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Old 01-04-2007, 01:28 PM   #1
MichelleMoon
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Join Date: Oct 2006
Location: Chicago
Posts: 36
Question Brain met treatment w/ Xeloda/Temodar

Hi there,

As if stopping lung mets a few months ago wasn't enough display of my character , now I need to beat back brain mets. I have a scattering of small lesions, the largest being 4 mm. Esther provided me an excellent overview of the radiation and surgery options. Although I haven't spoken directly with my doctor since finding this 2 days ago (argh!), the other oncologist said he would recommend WBR straight away.

Believe me, I don't want to mess around with these things, but is Xeloda/Temodar ever used as a first line treatment for brain mets? I know a few of you have gone this route after radiation.

I lurk very often and I'm amazed at the strength and knowledge of this group!

Michelle
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Michelle


Stage 2 '99, triple negative, 5 nodes involved
mastectomy, AC + T, rads, '01 TRAM flap
Stage 4 '06, lung mets, ER/PR-, HER2++
07/06 - 11/06: Taxol + Herceptin to 'strong partial remission'
11/06: Herceptin every 3 weeks indefinitely
01/07: brain mets, finished WBR, NED in head!
04/07: Xeloda and Tykerb for lung met progression
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Old 01-04-2007, 09:30 PM   #2
Annemarie
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Join Date: Nov 2005
Location: New York
Posts: 90
Brain Mets

Hi,
Sorry for your news. I have had brain mets 3 times. Twice tiny like yours. You would be an excellent candidate for gamma knife being it is so small. Then follows WBR. Tykerb will be out in Feb. which crosses the bbb. I do take Temodar because there is not a lot of options. The studies show it works well for primary brain tumors and not that impressive for brain mets.
Annemarie
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Old 01-05-2007, 11:12 PM   #3
Adriana Mangus
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Join Date: May 2006
Location: California
Posts: 668
Smile Brains mets

So sorry to hear about the brain mets. I worry so much about brain mets. I have a recurrence in 2003 to rt lung and was on navelbine + herceptin, I will start xeloda next week due to tumor growing back. I do not know about xeloda, but send a message to Stephan, she's been dealing with brain mets for awhile. Best whises for you. Take care.
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1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 01-05-2007, 11:19 PM   #4
Adriana Mangus
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Join Date: May 2006
Location: California
Posts: 668
Wbr?

How did you find out you had mets to the brain? Also what does WBR mean?
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 01-06-2007, 08:22 AM   #5
MichelleMoon
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Join Date: Oct 2006
Location: Chicago
Posts: 36
How brain mets found

I'm almost afraid to fess up about the brain met symptoms because I don't want to alarm all of you healthy people!

I began having mild intermittent headaches a couple months ago and initially blew it off as holiday tension. My oncologist ordered an MRI, more to appease me because he didn't seem concerned (I was staged in June). Well, wouldn't you know the MRI found 7 very small tumors. Neither my oncologist or the radiology oncologist believe these tumors caused headaches because I have no brain edema. The princess and the pea story comes to mind...

I'll be starting 15 rounds of WBR (whole brain radiation) next week. I'm hopeful this will take care of these.

Good health to you!
__________________
Michelle


Stage 2 '99, triple negative, 5 nodes involved
mastectomy, AC + T, rads, '01 TRAM flap
Stage 4 '06, lung mets, ER/PR-, HER2++
07/06 - 11/06: Taxol + Herceptin to 'strong partial remission'
11/06: Herceptin every 3 weeks indefinitely
01/07: brain mets, finished WBR, NED in head!
04/07: Xeloda and Tykerb for lung met progression
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Old 01-06-2007, 08:52 AM   #6
Sandy H
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Location: Norridgewock, Maine
Posts: 778
Michelle, I have a question. I see from your profile you are Her2- then why are you getting Herceptin???? It is for Her2+ patients. Is this your oncologist idea. I had a friend who's doc wanted to put her on Herceptin and hormones and she was negative for both. She went for a second opinion at Dana Farbar and was told no reason to take either she was negative. Her doctor said he felt it wouldn't do any harm for her to take these drugs it might help!!! Dana Farbar said no sense in putting any drugs not necessary in the body as they all have side effects. I hope I haven't opened up a can or worms here but I was just wondering. You may want to check this out. I am surprised your insurance will pay for it however, my friend's insurance was going to pay. Some things I don't understand with these insurances. Wishing you well and sorry to hear about your mets. hugs, Sandy
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Dx. 03/01, Rt. IBC
AC/Taxatere
Rt. MRM-with graft Lt. simple
5 rads-skin mets
Herceptin, taxol, carboplatin (taxol seem to be the magic drug)
Navelbine & xeloda (did not work)
topical miltex for skin mets
Tykerb/xeloda
thoracentesis x 2 left lung fluid shows cancer cells
Port removal (4 years) with power port replacement
Doxil
Updated 05-07 Scans show no bone or organ involvement we shall see!




I shall not pass this way again. Any good I can do or any kindness that I can show let me not defer or neglect it for I shall not pass this way again.
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Old 01-06-2007, 08:56 AM   #7
MichelleMoon
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Join Date: Oct 2006
Location: Chicago
Posts: 36
Was HER-, now HER+

Hi Sandy,

I seem to be a unique case! I was triple negative upon my initial diagnosis in '99. My '06 lung mets had turned HER2+++, so that's why I'm on herceptin. This is why I encourage everyone to have their mets biopsied and retested. Maybe the length between my initial diagnosis and mets made this more possible?

Take care of you,
__________________
Michelle


Stage 2 '99, triple negative, 5 nodes involved
mastectomy, AC + T, rads, '01 TRAM flap
Stage 4 '06, lung mets, ER/PR-, HER2++
07/06 - 11/06: Taxol + Herceptin to 'strong partial remission'
11/06: Herceptin every 3 weeks indefinitely
01/07: brain mets, finished WBR, NED in head!
04/07: Xeloda and Tykerb for lung met progression
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Old 01-06-2007, 08:26 PM   #8
Annemarie
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Join Date: Nov 2005
Location: New York
Posts: 90
Mets

Each met gets biopsied and tested for hormone status, Her 2 status and other markers. It is not unheard of to have different status than the primary tumor. Mine were always the same as the primary.
Annemarie
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Old 01-06-2007, 08:56 PM   #9
chrisy
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Location: Central Coast, CA
Posts: 3,207
Michelle,
Have you talked with Christine Druther, the founder of this site? She was diagnosed with brain mets in I think 2001 and is not only a great advocate but a wealth of information in this area.
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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 01-09-2007, 09:25 AM   #10
KathyA
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Join Date: Aug 2006
Posts: 16
Thumbs up Brain Mets

Dear Michelle, don't know a thing about xeloda but I too found out about brain mets on Dec. 28, 2006. Today I have my sixth radiation (WBR) treatment. I am only having 10 rounds though. Thank God. I am finding them difficult except today is the mildest headache I've had. I have 12 lesions ranging from 2mm to 22mm. My onc also said that wbr was best because there are probably lesions that we can't see. I have blurred vision and some imbalances. I thought that I might have a lesion or two because of the symptoms but I sure was surprised with 12 even though they are small. I was diagnosed first in Feburaty 2003 and then mets May 2005. I have bone, liver, lung and now brain mets. What a trip. I've been on some kind of chemo every week for the past year and a half. The last two treatments Gemzar and Navelbine didn't do anything positive not even stable. However, and this is big, I don't feel badly, that is sickly. I am truely blessed. The radiation has for the first time, though, made me feel like I have Cancer. But only 5 more treatments counting today. Sure hope thing go well for you. I willbe praying for you and the rest of the crew on this site.

Love Kathy A
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Old 01-09-2007, 05:17 PM   #11
Ceesun
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Good wishes to all, Ceesun
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