scan results & new treatment update

[Pam P]

Thanks Chrisy & Becky for more support on adding the femara. It's on my list to ask about next week.

Here's my understanding of what my onc disagreed with about treating with AI and chemo simultaneously. It doesn't apply to using AI with femara, faslodex, but with cytotoxic drugs such as navelbine, taxanes, etc. He says the AI s slow down the activity of the cells at least hormonally and maybe as a result in how fast they grow/divide. Cytotoxic drugs kill fast dividing cells so you want the cells to be fast dividing for the cytoxins to kill them rather than be slowed down by the ai and not as affected by the toxins. At least that's how I remember him explaining it to me, but that was many months ago and I mayhave it mixed up.

I'm trying to get myself in a more positive place. I agree with those who have said it's important to do. I'll get there i hope. Part of my issue other than bein bummed by the scan reports & sinus issues is that this week my hips & tops of my thighs have been so painful that I ache all over and feel like I'm having a hard time standing, sitting, walking, etc. This is new. Maybe it's muscle weakness from laying around so much with the sinus sickness. I'll give it the 2 week rule and report it if it doesn't improve soon. Wow, thanks for listening to my long list of woes. Pam
P.S. this eternal winter, snow, cold, ice isn't helping - spring can't come soon enough!!!

[Rich66]

It doesn't apply to using AI with femara, faslodex

Not sure what you mean. Femara and Faslodex are AI, Aromatase inhibitors.
But yes..the theoretical argument has been the same for proliferation targeting trugs as well as radiation: Don't combine with anything that slows the cells down.
In both cases the theory is being disproven. I put the support for chemo-endocrine here so it can be shared with oncs.

In the case of Her2 + Er targeting agents, there shouldn't even be a theoretical concern at this point. Recent Tykerb/Femara approval is case in point.

I get the sense that curriculums get pretty solidified and comfortable in clinical practice. It can't be easy for oncs to change the way they do things. Docs of all kinds seem to have strong training or inclination to never appear "wrong". There was an example on this board recently of an onc wanting to proceed with metronomic therapy but was afraid what clinical peers would think. That speaks to a strange professional pressure when the doc confides in a patient this way. It must be hard trying to appear informed and scientific when the science involved is so unpredictable. But patients have the larger right to all the tools at their disposal...even if it means changing the "rules" along the way. It's not being wrong. It's just part of the seemingly endless struggle to get it right.

[Pam P]

Rich - I typed that wrong. I meant to say "it doesn't apply to using ai with herceptin / tykerb". Sorry. Glad there's new research supporting more options. The stance you describe of docs supporting their old theories despite evidence to the contrary I don't believe applies to my onc., thankfully. However, he is more apt to site proven protocols. But he is very willing to listen to my questions and requests and consider these options.

[Rich66]

That's good. Because the chemo-endocrine thread just got a little longer. femara + various chemos + Avastin.

[Jackie07]

Pam,

Found a link talking about cleaning the 'debris' in the sinus:

http://www.arizonasinus.com/endoscop...us-removal.htm

Looks like an easy procedure to clean up the thickened mucous.

[Pam P]

Thanks, Jackie, for that link. Very informative. I sure hope I don't need to do that surgery though. I'm hoping some non surgery meds might clear it up first. Monday I'll see the ENT. Thanks again.

[Joan M]

Pam,

Thinking about you and hoping one of these combos will work to knock down the markers and mets.

Joan

[mmoons]

Pam-

I wish I am sending you lots of love and prayers. You have so much going on and I can only imagine how overwhelming it must be. Please feel all the love and support coming your way. This combo will be the one to get your back to NED.

Hugs,
Maureen