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[TSund]

<TABLE class=tborder cellSpacing=0 cellPadding=6 width="100%" align=center border=0><TBODY><TR vAlign=top><TD class=alt2 width=175></TD><TD class=alt1><!-- icon and title --> Hello and Help
<HR style="COLOR: #aa8799" SIZE=1><!-- / icon and title --><!-- message -->Hello,

New to board and new and struggling with my spouse's diagnosis of breast cancer; stage 2, graded 2-3 (but MRI called it Locally Advanced Breast Cancer), as it is an "area" of several tumors 7-8 cm. Possible 3 node involvement but not palpable and not verified yet. ER+ PR+ HER2+ 50 years old but still pre/maybe peri-menopausal. Have so many questions:

1) Has anyone heard anything positive or negative regarding the idea of Oophorectomy to reduce estrogen load for hormonally positive tumors either alone or paired with aromatease inhibitors? It was reported as having = effect as chemo on hormone + tumors. Seems like it should be considered especially as HER2+ often resistant to Tamoxifen but I have found little on the idea. It can be done laparosopically in a day surgery.

2) We welcome anything we can do to support health, have read here about fish oil, (how much?) vitamin D, olive oil, excercize, lower body weight, and fiber (soluable or insoluble?) If you could specify or suggest anything else we'd be so grateful.

3) I am confused about PR+. Read some of John Lee's book on natural progesterone years ago and I thought natural progesterone HELPED with excess estrogen. (that progesterone is in fact an antagonist of estrogen?) If progesterone also feeds tumors, then why is a ER+/PR+ diagnosis better than ER+/PR-?

My email is Profcollege@hotmail.com but I will also try to check out this board for answers if I can navigate my way back!

THank-you so much,

Terri
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[CLTann]

Terri,

Sorry that you are in this forum because of your wife's breast cancer, although we are glad that you find a very friendly place. Many here are much more knowledgeable than I on the questions you raised. I will share my opinion on your questions.

Most people here knew me as an advocate of not using chemo and radiation, when there is a questionable, tip on the balance, situation regarding treatments. However, in your wife's case, I would suggest that you should go for chemo after mastectomy. Oopherectomy is certainly recommended for pre menopausal women who are ER/PR positive.

What we should carefully weigh is that when one has nodes involvement, there is a greater chance that microinvasion of cancer cells may already take place. It will take 18 to 24 months for these distant invasions to be detectable by any medical test methods. Therefore, to be on the safe side, your wife should preemptively eliminate the possible microinvasions by chemo and/or radiation.

The removal of hormone generating sources would starve the cancer cells but this mechanism is not a sure way to slow down the cancer growth. One reason is that there are many potential ways for the body to feed the cancer cells. One source is the uterus. Another source is food. There are other parts of body that secret hormones too. Arimidex, Femara, Aromasin and the like have the ability of reducing the hormone level.

On the other side of actively fighting cancer cells, the body should be able to kill the cancer cells by its own immune system. Enchancement of immune mechanism can be achieved by taking right food and medicine. Fish oil, omega 3/omega 6 balance, curcumin, ganoderma, flaxseed powder ground freshly and other vitamins are some herbs/pills come in mind.

Get the Breast book by Dr. Susan Love. It is quite informative.

Good luck.

[mts]

What % positive is her ER/PR ? This could help you decide if oopherectomy is the way to go.
Many women opt for the oopherectomy regardless of their ER/PR status... I was Dx'd with <10% ER+ PR- and the onc put me on Tamoxifen but did not recommend oopherectomy. Just recently, we decided that the Tamoxifen was not going to help me.
You will see that cancer literature changes ALL THE TIME and therefore tx's change all the time.
Sometimes the info can be overwhelming, but you get used to it and find your way... Perhaps at some point, you may want to get a 2nd opinion. Many of us on this board opted for several opinions in order to come up with the best Tx. I will say however, that this board has been incredibly helpful in allowing me to figure out what to do next. At any given time there is at least one person on this board that has been or is going through what you are.

Warmly,

Maria

[Hopeful]

Terri,

I am sorry we have to meet you under these circumstances. Your spouse has a wonderful, supportive advocate in you. I wanted to respond to your question about PR+. If you search the Board, you will find links to various articles about ER+/PR- Her2+ bc, which is considered to be "more aggressive" than ER+/PR+ bc. The theory is that the PR pathway is usurped by additional growth factor signaling in PR- Her2+ cases. It is therefore better to be PR+, as it indicates the PR signaling is "intact." I found one study that said that PR+ had stronger prognostic value than Her2+; that PR+ was more significant for disease free and overall survival.

Best of luck to you both,

Hopeful

[Lolly]

Welcome, Terri and Spouse!
I am hormone negative so haven't stayed on top of the current recommendations, but do want to respond to your query regarding diet/supplements. I think you'll find much advice in this area on this site and others, but beware that there is a school of thought (and now supported in part by ongoing studies) that antioxidants while on chemo and radiation are counter-productive, as the antioxidants actually help cancer cells rejuvinate, so go easy on these supplements and certainly talk with your onc when adding any integrative/complementary modalities.

Best wishes to you both!

<3 Lolly

[Bev]

Terri, My guess is that they will put your partner on tamoxifen for a year or so until bloodwork confirms menopause and then switch her to an AI. With her profile, Tamox is not a bad thing. Hping it all works out. BB

[saleboat]

Hello,

I just have to add-- the removal of one's ovaries is in no way the standard of care for women who have strongly hormonally positive EARLY stage breast (Stages I-III) cancer. While some doctors may recommend it, and some women may elect to do that for either BRCA reasons, or peace of mind, there are serious health risks that should be considered, plus it has not been shown to be an effective treatment given all the new therapies that are now available. It was once the standard of care, many years ago, before the anti-hormonals were available.

If you would like an article that details the health risks, especially for younger women, of the removal of one's ovaries, please let me know.

I did go to three different Oncs on this issue, and they were all in agreement given my age. One even called it 'surgical castration' which shocked me.

Jen

[hutchibk]

I know it is a sage consideration for women who are BRCA 1 or 2 positive. Has she had the genetic testing done?

You have probably already googled it, but here is an informative link....

http://www.mayoclinic.com/health/breast-cancer/WO00095

[Bronny]

Are the health risks you mentioned Jen, related to ovary suppression, abation (OOPH) or both? I have a similar DX to you and have recently started zolodex monthly to suppress my ovary funcion as well as Tamoxifen. I am wondering if the Zolodex is necessary for early BC.