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Old 06-20-2007, 02:55 PM   #1
Barbara H.
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Muga

Hi,
I am trying to get into a trial and just had a Muga scan. It hasn't been completely analyzed, but the technician said it was 47. Since it is below 50 I am probably disqualified from the trial. Does this mean I have to discontinue Herceptin? Also, does anyone know how to increase this score? I am quite upset because I was looking forward to this trial.
Thanks,
Barbara H.
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Old 06-20-2007, 03:25 PM   #2
chrisy
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Hi Barbara,
I'm sure you are very discouraged right now. You are probably right about the trial, and may also have to stop Herceptin for a while to let your heart rebound. The good news is, most times the damage is reversible and after coming off Herceptin for a time, people can go back on again. Keep in mind, this is for your protection - none of this will do any good if you don't have a beating heart.

Couple of things to consider, tho - have you had ECHO's or MUGA's in the past? And if so, is this result appreciably different from your prior? Perhaps you could get it "redone". I've had mine fluctuate to as low as 53 then up to 68. I just had an ECHO yesterday - so of course I've got that top of mind myself.

As to how to get things back on track, here is a link Becky posted regarding aerobic training, and I know many have taken CoQ10 supplements to support their heart health.
http://her2support.org/vbulletin/sho...light=ejection
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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 06-20-2007, 03:46 PM   #3
Barbara H.
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Thank you Chrisy. I have only had an echo.
Barbara H.
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Old 06-20-2007, 04:09 PM   #4
Susan McQ
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Mine went down to 47, I was taken off herceptin for 1 month. Then had a repeat Muga and it went back up to 54. I was then able to complete my year of herceptin.

Susan
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dx IDC @ age 39 Feb '06
stage 2 er/pr-, her2+
neoadjuvant chemo 4 A/C completed April '06, 12 weekly taxol/herceptin completed 8/06, lumpectomy 8/15/06 NED!
33 rads completed 10/06
weekly herceptin thru May 2007 --Stopped herceptin 4/07 due to drop in LVEF. Started Herceptin again 5/07
Final Herceptin 6/12/07
Port Removed -8/13/07
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Old 06-20-2007, 04:12 PM   #5
Mary Anne in TX
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Hi Barbara! I take the CoQ-10 and it surely does seem to work for me. ma
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Grateful for each and every day....

Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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Old 06-20-2007, 08:27 PM   #6
mamacze
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Hi Barbara!
How frustrating for you to have this be the only barrier to a promising clinical trial. Mine has fluxed from 56 - 66 %...when I hit my low, I saw a cardiologist who has me on a program of cardio work 1 hour per day and salmon, co Q 10, walnuts, lots of omega 3 fatty acids...you know the drill...if you are up to it, hit the gym....then wait and get your next MUGA the day BEFORE your next Herceptin...let us know what happens
Love Kim from CT
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Old 06-23-2007, 09:12 AM   #7
rentrac
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Since I've had Adriamycin and Herceptin over the last 3 years, I've seen my MUGA drop from 64% to 53%. I'm not on Herceptin now, but I"m convinced that a good half hour walk every day has protected my heart. Even when I felt weaker than a newborn kitten, I would still walk, just VERRY slowly, and with someone along to help me out. I'm pretty sure you can improve your MUGA numbers with exercise, but I'd get an OK from your oncologist about the best way to go about getting the exercise that's best for you. Incidently, I found that swimming was even more enjoyable for me than walking, even if "swimming" means a very slow back stroke for 1/2 the pool length. I figure that as small as a grain of sand is, with enough of them you can get a sand dune, so a little exercise is better than none! Best of Luck to you!
Rentrac
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Old 06-23-2007, 10:06 AM   #8
chrisy
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Maybe a little encouragement

Hi Barbara,

I got the results from my ECHO on Thursday - the first one since I went off Herceptin - and my LVEF is up to 73! The ones prior to entering the trial were 65 and 68. The 68 was "longer after" my last herceptin treatment, so maybe there is a difference when in the cycle you get the test done, as someone else said, get the test the day before your herceptin. But the 73 is for me a personal best since they have been measuring it, it was at some points in the mid-low 50's. So a break from the Herceptin may turn things around for you quickly and possibly allow you to get into the trial after all.
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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 06-23-2007, 11:06 AM   #9
Barbara H.
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Unhappy

Hi Chrisy,
Thank you for the encouragement. I am pleased for you that your score has increased. Unfortunately, it turns out that my Muga score was 45%. The oncologist running the trial even called Genentech because he felt that I was a perfect candidate for the trial. Actually, I had been off Herceptin for 5 weeks when I took the test. I feel like a diabetic that has to lose insulin. When I started on Herceptin alone (July 04) with mets to my brain, lungs, liver, skin, and through out my body in the lymph nodes I became NED in about two months. I stayed that way until Feb. 06 when it came back in the bones, the only place it didn't appear in May 04. Everything else has remained OK and it is felt that Herceptin continues to help even if the cancer appeared in the bones.

I already take 150 mg of CoQ10 in the morning. I plan on increasing the dose and need to start exercising again. I was put on Navelbine in Feb 04 which wiped me out. I responded with only stable bone mets. I went off of it in Dec. 06 because I had to have brain surgery again for radiation necrosis. Then I had a bone biopsy in Feb. 07 to see if my hormones had changed to positive. The biopsy did not work. I did a few rounds of Faslodex just to see with no result. So here I am with a great trial for me, but I can't participate, at least not at this time. I will see my oncologist on Thursday and probably start Tykerb with Xeloda.

Through all of this I have continued to teach third grade full time and have missed very little work. The only time I took off this past year was two weeks for my brain surgery. My big problem is that I haven't made time in my life to exercise since my cancer returned to my bones, and this Muga test result is certainly a wake up call. My plan is to start walking, kyaking this summer, and see a cardiologist.

I have to say that I have tried to stay as positve as I can about this latest bump in the road, but I have short moments of feeling quite sad.

I typed Muga into the search section and gained some helpful information about how I might improve my score. I appreciate this information and those of you who have responded to my post.

Best regards,
Barbara
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Old 06-23-2007, 02:57 PM   #10
Andrea Barnett Budin
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Wink Better Echo Scores

Barbara, You're amazing! Working and all you've been through. Taking time off for brain surgery... Hope you're doing a lot of deep breathing exercises.

You can check my signature for my story. I initially had a MUGA, then ECHOs ev 6 mnths. Last yr Pegram graduated me to annually at this point in my career as a Survivor. My NY onc/supplement guru has me on Co Enzyme Q10 150 -- twice a day. Has added Perfusia (arginine, but that's the one he prefers, best quality I suppose) 380 -- just once a day, though the bottle says take lots more. He swears THAT 1 Perfusia a day will boost your ECHO right off! I take Omega 3s EPA 800 + DHA 400. My doc wants me to take NEUROMINS instead. I'm thinking about it. B6 (P5P50 activated B-6, which doc says is best). Grapeseed Extract 150, Carnithane 500, Magnesium 200 and Potassium 545 twice a day. ALL FOR HEART HEALTH. I get most of my vitamins from Vitacost -- good quality and reasonably priced. A bargain isn't always a bargain when it comes of vitamins, you know. Hope this helps, as I know only too well how vital staying on Herceptin is. YOU CAN DO IT!

I wish you WELL. I am sending loving, healing energy to you right this moment. Let us know how you do. My money is on YOU, Barbara. You sound like you have it together, besides the sad moments, which come crashing down on us all from time to time. We just have to walk right through the fear and uncertainty and move over to the positive side. Stay strong in Spirit and in health. LOVE, ANDI

Hope you
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'95 post-meno dx Invasive LOBULAR w/9cm tumor! YIKES + 2/21 nodes. Clear mammo 10 mnths earlier. Mastec/tram flap reconst/PORT/8 mnths chemo (4Adria/8CMF). Borderline ER/PR. Tamoxifen 2 yrs. Felt BLESSED. I could walk and talk, feed and bathe myself! I KNEW I would survive...

'98 -- multiple mets to liver. HER2+ 80%. ER/PR- Raging, highly aggressive tumors spreading fast. New PORT. 9 mnths Taxotere Fought fire w/fire! Pronounced in cautious remission 5/99. Taxotere weekly for 6 wks, 2 wks off -- for 9 mnths. TALK ABOUT GRUELING! (I believe they've altered that protocol since those days -- sure hope so!!)
+ good old Vit H wkly for 1st 3 yrs, then triple dosage ev 3 wks for 7 yrs more... The "easy" chemo, right?! Not a walk in the park, but not a freight train coming at 'ya either...

Added Herceptin Nov '98 (6 wks after FDA fast-tracked it for met bc). Stayed w/Vit H till July '08! Now I AM FREE! Humbly and eternally grateful for this life-saving drug! NED since '99 and planning on keeping it that way. To hell w/poor prognosis and nasty stats! STOPPED VIT H JULY '08...! REMAIN STABLE... Eternally grateful...Yes is a world & in this world of yes live (skillfully curled) all worlds ... (e e cummings) EVERY DAY I BEAT MY PREVIOUS RECORD FOR # OF CONSECUTIVE DAYS I'VE STAYED ALIVE. Smile KNOWING you too can be a miracle. Up to me and God now...
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Old 06-23-2007, 03:34 PM   #11
Barbara H.
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Thank you!

Hi Andi,
Thank you for your advice and healing energy. I have been reading your posts and marvel at how you are holding up under the stress and what you are going through. My thoughts are with you as well, and I'm sure that all will work out well in the end.
Best wishes,
Barbara H.
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Old 07-15-2007, 11:57 PM   #12
Gina
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To improve MUGA...

I swear by walking and Magnesium...also, eating onions and garlic are age old supporters of the heart muscle, but REMEMBER, it is a MUSCLE, that is why the walking is essential...also, you need to somehow get more rest. Try a warm epsom salt soak before sleep.

Have missed talking with you--it has been a long while,
Gina
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Old 07-16-2007, 07:04 AM   #13
BonnieR
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I have had Echocardiograms in the past but what is a MUGA?
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Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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Old 07-16-2007, 09:43 AM   #14
Barbara H.
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Muga scans

Gina, thank you for your wisdom. It is so great to see you posting for the support group again.

Bonnie, the muga test is another way of measuring the pumping action (ER fraction) of the heart. Check this site for more information.
http://heartdisease.about.com/cs/car...sts/a/muga.htm
I have been walking and exercising. I will have another muga scan next Monday. Hopefully, it will be normal again.

Best regards,
Barbara H.
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Old 07-16-2007, 10:41 PM   #15
StephN
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Thumbs up Successful MUGA test

Dear Barbara -
I certainly am sending you big, best wishes for a better score this next time.

My annual MUGA was today and the technician told me that my score is just the same as last year - 60. Naturally I am VERY pleased about that.

I was wondering if you need more of a workup than what the cancer center does. Maybe your GP can send you to a good cardiologost just to put you through another test or two and maybe vary your plan. Since it seems you are doing many of the "normal" right things to keep your heart in good condition. That left ventrical is the "workhorse" of the four heart chambers and important to keep in good running order.

Got family descending on me from all sides at the moment, so have to cut my time on the site here.
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"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.
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