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Old 12-09-2015, 07:47 PM   #1
annettchen
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Join Date: Mar 2014
Posts: 95
Unhappy Suspicion of many scattered brain mets

Hi there,

Had a CT scan of the brain. They now sugegst a follow up MRI as the CT scan was "suggestive of many, small scattered brain mets". Trying to get the MRI scheduled ASAP to get clarity, but has anyone been in this situation? If so, assuming it is in fact mets, what treatment(s) did you get? How long ago? Any way to get around WBR?

It's galling that the rest of the body is still stable, apparently. Oh well, BBB, I guess, is doing it's job...

Needless to say, very, very scared right now.I have a daugther that will turn 7 next week. I so wanted to see her turn 10...

Thanks!
__________________
Annette
----------------------------------------
03/2014: Diagnosed with ER/PR-, HER2+++ MBC (bone mets, oligometastatic)
04/2014: Started 6 cycles of "PHD" (Perjeta, Herceptin, Docetaxol)
07/2014: Finished 6 cycles of PHD; restaging; 2 bone mets are sclerotic - looks like Herceptin and Perjeta is working
10/2014: STABLE!
01/2015: STABLE!
04/2015: STABLE!
08/2015: STABLE!
12/2015: BRAIN METS. BODY STABLE.
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Old 12-09-2015, 09:48 PM   #2
MaineRottweilers
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Posts: 570
Re: Suspicion of many scattered brain mets

I don't have any experience with this but I wanted to extend my sincere concern to you. I'm sorry you are going through this. waiting for confirmation is excruciating. I pray your wait is short and results are not serious.
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___________________________________________
11/12 BSE ignored the lump for SIX months.
5/1/13 IDC ER/PR- HER2/neu+++
5/14/13 Mastectomy and SN biopsy
5/20/13 IDC Stage IIb Grade 3 Nodes 1/4 also IDC and DCIS multi focal in remaining dissected tissue.
5/30/13 MUGA and CT thorax, abdomen & pelvis, establish baseline.
6/4/13 Installed my little purple power port.
6/14/13 Chemo started TCH
6/14/13 Informed of suspicious ares on scans scheduled PET.
7/1/13 PET Scan NED!
9/27/13 FINAL CHEMO taken! ----well, maybe not.
10/15/13 Three little tattoos.
10/24/13 Radiation begins and fourth tattoo placed.
11/27/13 Perfectly radiant! Radiation completed the day before Thanksgiving and so, so much to be thankful for this year and every day hereafter.
1/2/14 Happy New Year, you have a Goiter? Muga down to 59%.
1/17/14 Hashimoto's Dz Dx'd. Now maybe I'll feel BETTER!
5/2/14 Herceptin completed! New kitten!
8/19/14 Prophylactic mastectomy (right) and PORT OUT! I'm DONE and now I really am a SURVIVOR.
2/15 Started not feeling so swell. Memory lapses and GI issues with nausea and blurry vision.
4/30/15 U/S cystic gallbladder, cyst on right ovary and mass in my uterus. GYN consult scheduled---and cancelled. I'm not ready.
5/4/15 Brain MRI clear (big sigh of relief)
7/30/15 Back Pain
8/31/15 Radiograph: compression fracture L2
9/10/15 Bone Scan positive
9/21/15 CT scan conclusive for tumor
10/1/15 CT guided biopsy & Brain to Pelvis MRI reveal additional lesions on spine C6, T10, T11 and L2 is collapsing.
10/8/15 Abbreviated pathology: new tumor(s) poorly differentiated carcinoma consistent with known breast primary.
ER-/PR+ (40%)
HER2/neu+++ Ki-67 4% Pancytokeratin AE1/3 Strong Positivity in all malignant cells.
10/13/15 Abnormal Dexa: moderate risk of fracture to both femoral head/neck R&L. Significant risk to lumbar spine.
10/14/15 Radiation consult back to the cooker.
10/20/15 MUGA 50% down from 54% after a year off Herceptin (???)
10/21/15 Kyphoplasty L2
10/22/15 Re-start Chemo: Perjeta, Herceptin & Taxotere
10/26/15 PET Scan confirms C6, T10-11, L2, new lesion noted at L4 but no visceral involvement---Happy dance!!!
10//29/15 Xgeva
10/29/15 Radiation Simulation--three new tattoos to add to my collection. Just call me Dotty.
10/30/15 CA27-29 63 U/mol (<38 U/mol)
11/3/15 First Trip to see Dr. E. Mayer at DFCI
11/4/15 Surgical consult to re-install my little purple power port.
11/9/15 Radiation treatment one of five.
11/10/15 Installed my little purple power port and not a moment too soon, took them four tries to get an IV started today.
Yes, we really are going down this road again.
12/5/15 CT for suspected pulmonary embolism demonstrates increase in T10-11 mets.
12/8/15 Bone Scan uptake at T10-11 (not seen 9/17/15) & Right 8th Rib (not evident on PET 10/26/15)
12/10/15 Consult Re: PROGRESSION. Halt THP due today. Schedule PET and order TDM1 for next week. PLAN B.
12/14/15 PET scan: NO PROGRESSION! THP is working, metabolic activity minimal. Merry Christmas to me! Sticking with PLAN A, it's working.
1/7/16 Start Taxol weekly instead of Taxotere (has been too taxing and not rebounding between txs.) Zometa instead of Xgeva.
3/28/16 CT shows new sclerotic lesions on T12, L3, L5, L6, right ilium and head of right femur. No uptake on Bone Scan (progression????)
3/31/16 Discontinue Taxol start Arimidex, still getting H&P.
6/2/16 Discontinue Arimidex and start Exemestane.
6/18/16 PET is NEAD!!
7/1/16 Discontinue Exemestane and restart Armidex (SEs)
8/29/16 CT/Bone Scan Stable (still uptake at T10-11)
10/3/16 BSO pathology negative
10/10/16 MRI: Brain clear!
10/14/16 Switched care to Harold Alfond Center for Cancer Care
11/24/16 Xgeva, New MO preference to Zometa
12/12/16 CT/Bone scan Mostly stable significant uptake at L2 plan to PET
1/12/17 PET shows NEAD celebrate with a new puppy!
3/29/17 CT & BS = NEAD
7/31/17 Aetna denies access to H&P <gearing up for a fight>
8/4/17 CT& BS= STABLE
8/9/17 No treatment, Aetna still denying H&P
8/14/17 Aetna appeal approved H&P through February 2018!
2/5/18 CT & BS = STABLE

//
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Old 12-10-2015, 05:57 AM   #3
Lucy
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Re: Suspicion of many scattered brain mets

I'm so sorry you're having to deal with this. I don't have any experience with this either so can't offer any advice, just my prayers for a good outcome.
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Old 12-10-2015, 09:58 AM   #4
thinkpositive
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Posts: 411
Re: Suspicion of many scattered brain mets

I don't have any experience with mets. However, I do know that there are many women on this site that do. One member (StephN) had brain mets 10 years ago and is still doing well. Additionally, my understanding is that there is a lot of research and trials underway currently for treating brain mets.

The waiting and not knowing is brutal. I feel for you. I pray that you get the results soon and that the results bring you back to stable asap.

Take care,
Brenda
__________________
8/2013 Diagnosed IDC Left Breast ER-/PR-/HER2+ Stage 3C, DCIS ER+/PR+/HER2- Right Breast (54 yr)
8/2013 PET/CT scan shows mass in uterues and suprclavicular nodes
8/20/13 Begin 6 rounds TCH chemo, Perjeta added for rounds 4-6
9/2013 After 1st round of chemo, mass in neck and breast no longer able to feel
11/2013 Hysterectomy, mass from PET/CT scan not cancer (adenomylosis)
12/2013 Finished chemo
1/2014 Double mastectomy with chest expanders
1/2014 Pathology report from surgery and SNB show complete pathological response!
3/2014 Finish IMRT radiation
8/2014 Fat transfer to radiated breast
8/2014 Completed 1 yr of Herceptin
10/2014 exchange surgery expanders removed implants placed
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Old 12-10-2015, 10:54 AM   #5
agness
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Re: Suspicion of many scattered brain mets

The research they are using is several years out of date. They are going to offer you WBR because its the best they can offer to you right now. It might work, it might not. They can do things like give you alzheimers drugs and try to spare the hippocampus -- you will still likely experience a cognitive deficit.

I don't know where you live but right now new "Right to Try" laws are being passed across the country and they allow patients like you to try to do something different. Take a look and see if your state shows up, if not it is still probably leveragerable in your favor.

A little bird told me that Genentech knows that IT Herceptin can go after deep brain mets in a way that existing therapies for brain mets do not. They aren't reporting on this as they don't want to get in trouble with the FDA. IT Herceptin is a reach for you without leptomeningeal disease but it might save your life.
__________________
  • Dx 2/14 3b HER2+/HR- left breast, left axilla, internal mammary node (behind breast bone). Neoadjuvant TCHP 3/14-7/2. PCR 8/14 LX and SND. 10/21-12/9 Proton therapy to chest wall.
  • Dx 7/20/15 cerebellar met 3.5x5cm HER2+/HR-/GATA3+ 7/23/15 Craniotomy.
  • 7/29/15 bone scan clear. 8/3/15 PET clean scan. LINAC SRS (5 fractions) Sept 2015. 9/17/15 CSF NED, 9/24/15 CSF NED, 11/2/15 CSF NED.
  • 10/27/15 atypical uptake in right cerebellum - inflammation?
  • 12/1/15 Leptomeningeal dx. Starting IT Herceptin.
  • 1/16 - 16 fractions of tomotherapy to cerebellum, break of IT Herceptin during rads, resume at 100 mg weekly
  • 3/2016 - stable scan
  • 5/2016 stable scan
  • 7/2016 pseudoprogression?
  • 9/2016 more LM, start new chemo protocol and IV therapy treatment with HBOT
  • 11/2016 Cyberknife to temporal lobe, HBOT just prior
  • 12/2016 - lesions starting to show shrinkage
  • 8/2017 - Stable since Dec 2016. Temporal lobe lesion gone.
  • Using TCM, naturopathic oncology, physical therapy, chiro, massage, medical qigong, and energetic healing modalities in tandem. Stops at nothing.
  • Mother of 2 boys - ages 7 and 10 (8/2017) and a lovely partner with lots to live for.

Last edited by agness; 12-10-2015 at 12:58 PM.. Reason: adding a hyperlink, fix typo
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Old 12-10-2015, 12:57 PM   #6
agness
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Location: Seattle, WA
Posts: 285
Re: Suspicion of many scattered brain mets

I sound jaded, that is because I am.

I have been offered WBR several times now. First after they resectioned my cerebellar tumor in the summer. I declined and received LINAC SRS to the tumor bed instead.

Then last week, the proscribed plan included WBR. I declined to the RO -- who admits she doesn't know what targeted therapies can do at all. I was even lambasted by the MO (hello? not your practice area or discipline) for declining WBR.

I still have WBR in my back pocket if I want to do it, if treatment doesn't work. It isn't off the table. But consider this:

They offer WBR because it it standard of care
They offer WBR because "sometimes" it works
They offer WBR because they believe we are going to die soon anyway so it is a reasonable palliative measure in that situation.

It might buy weeks, months or if you win the jackpot -- even years. If you live long enough then the side effects will become evident, the toxicities to the brain of irradiating it are permanent and you cannot undo them.

Compare that instead to IT Herceptin, especially where there is a known PCR elsewhere in the body:

It is known to be safe
It is reversible -- you can undo it if you really want to and without harm to your body
It is well-tolerated
(and evidently it treats deep brain mets too)

The problem is that there aren't studies supporting this yet and they aren't even studying it either. They don't know how long to do treatment for, with what agents, and they don't know when to stop or how. From what I have been reading women are living 4+ more years -- even when given poorer dosing regimes than RuPaul has described. Compare that to the 3-6 months given for LM patients, or at best guess high GPA (graded prognostic assessment) of a 50% chance of living longer than 2 years and they can bite me.

Fight this girl.
__________________
  • Dx 2/14 3b HER2+/HR- left breast, left axilla, internal mammary node (behind breast bone). Neoadjuvant TCHP 3/14-7/2. PCR 8/14 LX and SND. 10/21-12/9 Proton therapy to chest wall.
  • Dx 7/20/15 cerebellar met 3.5x5cm HER2+/HR-/GATA3+ 7/23/15 Craniotomy.
  • 7/29/15 bone scan clear. 8/3/15 PET clean scan. LINAC SRS (5 fractions) Sept 2015. 9/17/15 CSF NED, 9/24/15 CSF NED, 11/2/15 CSF NED.
  • 10/27/15 atypical uptake in right cerebellum - inflammation?
  • 12/1/15 Leptomeningeal dx. Starting IT Herceptin.
  • 1/16 - 16 fractions of tomotherapy to cerebellum, break of IT Herceptin during rads, resume at 100 mg weekly
  • 3/2016 - stable scan
  • 5/2016 stable scan
  • 7/2016 pseudoprogression?
  • 9/2016 more LM, start new chemo protocol and IV therapy treatment with HBOT
  • 11/2016 Cyberknife to temporal lobe, HBOT just prior
  • 12/2016 - lesions starting to show shrinkage
  • 8/2017 - Stable since Dec 2016. Temporal lobe lesion gone.
  • Using TCM, naturopathic oncology, physical therapy, chiro, massage, medical qigong, and energetic healing modalities in tandem. Stops at nothing.
  • Mother of 2 boys - ages 7 and 10 (8/2017) and a lovely partner with lots to live for.

Last edited by agness; 12-10-2015 at 01:00 PM.. Reason: typo
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Old 12-10-2015, 01:39 PM   #7
Donna H
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Join Date: May 2014
Posts: 307
Re: Suspicion of many scattered brain mets

Fight with everything you have. Be a squeaky wheel. Stay strong and try to remain positive. Everyone on this site is praying for you!
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Old 12-14-2015, 09:10 PM   #8
annettchen
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Join Date: Mar 2014
Posts: 95
Re: Suspicion of many scattered brain mets

Unfortunately no good news here. Brain mets confirmed. Two 5 mm ones in the cerebellum (still horseback riding, though, which I find kind of amazing), and apparently a scattering of "points that light up" "everywhere". Meeting with onc on Wednesday. From my perspective first choice is IT Herceptin - wondering whetehr that is sometimes combined with stereotactic radiosurgery (on the two bigger ones?).

Second choice T-DM1 + Perjeta. Or possibly try and get into the trial (or compassionate access?) for ONT-380.

CANCER SUCKS.

I need another 10 years with my daughter. I cannot go yet.
__________________
Annette
----------------------------------------
03/2014: Diagnosed with ER/PR-, HER2+++ MBC (bone mets, oligometastatic)
04/2014: Started 6 cycles of "PHD" (Perjeta, Herceptin, Docetaxol)
07/2014: Finished 6 cycles of PHD; restaging; 2 bone mets are sclerotic - looks like Herceptin and Perjeta is working
10/2014: STABLE!
01/2015: STABLE!
04/2015: STABLE!
08/2015: STABLE!
12/2015: BRAIN METS. BODY STABLE.
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Old 12-14-2015, 09:31 PM   #9
agness
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Join Date: Aug 2014
Location: Seattle, WA
Posts: 285
Re: Suspicion of many scattered brain mets

We are going to try to heal you and me both. Your girl needs you, your family needs you.

Don't give up yet. Are you willing to switch your diet drastically? I just did it and I think it makes a huge difference. HER2+ BC likes the CNS because it is protected there and it loves the glucose. You can switch what you eat to have your body change its energy source and burn ketones instead and it will f@#K with the cancer.

Have you requested IT Herceptin yet? Where do you live?

((big hugs)) coming your way
__________________
  • Dx 2/14 3b HER2+/HR- left breast, left axilla, internal mammary node (behind breast bone). Neoadjuvant TCHP 3/14-7/2. PCR 8/14 LX and SND. 10/21-12/9 Proton therapy to chest wall.
  • Dx 7/20/15 cerebellar met 3.5x5cm HER2+/HR-/GATA3+ 7/23/15 Craniotomy.
  • 7/29/15 bone scan clear. 8/3/15 PET clean scan. LINAC SRS (5 fractions) Sept 2015. 9/17/15 CSF NED, 9/24/15 CSF NED, 11/2/15 CSF NED.
  • 10/27/15 atypical uptake in right cerebellum - inflammation?
  • 12/1/15 Leptomeningeal dx. Starting IT Herceptin.
  • 1/16 - 16 fractions of tomotherapy to cerebellum, break of IT Herceptin during rads, resume at 100 mg weekly
  • 3/2016 - stable scan
  • 5/2016 stable scan
  • 7/2016 pseudoprogression?
  • 9/2016 more LM, start new chemo protocol and IV therapy treatment with HBOT
  • 11/2016 Cyberknife to temporal lobe, HBOT just prior
  • 12/2016 - lesions starting to show shrinkage
  • 8/2017 - Stable since Dec 2016. Temporal lobe lesion gone.
  • Using TCM, naturopathic oncology, physical therapy, chiro, massage, medical qigong, and energetic healing modalities in tandem. Stops at nothing.
  • Mother of 2 boys - ages 7 and 10 (8/2017) and a lovely partner with lots to live for.
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Old 12-14-2015, 09:41 PM   #10
annettchen
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Join Date: Mar 2014
Posts: 95
Re: Suspicion of many scattered brain mets

Hi Agness,

thank you. I live in Canada (GTA). A little bird told me that apparently 2 other women managed to get IT Herceptin in Toronto. That is what I will request from my onc on Wednesday, and I will not take no for an answer.

I have cut back on sugar (drastically reduced processed sugar, if any then fruit or honey). I can't manage to cut out all sugars and carbs - I would starve, I think. I don't mind the sugar too much, even though I occasionally ahve a pice of dark chocolate. But I love milk in my coffee and milk products. And while I will try for whole grain (pretty much anything: bread, noodles, rice, etc.) I can't always do that eating out. How do you manage that, and still live a halfway "normal" (ha! what the heck is normal now???) life?
__________________
Annette
----------------------------------------
03/2014: Diagnosed with ER/PR-, HER2+++ MBC (bone mets, oligometastatic)
04/2014: Started 6 cycles of "PHD" (Perjeta, Herceptin, Docetaxol)
07/2014: Finished 6 cycles of PHD; restaging; 2 bone mets are sclerotic - looks like Herceptin and Perjeta is working
10/2014: STABLE!
01/2015: STABLE!
04/2015: STABLE!
08/2015: STABLE!
12/2015: BRAIN METS. BODY STABLE.
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Old 12-14-2015, 11:27 PM   #11
waterdreamer
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Posts: 199
Re: Suspicion of many scattered brain mets

Please look at the Ketogenic diet. If you can read the book - Cancer as a Metabolic disease. I have have focused radiation on three instances (separate) of brain mets. The largest being 1cm. First in 2011, then 2013, and the most recent two in 2015. The latest is a mere 1mm. I was able to experiment a bit a long the way and I did see slight shrinkage of a brain met on the Ketogenic diet. Also look at using Frankinsense oil internally (1 drop on your tongue, pushed up to the top of your palate every 2 hours) must be pure enough for internal use. Hang in there, don't freak out, you can do this and you will celebrate your daughters 10th and many more. No carbs and no sugar. Another really good book, published this year - How not to die.
Please keep us updated.
__________________
Breastfeeding when diagnosed with Her2+ May 2008
Oct 2008 Double mastectomy 22/28 lymph nodes positive
Decline chemotherapy (decision I regret)
Nov 2009 Mets to lungs and bones.
Dec 2009 Start Taxotere and Herceptin, T1, T3 heal completely and lungs are clear, T2 and first rib have lytic lesions. First rib becomes sclerotic. Considered stable.
May 2011, Onc calls progression and I cross over from comparison arm of clinical trial to TDM-1
Brain scan in Sept 2011 showed small tumor in right cerebellum, did Novalis radiation.


Feb 2013 < 1cm tumor in left frontal lobe. Did Novalis in March and latest scan shows no sign of brain metastasis.
Aug 2013 did 36th round of TDM-1 Due to TDM-1 side effects, shortness of breath, and difficulty getting my balance when getting out of bed, agreed with my oncologist to stop TDM-1.
Took a six week break, bone scan showed small uptake on left first rib. CT showed hypodensities in liver (too small to biopsy) and small nodule in lungs (mediastinal).
Started Navelbine weekly. Did one round with Herceptin.
Skipped next 2 rounds, due to neutropenia. Next chemo 7th Nov - have had 3 Neupogen shots, so WBC should look better... Did not tolerate Navelbine well.
December 2013 scans show no sign of active cancer.
March 2014 - currently only on Herceptin - brain MRI clear, PET/CT two nodules in right lung show uptake
May 2014 - stop Herceptin.
Sept 22, 2014 Brain MRI clear :) PET/CT Progression in lungs.
Sept 2014, Xeloda, Tykerb and Herceptin.
Nov 2014 - Decide to take a break from all treatment.
May 2015 - Brain met radiated with Novalis
July 2015 - Have progression in right lung.
Sept 2015 - Perjeta and Herceptin alone after a 9 month break from all treatment.
Nov 2015 - Thoracentesis 1500ml removed from right lung.
Dec 2015 - Two tiny 1mm brain mets radiated in right cerebellum.
Feb 2016 - Thoracentesis 2200ml drained from right lung
Feb 2016 - Stopped Perjeta and Herceptin and started back on Kadcyla as I had no previous progression on it. After 1 cycle of Kadcyla markers begin to drop. On second cycle add Keytruda.
March 2016 - Thoracentesis 1650ml drained from right lung.
April 2016 – Thoracentesis 1500 ml drained from right lung.
June 2016 – CT scan shows progression in right lung, as well as moderate pleural effusion requiring Thoracentesis.
June 2016 – Decide to stop Keytruda, and will do chemosensitivity test through Rational Therapeutics. Plan to continue on Kadcyla for next two cycles.
July 2016 - Start weekly Abraxane with Herceptin. WBRT with hippocampal sparing, Taking Namenda. 15 sessions over 3 weeks.
Aug - Dec 2016 - 2 infusions of Navelbine, very hard on my body and still dealing with anasarca (generalized edema) 1 infusion of Havalen
My doctor wants to put me on hospice.
Dec 23rd 2016 - I am granted compassionate use of Neratanib.
May 31st 2017 - still on Neratinib, feeling good.
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Old 12-15-2015, 03:18 AM   #12
donocco
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Posts: 474
Re: Suspicion of many scattered brain mets

The Ketogenic diet is an excellent idea. Im reading that book now "Cancer as a Metabolic Disease. Im not page 300 of about 425 pages. Cancer cells have problems in their mitchondria and cant oxidise glucose so they ferment it. They also ferment glutamine. They are unable to ferment ketones and this diet could be used to treat cancer. You must have a scientific background Waterdreamer. If it were not for all the chemistry I took in pharmacy school there is no way I could follow the book. Its not easy reading

Paul
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Old 12-17-2015, 07:10 PM   #13
europa
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Posts: 362
Re: Suspicion of many scattered brain mets

I did the Keto Diet when I was on Herceptin. I did it for year and I was monitored by a dietician. It is a tricky diet to be on, not going to lie. You need to consume foods that are high in fat, not sugar, no carbs. But most importantly, you have to monitor your ketone levels every day. It's a science. It's tricky but doable if you are determined. I would highly advise you to become familiar with the Keto Calculator and maybe find a dietician that can help you navigate the diet. But it has amazing results.
__________________
DX 10/2011
PET Scan + MRI 10/2011
Lumpectomy 11/11/11
Stage 2B +++ ER+(10%), PR+(5%), HER2+++(1 positive node, 1 micromets to second node)
AC started 12/2011 ended 1/2012
Taxol + Herceptin weekly for 12 weeks ended 4/2012
30 zaps of radiation done 6/2012
Tamoxifen 6/2012
every 3 weeks of Herceptin for another year.
Metformin Trial 8/12
10/12 MRI- CLEAR
01/13 BRAIN MRI- CLEAR!
01/13 Neck MRI- CLEAR!
FINISHED HERCEPTIN 1/9/2013...Woot Woot
Starting Walter Reed Vaccine Trial 2/13
CT Scans + ultrasound of abdomen CLEAR-5/13
02/2015 through 11/2015 emergency D&Cs for Tamoxifen induced uterine polyps which caused uncontrollable hemorrhaging
12/2015 blood clot to left leg caused by Tamoxifen. No longer taking it. On Xarelto, a blood thinner
12/2015 Ablation to prevent hemorrhaging from potential issues with Tamoxifen residue in my system
1/2016 continuing journey without hormonal therapy. Reevaluating the option of a hysterectomy and oopherectomy.
4/1/2018 2mm stroke. Yes, stroke! No cause ever found but they believe it was a migraine that went bonkers and created a tiny clot. No deficits. I was back to normal with 24hrs. Now on baby aspirin for life.
7/27/2018 hysterectomy and oopherectomy
01/07/2019 Mastectomy and expanders put in
3/22/2019 Vtach, almost died. Cause unknown.
7/22/2019 New perky boobs put in
7/21/2020 Off of all drugs but a baby aspirin because of the stroke in 2018.


www.mychemobag.org
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8 YEARS NED
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