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Old 01-22-2011, 05:53 PM   #39
hutchibk
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Re: Help! Brain mets besides lung mets

Miscellaneous info I have been able to drum up:

http://cpharm.vetmed.vt.edu/VM9096/handout.htm

under anti-metabolites (fluorouracil is the infusion/Xeloda is the pill... they are the same drug)
......................................

In chemistry, weights are measured, not in kilograms, but in Daltons. In fact, it turns out that only molecules that have a molecular weight smaller than 500 Daltons can reliably get through the Blood Brain Barrier. Now a molecular weight of 500 Daltons is not very big. Water has a molecular weight of 18 Daltons, while insulin is up around 5,000 Daltons. Viruses (with molecular weights in the millions and billions) are a heck of a lot bigger than this, and bacteria are much bigger again. So in general it's rare for big chemicals, viruses and bacteria to be able to cross the Blood Brain Barrier and get into the brain.
xeloda (Capecitabine) molecular weight - 359.35
.............................................


http://professional.cancerconsultant....aspx?id=41058
Study participants had previously been treated with Herceptin, cranial radiotherapy, and Tykerb monotherapy. All patients in the current analysis received treatment with Tykerb plus Xeloda after experiencing cancer progression on Tykerb monotherapy.
  • 20% of patients experienced at least a 50% reduction in measurable brain metastases.
  • 37% of patients experienced at least a 20% reduction in measurable brain metastases.
  • Side effects of treatment included hand-foot syndrome (grade 1 or 2 in 37% of patients and grade 3 in 8%); diarrhea (grade 1 or 2 in 34% of patients and grade 3 in 4%); and nausea (grade 1 or 2 in 22% of patients and grade 3 in 8%).
__________________
Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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