Al from Canada....question for you!

Robyn · 01-15-2006, 09:17 PM

Hi,

I live in London, Ontario. I had a recur to mast. scar line (local)....had scan, bones, liver, pelic clear, lung has 7mm inconclusive nodule....will rescan in two months to evaluate. I will undergo rads to the mast.scar line...I asked if I could do chemo and herceptin as a re-adjunctive treatment, but they say it is NOT protocol and will NOT give me either as I do not fall in the qualifications of chemo or Herceptin. I figured in the least, I would be eligible for Herceptin, but apparently I am in this "gray" area. Unless I pay for it? I have been reading your posts and you seem very knowledgeable in this area....any thoughts?? I suppose if this spot grows it is cancer and then I am eligible....I am curious though. I have a friend that lives in Manitoba and has the same recur. except the her2, but they recommended chemotherapy as a "back up"???

Thanks for your help or any other Canadians out there with info on this.....I like to be armed with all my facts.

Robyn
xx

julierene · 01-15-2006, 09:23 PM

2 months seems like a long time. Can you push for 1 month?

Lolly · 01-15-2006, 10:03 PM

Robyn, if it helps your case at all, here's a link to the Seattle Cancer Care Alliance's web site, along with an excerpt; their recommendation would support radiation and/or chemo. If that is what you want to ease fears of a more serious recurrence, you will possibly have to "shop" around; ie. a second opinion?

Also, I agree with julierene, 2 months seems like a long time to wait, not knowing what you're dealing with in the lung. What is your health system's take on PET scans? If that's not possible, push for another CT to the lungs/abdomen, but be sure it's WITH contrast, a nuclear injection that will help "highlight" any areas of abnormality.

Treatment Options

Treatment for a Local Recurrence

Despite treatment, breast cancer sometimes comes back. If the cancer reappears in the breast or near the mastectomy scar, it is a local recurrence.

The treatment you will receive for a local recurrence depends on the treatment you had initially.

· If you had a lumpectomy or other breast conservation surgery, a local recurrence in the breast will probably be treated with a mastectomy.

· If you had a mastectomy, a recurrence will be treated by removing the tumor, if possible, and then radiation therapy.

· In either case, this initial treatment may be followed with hormone therapy, chemotherapy, or both.

http://www.seattlecca.org/patientsan...Recurrence.htm

al from Canada · 01-15-2006, 11:10 PM

It's all about staging....in my books you are stage 4; lung mets or not, you now have skin mets. Don't fight it just get a new onc. If you need to come to Cambrige, so be it. Start the treatment where you can and transfer it back to London as the precedence is set. Another option is Dr. Maureen Trudeau at Sunnybrook Womens' health science centre but that's really a long way for you.

The trick is don't screw around with these people and get the job done before you get anymore spread. E-mail me at al@sentex.net for further discussion if required. There is absolutely NO reason for you to have to go through this crap as if having cancer isn't enough!!

Stay in touch and good luck,
Al

PS, I thought Western was a progressive hospital

Robyn · 01-16-2006, 05:54 AM

Thanks for you response...

I don't have skin mets. There is a difference between the two. I have no skin involvement from the tumor the excised. The dermis from my path report is not involved. It is a local recur to the mastecomy scar line. However, it still puts me in the "no" stage category. I do agree on a second opinion and will do this....my question was to you if you knew the protocol of Herceptin in my category/stage. Obviously Canada is using Herceptin differently....but I will see if I can get a second opinion.

Thanks for you concern and help!
Robyn

al from Canada · 01-16-2006, 12:43 PM

Robyn,

When were you diagnosed and when did you receive your last chemo?

Al

Robyn · 01-16-2006, 02:16 PM

I was orginally dx'd Sept 02. I had chemo shortly after. 6 rounds of FEC. Orginal dx's was T2N0M0. Recur. Oct 05. Tumor excised successfully, clear margins. Will start rads soon to scar line. Then re-scan lungs/liver in 2 months.... They didn't even test orginial tumor for her2neu status as you know the drug wasn't available for adjunctive use anyway. So, now they say with local/or regional recur. it puts me in a non-category, unless I want to pay for it. My onc wishes there wasn't this sub-set of in between, but there is....and appparently I am in it. I will have the lung re-scanned or bx'd to make a final conclusion so this may change in two months anyway.....

Thanks for your thoughts and help!!
Robyn