last edited by SoCalGal; 06-29-2009 at 11:50 PM..
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06-30-2009, 07:20 AM
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#9
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Senior Member
Join Date: Jan 2009
Location: Colorado Springs, CO
Posts: 430
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I agree with all of the ladies above. If it were me, I would have the mastectomy without a second thought. But that is me, looking back in retrospect. If reconstruction is a worrisome issue, she might look into the DIEP surgery. That is what I had and would do all over again, given the chance. You can do a search for it here to find some of my previous posts about the subject.
__________________
9/15/08 (age 52) - Mammo: calcifications
9/22/08 - Biopsy: DCIS, grade 3. ER,PR status: Pos. in 75-90% of tumor cells.
10/01/08 - Ob/Gyn appt.: found complex, mostly cystic mass on right ovary - 11cmx12cmx 8cm
10/15/08 - Hysterectomy & Oophorectomy, Lumpectomy: Cyst on uterus, not ovary - all was benign. Breast - 5 of 6 bad margins. 2 Sentinel Lymph nodes removed, both negative. Stage 0, Tis, N0
12/11/08 - Mastectomy & DIEP reconstruction: Surprise! 2 cm Invasive DC, grade 2 found. One benign internal mammary lymph node. Stage 1, T1c, N0, all clean margins. ER+ (Proportion Score = 2/5, Intensity Score = 2/3) and PR+(Proportion Score = 3/5, Intensity Score = 2/3)
HER2 score = 3+
1/09/09 - Oncotype DX: Recurrence S/core of 60 !?!?! ER status is NEG!! PR staus is NEG! HER2 score = 12.2 (still positive, greater than 11.5 is positive).
1/20/09 - Started chemo: TCH
5/26/09 - FINISHED CHEMO!
1/05/10 - FINISHED HERCEPTIN!
1/22/10 - Port-a-catheter removed!
3/07/18 - Still NED
9/10/23 - Still NED
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06-30-2009, 09:21 AM
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#10
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Senior Member
Join Date: Jan 2007
Location: Thornhill, Ontario
Canada
Posts: 2,320
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I am also not a propeller head, but I agree with the majority of the group here - Her2+ is a sneaky nasty sucker - Flori said it all - recurrence in the same breast? hello? As I told my onc. and breast surgeon who really wanted to try and save my breast - I told them both - It's just my boob, my life is more important.
I also asked my BS what he would recommend if I were his wife - he said he'd been doing the mastectomy.
JMHO.
all the best
caya
__________________
ER90%+/PR 50%+/HER 2+
1.7 cm and 1.0 cm.
Stage 1, grade 2, Node Negative (16 nodes tested)
MRM Dec.18/06
3 x FEC, 3 x Taxotere
Herceptin - every 3 weeks for a year, finished May 8/08
Tamoxifen - 2 1/2 years
Femara - Jan. 1, 2010 - July 18, 2012
BRCA1/BRCA2 Negative
Dignosed 10/16/06, age 48 , premenopausal
Mild lymphedema diagnosed June 2009 - breast surgeon and lymph. therapist think it's completely reversible - hope so.
Reclast infusion January 2012
Oopherectomy October 2013
15 Years NED!!
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06-30-2009, 09:42 AM
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#11
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Senior Member
Join Date: Oct 2005
Location: New Jersey
Posts: 3,154
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Tom,
Just tagging onto this thread again.
What Flori mentions is very vital regarding herceptin.
While I do not know of anyone getting herceptin in the DCIS stage this is an interesting topic. Knowing that
the Her2 is sitting there in the duct of the breast, at what point can a women push for herceptin treatment.
Off label maybe? This reminds me when early stage bc was not given herceptin. I would certainly explore this with her dr. Please do keep us posted on your friend
and I send my best wishes.
Kind Regards,
jean
__________________
Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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06-30-2009, 12:08 PM
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#12
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Senior Member
Join Date: May 2006
Location: Haarlem, the Netherlands
Posts: 835
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I agree with all of the above, and would like to mention that the cosmetic effect of another lumpectomy might not be very good. After 5 years, my scar still contracts slightly and on each subsequent mammo I can see the skin being pulled a bit more inwards. So if she's a tough cooky, I'd go for the mastectomy. And for proven treatment.
And as a coach I think you would be better off asking questions in stead of advising. It will have to be her decision, so you can help her by asking her to visualize the various options. E.g.: Suppose you go for option A, how would you be feeling? Would you feel safe? Would you be happy, whatever the outcome will be? Will you be convince that you've done everything you could to survive? etc. Do the same for the other option(s). That way she will find out what she really wants.
Just my thoughts
Jacqueline
__________________
Diagnosed age 44, January 2004, 0.7 cm IDC & DCIS. Stage 1, grade 3, ER/PR pos. HER2 pos. clear margins, no nodes. SNB. 35 rads. On Zoladex and Armidex since Dec. 2004. Stopped Zoladex/Arimidex sept 2009 Still taking mistletoe shots (CAM therapy) Doing fine.
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06-30-2009, 12:21 PM
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#13
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Senior Member
Join Date: Jun 2007
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
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Tom, all I cannot offer medical information because I know most about inflammatory. But prayers come in all languages and that I am fluent in. Sending prayers to your friends and to you too, I know you never expected to be where you are today. Yet a friend has summoned and you have shown up at her side, you are an awesome friend....to them and to us. Stay strong.>>Believe51
__________________
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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07-01-2009, 10:41 AM
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#14
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Senior Member
Join Date: Sep 2005
Posts: 290
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Dearest Friends,
All of you bring me to tears with your willingness to help at a moments notice. I know I am on dangerous ground here, both for my friend and I. Jumping back into the fray of worrying on a daily basis about a close personal friend was a gut wrencing decision for me, but I thought of what my Mom would have said about helping a friend of hers with this stinking mess. I also take into consideration that she is messing with a dangerous pitbull of sorts that will wreak havock on her if it gets out of the yard.
Let me respond as best I can to the stimulating answers you have all posted.
Laurel, I agree that this is a recurrence and should be treated as such. The option of more radiation therapy is out because of the prior course of radiotherapy according to her doctor and is unrelated to any requirement of the vaccine trial protocol. His protocol is quite liberal with respect to much other than that the disease be HER2+ DCIS. Also, thank you so much for the ASCO article. I found it fascinating to say the least, and will site it to her surgeon. This doctor is gonna hate my guts before this is all over. Oh well. I have always been interested in the strange response other areas of disease seem to have when their primery friend is removed. It's as if they know they lost their home base and go into overdrive to battle those trying to make them go away.
Rich, I was concerned about what diagnostics she would have, as again we are dealing with such a rascally rabbbit. As it turns out, the trial will provide tons of diagnostic testing including whole body MRI's before and after her surgery, as well as the latest tumor markers.
Chrisy, you are thinking what I have been thinking all day. Go for the sledge hammer while she can: Vaccine AND mastectomy. She is not obsessed with keeping her breasts intact mind you, but she is toying with the idea of not having to have one or both hacked off if she doesn't have to. I reminded her in the doctor's office that breasts were for nursing, so not to sweat it. Then I realized what a stupid thing I had said and apologized for my insensitivity. What if I were being told I needed to have one or both of my testicles removed? Geez...now that's an eye opener.
Jean, the barn door reference is not lost on me. Thanks for reminding me. They sure are hard to close afterwards.
Flori, I did ask the doctor if anything regarding the vaccine trial might later preclude her form getting Herceptin or other new drugs, and he said absolutely not. Asking for herceptin because of this "recurrence" sounds like a great question. I feel the air from your propeller hitting me in the face as I read your post.
AliceM, the construction issue is already being handled, as the surgeon has a team of plastic surgeons that operate with him at his request. Thank you.
Caya, another vote for the guillotine. I'm getting the message loud and clear now. Life goes on without breasts all the time. Stay alive to enjoy it.
Jacqueline, you are so right about your approach to coaching. I have already asked to have a long sit down with her and her two grown daughters. Sadly, her husband doesn't really seem to give two flying poops about much of it. I never did undersand that side of him. Then again, it isn't his body that they want to rearrange anyway, so who cares what he thinks. I confess they don't have the best relationship to begin with.
Marie, I don't have to say anything about your response. Just watching you in your daily struggle to keep your sweetie speaks volumes and adds support to my new mission. Thank you as always.
Well, this has been an intersting Internet session for me. Oddly, my computer is down and I am writing from the local library which my sweet Mother headed for so many years before retiring to battle one illness after the other. It is difficult for me to sit here where she walked around since I was a child, but I feel her presence as I read all of your posts and rack my mind for the right answers. I must confess that I might not have appreciated the significance of her disease at first blush, knowing that it was "just DCIS". Clearly this is nothing to take any more lightly than if it were a more advanced disease. It's time to slam the door on these hideous little cells while there is still time.
I cannot thank all of you enough for helping me with this difficult task. The pressure of worrying about somebody else almost overwhelmed me until this moment. Thank you all for your mindful input. Watch your home mail boxes. I will be sending new propeller hats to all of you. I am still praying for all of you wonderful patients and family members that are burdened with this disease.
Sweating just a little bit less,
Tom
Last edited by Tom; 07-01-2009 at 10:45 AM..
Reason: Typos
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07-01-2009, 11:55 AM
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#15
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Senior Member
Join Date: Nov 2004
Location: Misty woods of WA State
Posts: 4,128
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Dear Tom -
You have taken on a burden that would make ANYONE sweat! If not from the load itself, or from the memories of all the hard work you did for Mom, just from the stress of getting involved in another person's disease.
Just wanted to point out that I feel that this woman NEEDS Herceptin and should get it however she can and NOT wait. You know what the stats are, or can find them easily enough.
There is a vaccine trial at the University of Washington which is CONCURRENT with recieving Herceptin. Right now we have Schoolteacher and Suthorn taking part that I know of. They both come from the south and have their travel, lodging and taxis covered (for themselves and an "escort").
Not that I have a particular bias from living here, but this sounds like a very solid approach to me.
And I do agree that if the previous rads did not eradicate all the cancer in that breast, it is time to ditch it. Having only one breast 24 hours a day is better than being dead 24 hours a day ...
P.S. "Getting involved with" does not have to mean "make the decisions" - just acting as a filter and passing on your not incondisiderable experience is a huge commitment.
__________________
"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.
Last edited by StephN; 07-01-2009 at 11:58 AM..
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07-01-2009, 05:17 PM
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#16
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Senior Member
Join Date: Jan 2008
Location: "Love never fails."
Posts: 5,808
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Just saw this thread - had to ask hubbie again what 'propeller heads' mean to him. [He's looking up the dictionary right now - must not be a term used in the 'old south' ]
The information provided here is wonderful. Thought I would 'bump' it up.
__________________
Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2
NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa
Advocacy is a passion .. not a pastime - Joe
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07-02-2009, 06:16 AM
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#17
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Senior Member
Join Date: Sep 2005
Location: Melbourne Victoria
Australia
Posts: 330
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been there
Hi Tom
I had a recurrence not seen by ultrasound and barely by mammo in the same breast 4.5 yr after first lump. I wanted a mastsectomy first time but was talked out of it. If I had had it off then I might not have had a liver met second time as well as a 4 cm lump in breast. I am totally convinced that the "recurrence" was actually there all along but was not "seen" and was then shrunk by chemo and rads and then grew back to 4 cm over the next four years. An MRI of the breast could give a better picture of what is going on for your friend.
If it was me..off with the breast and on with the herceptin!
Jackie (down under)
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