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Old 12-05-2008, 02:14 PM   #1
Believe51
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Location: RHODE ISLAND (Ed getting me a latte on 2nd Cancerversary Cruise 2008) 'BELIEVE': To accept as true or real, To have faith in, To presume ALWAYS BELIEVE
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cullenhill@earthlink.net
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What to do now?
Just wondering, when can someone start Tykerb. Is this only taken after there's a reaccurrance. I was dianosed in Aug.2007, age 43, Ivasive Ductial Carcinoma, poorly Differentiated. ER/PR-, HER2+ gene amplification with a HER217Z1 ratio of 12.0, node positive. I had 4 rounds TAC, weekly Herceptin. Bilateral mastectomy Dec. 11,2007. Residual minute foci of Invasive Ductal Carcinoma, Nodes showed no evidence of malignancy, at surgery. Jan.2008 started Taxol, continued weekly Herceptin, 35 radiation treatments. I should be finished with Herceptin in Jan. 2009. I have asked 2 oncologist, and my nurse if I could take anything else, they all say no. One onc. told me if I had a reaccuuance I needed to come to his cancer center and see their BC oncologist. (Since June 2008 we have not had a regular onc!!!) I have read that Tykerb sometimes is given after one finishes Herceptin. Anyway I am ready to finish with treatments, been weekly since Aug. 2007. But am really scared not to be doing something to keep this at bay. One onc. I saw said there was a 50/50 chance of reaccurrance. HELP! If any one has any advice please let me know.

Cheryl

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Today, 03:53 PM #2 Believe51


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Location: RI State Motto "HOPE"<<>> 'BELIEVE': To accept as true or real, To have faith in, To presume ALWAYS BELIEVE



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Hello Cheryl



Welcome to our family, so glad you found us but sad that you had to. First off I was wondering if you could let us know a little more about yourself so others could help better.




Few things.....let no one tell you what your chances are (re:50/50), we break the rules and stats all the time.


Then I must say there is always hope, many new treatment regimes and combinations to try. I am not an expert but even when potentially failing with one drug does not mean it cannot be combined in another regime (although we try not to).



I will be taking your post and placing it in the MAIN FORUM so many can see it. We will try to get you the help you need and the answers you seek.



Wish I could ramble on a bit more but I have a headache and it gets hard on the old eyeballs.



Keep us posted with yourself, there are many wonderful people that will be helping and routing you on. Best of luck and we will speak soon, Cheryl.>>Believe51
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9/7/06Husband 50yrs=Stage IV IBC/HER2+ w/BoneMets 10/06Taxotere(10),Herceptin(1x wk), Zometa,Tamoxifen 4/12/07Last Taxotere; (Her,Zom,Tam) 5/18/07Pet=rapid cell activity, no organ mets, many Lytic Lesions(L4,Humeral Head,C2,DiscSpace)-Degenerative Changes, some bone repair 5/07Chemo fail 6/01/07Pleural Thoracentisis=Effusions, no malignant cells 6/19/07+7/2/07DFCI 6/25/07Brain MRI=Brain Mets, many-(5-9mm) 7/10/07WBR/Pelvis rads(37.5G x15) & Nutritionist 8/19/07Tykerb/Xeloda9/20/07BrainMRI=2 mets(2 mm)10/6/07Pet=Bone Progression10/24/07Chemo fail11/9/07A/C(10), end Tamoxifen 12/7/07Faslodex 12/10/07Muga 75 12/13/07Blastic Lesions 1/7/08Brain MRI=Clear 4/1/08Petscan=Bone Improvement, no progression, stable! 4/7/08Brain PERFECT 5/16/08Last A/C(10)8/26/08Brain Mets Again=10(all under 9mm) 9/10/08GAMMA KNIFE~take that!~10/30/08 One New Met=5mm! Uggh!~10 Others Are Gone!




Today, 03:55 PM #3 chrisy

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Hi Cheryl,


What you are hearing is correct, you have "done" it.



I'm not real clear on what stage your cancer was, but it sounds as if you have had all the treatment that would be considered "standard of care" as adjuvant treatment. You should specifically recheck the stat on recurrence - 50/50 seems incorrect, way too high particularly having no positive nodes prior to the surgery.



There is a statistic on adjuvant use of Herceptin which is that getting herceptin reduces your chance of recurrence by 50% compared to not getting Herceptin. So if your chance of recurrence before Herceptin would have been 20%, you reduce that to 10% if you get Herceptin. Maybe what you heard was a mixed up version of reducing your risk by 50%.



I think the recurrence stat was not clearly communicated to you.


At any rate, it is not standard of care to have any treatment beyond what you have had, although some ladies here who were diagnosed with Stage III and at high risk for recurrence have been able to extend their time on Herceptin and/or get Tykerb. Tykerb is not FDA approved for early stage bc, so this would be a challenge.



First, my suggestion is to get clarity on your staging and recurrence risk.


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Chris in Scotts Valley



Diag 6/02 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node)



Mastectomy/implant - no chemo, rads. "cured?"



Diag 9/04 extensive (hate that word!) liver mets (!) ER/PR- Her2+++



10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!



04/05 - 4/07 Herception every 3 wks, stable <.5mm "area of interest" , not thought to be cancer.



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


02/08 Trastuzumab-MCC-DM1 trial 8/08 - "it's working"
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9/7/06Husband 50yrs=StageIV IBC/HER2+,BoneMets10/06TaxotereX10,'H'1X wk,Zometa,Tamoxifen4/12/07Last Tax5/18/07Pet=Rapid Cell Activity,No Organ Mets,Lytic Lesions,Degeneration,Some Bone Repair5/07ChemoFail6/01/07Pleural Thoracentisis=Effusions,NoMalignantCells6/19/07+7/2/07DFCI
6/25/07BrainMRI=BrainMets,Many<9mm7/10/07WBR/PelvisRad37.5Gx15&Nutritionist8/19/07T/X9/20/07BrainMRI=2<2mm10/6/07Pet=BoneProgression
10/24/07ChemoFail11/9/07A/Cx10,EndTam12/7/07Faslodex12/10/07Muga7512/13/07BlasticLesions1/7/08BrainMRI=Clear4/1/08Pet=BoneImprovement,
NoProgression,Stable4/7/08BrainPerfect5/16/08Last A/C8/26/08BrainMets=10(<9mm)9/10/08Gamma10/30/08Met=5mm12/19/08Gamma5mets5
12/22/08SpinalMets1/14/09SpinalRads2/17/09BrainMRI=NoNewMets4/20/09BoneScan5/14/09Ixempra6/1/09BrainMRI=NumerousMets6/24/09DFCIw/DrBurstein6/26/09Continue
Ixempra/Faslodex/Zometa~TM now lower7/17/09Stop Ixempra By Choice9/21/09HOSPICE10/16/09Earned His Deserved Wings And Halo=37 Month Fight w/Stage 4 IBC, Her2+++,My Hero!!
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Old 12-05-2008, 09:07 PM   #2
Joan M
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Cheryl,

Thanks for coming to the board and letting us know what's happening with you.

It's usually not common to continue on any chemo or Herceptin after treatment for early stage breast cancer. However, it's important for you to settle in with an oncologist who you feel comfortable with and try to have a follow-up CT scan of the chest, abdomen and pelvis at least annually even if you don't have any symptoms. Since you had a positive node you should have those scans done now, unless you've had them already.

You may have a good point with your oncologist about having the scans continuously because you had a positive node, are HER2+ and ER-/PR-. Use that argument if you're told that scans are not given for follow-up of early stage breast cancer.

In general you should be having a regular follow-up every three to six months for at least the first two years. And you should be followed for at least 10 years. You should have regular blood work at each of your visits with the onc. You should also have tumor markers, at least every six months initially. Do you have tumor markers (CA27-29, CA 15-3)? Even if they were not taken before treatment you can still have them done starting now (I didn't have tumor markers initially, but when I switched oncs, my new onc started markers).

Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2023 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 12-06-2008, 06:49 PM   #3
RobinP
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Hey, glad you posted Cheryl. There are things you can do to prevent a relapse beyond drugs. Watch you weight and fat intake, as it is very bad for estrogen and progesterone negatives. Also, look up the her2 diet which should include among others...green tea, olive oil, vitamin D3. See some of my older posts or Rhonda's for more detail on diet and supplements against her2 breast cancer.
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