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		|  04-25-2007, 09:26 PM | #1 |  
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				Join Date: Sep 2005 Location: Central Coast, CA 
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				 Well, it was quite a day... 
 but I’ve officially started the Tykerb/Avastin trial! Long post because it was a long day... 
 
 8am – leave for UCSF (usually a 90 min drive)
 
 9am – have traveled 25 of the 70 miles! Note to self – take alternate route during rush hour!
 
 10am – arrive UCSF (lady leadfoot in a mustang!)
 
 10:01 – hit the restroom
 
 10:05 – trial coordinator takes me to lab to give 5 vials of blood and ante up a urine sample. OOPS! Leave the lab with an empty cup in a Ziploc bag – homework already!
 
 10:45 – get EKG – 30 minutes waiting around, 8 second scan
 
 10:47 – get exam and see doctor – since I had seen her only a week ago, she just basically said “you’ll do fine”, handed me orders and left.
 
 10:52 – after realizing nobody was going to escort us (gee, I was getting used to the VIP treatment!), decided to go find the infusion center on our own
 
 From there the timeline is a bit of a blur. I think they deliberately don’t have clocks in infusion rooms, just like in Las Vegas! But you ladies all know the drill – wait for a chair, get a chair, wait for an IV hookup, blah blah blah.
 <?XML:NAMESPACE PREFIX = O /><O:p></O:p>
 
 Overall, the infusion center was a bit of a traumatic experience for me. I’m accustomed to my local onc’s office, where everyone is all together and within shouting distance, and you really can see what’s happening. UCSF is a big city place! I’m sure I’ll feel better about it as I go, but it seemed real impersonal to me – it was a little like the BORG, with 5 or 6 “pods” of 5 chairs. I felt like I was “2 of 5” instead of Chris. For those of you non Star Trek fans, my apologies!
 
 I was a little annoyed by the first chemo nurse, who after declaring I had no veins set up the IV in a really goofy place – while proclaiming that I had gotten “too much Herceptin” – you should only get a year. DUH – I was actually hoping for more like 10 years!
 
 Then after sitting there for about 45 minutes with teeny dribble coming through the IV, we’re thinking wow – this is gonna be a 3 hour infusion, not 90 minutes! Turns out, the doctor had not put the dose on the orders and I was only hooked up to a saline drip! Because the doctor is on another floor, and of course very busy, it took about an hour to get the actual medication set up! In the meantime, the chemo nurse had gone home (without saying goodbye)! Eventually another nurse was assigned, and she was actually VERY cool. Liked her a lot. Not just because she gave me my goodies.
 
 Finally it’s 4:15 and the Avastin is done. Boy was I ready to get out of there! Then “nice” chemo nurse comes in and says Oh I hate to tell you this, but your calcium level was a little high and we have to do another blood draw and more labs. Hubby assumes its because of bone damage from cancer – which nurse acknowledges was possible. Or I could have just been dehydrated.
 
 During this 45 minute wait, I really started to meltdown. I actually had thoughts like “what’s the point – maybe I should just go ahead and die right now and save all the hassle". Good thing hubby was there to comfort me. Next minute, nice nurse bounces back in and says “You’re NORMAL”. I told her nobody had ever accused me of THAT before!
 
 5:00 pm – we flee UCSF. Just in time for rush hour. On the way out, we hit the restroom. I notice the LIVE PERSON playing a baby grand piano in the lobby. Nice soothing music. On the way out the door, I notice the little zen-pool with zen rocks. Very nice and soothing.
 Maybe this joint isn’t so bad after all…
 
				__________________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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		|  04-25-2007, 09:45 PM | #2 |  
	| Senior Member 
				 
				Join Date: Nov 2004 Location: Misty woods  of WA State 
					Posts: 4,128
				 
		 
		 
		
		 
		
		
	
		
	
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				 The "trials" of a trial ... 
 Glad things all worked out in the end.  Having the right orders in the first place makes a huge difference in how the infusion day goes!  
 Is the Avastin weekly?? The answer may be in one of your other posts, but was wondering as you have that commute to contend with.  I can imagine your blood pressure reading was a little out of whack by the time you got to sit down and someone could check it!!
 
 All best wishes that this combo will put your mets behind you without cutting too much into the rest of your life.
 
				__________________"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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		|  04-25-2007, 10:28 PM | #3 |  
	| Senior Member 
				 
				Join Date: May 2006 Location: northshore suburb of chicago 
					Posts: 1,093
				 
		 
		 
		
		 
		
		
	
		
	
	 | Wow, what a day.  I sure hope this new regiment does the trick and that you feel well during it. 
				__________________~Rina~
 Dx:3/06 had a lumpectomy April 19, 2006
 Her2+ er/pr- Stage I Grade 3 tumor size 1.4 cm, node negative
 AC 4 dense doses
 34 radiation treatments including booster doses
 receiving herceptin every 3 weeks since late August 2006 for 12 months
 
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		|  04-25-2007, 11:03 PM | #4 |  
	| Senior Member 
				 
				Join Date: Aug 2001 Location: Oregon 
					Posts: 1,756
				 
		 
		 
		
		 
		
		
	
		
	
	 | Chris, you make it sound like fun! What a day, and first nurse didn't make things any easier but we're all human. #2 more than made up for #1, and you left with a good feeling so hoping the subsequent visits are all way cool!Avastin is an exciting option, and thank you for helping the research along.
 
 <3 Lolly
 
				__________________Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.
 
 Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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		|  04-26-2007, 05:07 AM | #5 |  
	| Senior Member 
				 
				Join Date: Aug 2003 Location: Morris, IL 
					Posts: 3,507
				 
		 
		 
		
		 
		
		
	
		
	
	 | Chrisy
 WOW, was a cozmo in order after all that?  We get so used to our usual routine, that it makes it hard when we are sent to what seems to be an impersonal chemo center....looks to me it is up to Chrisy to show them what we expect! There is NO excuse for crabby, impersonal nurses! Hope the rest of your day was peaceful and relaxing, and especially hoping this is magic for you! So glad the calcium levels were good.
 Reading your post is what we love about you Chrisy, you made an absolutely horrible day seem funny and tolerable.....I was glued to the edge of my seat waiting to see what happened next...you should write stories, I'd be your biggest fan!
 
				__________________ "Be kinder than necessary, for everyone you meet  is fighting some kind of battle."Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications) 
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant 
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin 
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments 
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression 
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin |  
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		|  04-26-2007, 08:42 AM | #6 |  
	| Senior Member 
				 
				Join Date: Aug 2006 Location: Sheboygan, WI 
					Posts: 2,582
				 
		 
		 
		
		 
		
		
	
		
	
	 | Wow, I'm out of breath and dizzy from only reading about your day. I can only imagine how you must have felt. LOL! Oh well, the important this is you are started. Only good things to come, I pray.
 Loving you "sister"
 
 Mary Jo
 
				__________________ "Be still and know that I am God." Psalm 46:10 Dx. 6/24/05 age 45 Right Breast IDC ER/PR. Neg., - Her2+++ RB Mast. - 7/28/05 - 4 cm. tumor Margins clear - 1 microscopic cell 1 sent. node No Vasucular Invasion 4 DD A/C - 4 DD Taxol & Herceptin 1 full year of Herceptin received every 3 weeks 28 rads prophylactic Mast. 3/2/06 17 Years NED <>< Romans 8:28 
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		|  04-27-2007, 07:11 AM | #7 |  
	| Senior Member 
				 
				Join Date: Oct 2005 Location: TAMPA, FL 
					Posts: 568
				 
		 
		 
		
		 
		
		
	
		
	
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				 Life and times in an Infusion room.... 
 Wow Chrisy what a day you must have had along with the anticipation of starting a new drug. I am glad that your day ended up on a more positive note about the center. I think its good to be comfortable in a place where you are going to spend so much time at, and as time passes you will become more comfortable there. Unfortunately some nurses are great at what they do and some are not. 
 Let me know how you feel on the Avastin. That is the next drug that I am researching for myself in the event the Tykerb/Xeloda starts to fail on me.
 
 I wish you all the best with this chemo and keep up that wonderful spirit. We SHALL overcome .
 
				__________________Irene from Tampa
 1996 - INFILT DUCTAL CAR.W/ LYMPH NODE INVOLVEMENT. ADRIA/CYTOXIN/5FU
 1999 - RECURR. TO AUXILA AND 2 TUMORS IN LIVER
 TREAT: STEM CELL REPLACEMENT/HERCEPTIN.
 2002 - RECUR TO LIVER
 TREAT: NAVELBINE, THEN GEMZAR, THEN XELODA.
 2004 - TUMORS STILL IN LIVER
 TREAT: RFA TO LIVER
 STABLE UNTIL
 2004 - TUMOR PROGRESSION IN LIVER.
 TREAT: RESECT HALF OF LIVER.
 2005 - RECURR TO LYMPH NODE OUTSIDE OF LIVER.
 TREAT: TAXOL/CARPO/HERCEPTIN. FAILED ON
 THIS TRIO. STARTED ON ABRAXANE.
 2006 - PROGRESS WITH 2ND TUMOR GROWTH.
 TREAT: AUG. BEGAN ON TYKERB/XELODA
 TRIAL. CONSIDERED STABLE TO DATE.
 2007 - TAKEN OFF OF TYKERB/XELODA TRIAL DUE TO
 PROGRESS STARTING TYKERB/AVASTIN.
 NOV 2007 - SCANS SHOW PROGRESS TUMOR GROWTH
 IN ABDOM. AND TWO NEW TUMORS IN NECK AREA.
 BEGAN HERCEPTIN/AVASTIN/TAXOTERE
 Feb 08 - Ixempra/Xeloda
 June 08 - Her/DM1 trial
 
 "I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY."
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		|  04-27-2007, 08:08 AM | #8 |  
	| Senior Member 
				 
				Join Date: Jun 2006 Location: South Florida 
					Posts: 477
				 
		 
		 
		
		 
		
		
	
		
	
	 | Hi Chrisy,
 Wow, what a day.  I would sleep for a week after that.  I hope that the treatment works wonders for you.  Thanks for sharing.  You remain in my prayers.
 
 Love, Peace, and Hope,
 
 Carolyns
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