Adriamycin

Member_of_the_Club

Adriamycin

Member_of_the_Club

I know we've talked about this before, but the news about adriamycin out of San Antonio is depressing me today. Not oly is it most likely not effective, but it is linked to heart disease and leukemia. I knew this, but . . .

Stack

i try to remember all the good this drug has done for many. there are alot of people who have benefitted from it and who have gone on without any problems. i can only hope i will still be one of them in the years to come

JoanofArdmore

I was upset when I first learned it.

I'll be 5 years out this July.

Last summer I had edema that was frighteningly like CHF.Huuuuuuuuuge ankles,pitting, no visable knuckles, moon face.

I asked my onc if ths was the dreaded heart problems from Adriea.

He ordered a MUGA scan.

It came back totally fine.

And my onc said quiely "I knew it was from the Femara"

Yes, the femara has been giving me ever-increasing edema.

And now I read the protocol is to not give adriea, but to giveAIs immediately?

Well NO THANKS!

Adriea did me no harm.It is a known, established drug.AIs ar enew, nobody knows ANYTHING about them, they have only been tested for 5 years.

Femara gave me sickening edema, increased lipid scores, increased glucose scores, HORRIFFIC joint pain.It essentially ruined my life!

And now who knows if I can recover myself.

I'd take Adriea ANY DAY!!

Sorry, MotC.I know I'm going sidewise into my own rant.But it does have SOME relevence.

JoanofArdmore

I was upset when I first learned it.

I'll be 5 years out this July.

Last summer I had edema that was frighteningly like CHF.Huuuuuuuuuge ankles,pitting, no visable knuckles, moon face.

I asked my onc if ths was the dreaded heart problems from Adriea.

He ordered a MUGA scan.

It came back totally fine.

And my onc said quiely "I knew it was from the Femara"

Yes, the femara has been giving me ever-increasing edema.

And now I read the protocol is to not give adriea, but to giveAIs immediately?

Well NO THANKS!

Adriea did me no harm.It is a known, established drug.AIs ar enew, nobody knows ANYTHING about them, they have only been tested for 5 years.<

ravdeb

Member..I am with you. With studies showing that only 8% benefit from this...I almost died from the combo AC. After my 3rd treatment I was hospitalized for a month with a life threatening bacterial infection that had gotten into my blood.

I was in terrible pain.

The doctors definitely said this happened because of the chemo.

Maybe the pain was for nothing. Good thing I didn't know about the 8% benefit at the time because I believe I survived because I felt I was doing what I needed to do to kill the cancer.

pennylane

I try to keep a positive spin on this news, but it's time I admit to the feeling in the pit of my stomach that says I have been screwed.  Like Ravdeb I almost died from the AC combo.  My onc and I thought it was important that I get the 4th treatment even though I had high fevers for weeks.  Next thing I knew I woke up an intubated wreck after being on a ventilator for a couple of weeks...I was  85lbs and had to learn to walk again and shake off horrible "vent delerium". I had somehow escaped chemo-related death....No taxol for me after that...lucky to get the rads treatment. I am really having a hard time being a good sport about this adriamycin news.  I try not to think about it too much 'cause it gets me so pissed.....    

abbadoodles

This is not new "news" about Adriamycin.  It has been known for a long time, according to my onc.  It's just a new spin on the statistics.

Like everyone else, I was a bit nonplussed when I discovered this several months ago, DURING my A/C treatments. 

Tina

BethNY

every drug will carry risks.  I think to myself, I'm alive, I'm NED, and I can't knock the tx's that got me here.

Jellydonut

You made a decision based on what was known at the time.  Obviously, as time evolves, all things change.  You can't beat yourself up now, for what wasn't known then.  And that goes for every facet of medicine.

Anonymous

Yes, remember when blood letting was the cure for infectious diseases in the 17th and 18th century.  At the time, they thought it was the best thing to do.  We know better now.

nosurrender

Hi there MOTC, that wasn't the only news out of San Antonio re adriamycin.

There was a positive report, based on a ten year study that was also given.

Of course, only the negative one got the press, because it scares us more.

But they have ten years of data that back up how GOOD Adriamycin is.

 

TEN YEAR FOLLOW UP STUDY SHOW THAT ADRIAMYCIN WORKS

 

[3077] Annual hazard rates of recurrence for early breast cancer. What has changed in the last 10 years? Results from the NORA study.

 

Cazzaniga ME, Mustacchi G, Pronzato P, De Matteis A, Di Costanzo F, Nardi M, Barberis G, D'Aprile M, Rulli E, Floriani I. Az Osp Treviglio-Caravaggio, Treviglio, Bergamo, Italy

 

BACKGROUND: 10 years ago, Saphner et Al (J Clin Oncol 14: 2738-2746, 1996) analyzed 3585 breast cancer (BC) patients (pts) in terms of annual hazard rates (HRs) of recurrence; 2661 (74.2%) were N+ve, 429 (11.9%) high-risk N-ve, 1965 (54.8%) were treated with CMF-based chemotherapy (CHT), 650 (18.1%) with anthracycline-based CHT, with or without tamoxifen (T) and 87 (2.4%) with T alone. The remaining pts were followed up. For the entire group, highest HRs of recurrence occurred during first and second year (13.30.7).

PURPOSE: to analyze in a cohort of early BC pts prospectively followed up for a median interval of 3.4 years whether the widespread of adjuvant therapy and the use of more active regimens, mainly 3-drug anthracycline-based, have induced modifications in the magnitude of recurrence peaks or in the appearance time.

METHODS: NORA is a cohort study aimed at investigating treatment modalities and clinical outcome in 3515 early BC pts radically resected in 71 oncological Italian centers. 56.5% of the pts were N-ve and 17.1% had >4 positive axillary nodes. Results concerning treatment details have been already published (Cazzaniga ME et Al, Ann Oncol 17: 1386-1392, 2006). Adjuvant medical treatment was delivered in 97.8% of the cases. Briefly, 1234 (35.1%) were treated with anthracycline-based CHT and 82 (2.3%) with taxanes, with or without T or aromatase inhibitors (AIs). CMF was delivered in 963 pts (27.3%). 3433 pts (97.7%), for whom full data concerning relapse are available, were analyzed in terms of annual HRs of recurrence, defined as the fraction of pts who recur during a 1-year interval.

RESULTS: for the entire group, the peak hazard of recurrence occurred in the interval from 3rd to 4th year (HR=3.4 0.5). The peak hazard of recurrence in all pts traditionally considered at high risk (N>10; T4) remained in the interval from 1st to 2nd year (18.2 3.6, 11.5 3.8, respectively), even if in some cases 2-3 fold reduced in comparison a decade ago. Details are listed in Table 1.

 

CONCLUSION: our results suggest that the widespread of adjuvant systemic therapy and the use of more active drugs, mainly anthracyclines, have delayed and reduced the peak hazard of recurrence in some groups of early BC pts. High risk pts showed a significant reduction of recurrence number but not a delay in the time of appearance.

nosurrenderbreastcancer

2up

if there is a long term/life altering side effect from adriamycin, i have it (aside from leukemia, so far) ...... but i was well informed of the "small risks" going into it lol!

...........  am i disappointed with the added heart failure etc on top of the "new normal?" ............. YOU BET!!!!! 

............ am i sorry i 'tried everything?' ........... NO, NO, NO!

it's like we all used to say in almost every thread ......... 'it's a crapshoot' (and i've learned that this phrase applies on many, many levels since being dx'd with heart failure and mets within a short time of each other and shortly after finishing chemo).

............ even knowing what i know now, i believe i'd endure it all again ...... i believe my initial dx would have killed me long before i even had the chance to "enjoy" the side effects of 'adria' had i declined treatment.  

i refuse to second guess my initial decisions ........... i haven't learned much over the course of the last 2 years except that 'life is too short' therefore "no regrets"(oh yeah, and there is NO santa claus lol) 

i'll never spend a solitary second regretting any of my attempts to live, never second guess my treatments, never regret fighting etc (even if these decisions may possibly have been in vain) ...........  because, in my mind, "you do what you have to do to make yourself feel whole and comfortable and viable" ......... and that may be many different things to many different people.

cancer is teaching me to stop doubting myself for the first time in my whole life ........... to take a chance, to accept humility .............. so you see, i can't spend one minute looking up anything that will cause even one second of regret .............. i want to know i did everything i could and more importantly i want my daughter to know i did!

CHF can be managed in the long term .......... cancer? well ...............?

jmho (and please know that i do not take dealing with the added health problems lightly or jovially) ....... i just can't spend one more day living in the past and questioning my decisions .......... none of which were made with ease! 

ravdeb

Shel..you are probably right. Besides, we can't really look back but must look forward. And, we did what we thought was the best way to fight the cancer. We did our best and our doctors did their best.

And in another few years they will go back and say that the AC combo IS the best, or whatever cuz they just don't know. Each study brings new information.

Thanks for the different perspective, Shel.

2up

deb ...... i well remember your woes during chemo ........ you had a horrible experience throughout .......... please know that i make no parallel ......... i did ok 'during' treatment ............ i can only speak to the long term and permanent effects.

had i been as sick as many of you girls during treatment i would have a quite different response i'm sure!  i'd most likely have quit in a hearbeat!

i am only speaking from one who is just now dealing with the 'polypharmacy' and physical alterations after the fact .......... things that i never dreamed would happen ,but have .......... that i accept because i have to.

i completely respect where everybody else is coming from, past present and future ........... it's a tough call!

............... we all deserve to feel comfortable in our decisions, to help ourselves move forward ........... that was the crux of my post ......... whatever one finds therapeutic before, during and after the fact should be 'gospel' for the person involved.

and you are sooooo right, the research news changes like we change our panties ............ that is why i've moved away from it all and chosen to congratulate all of us on whichever path we feel/felt most content with and hope that we can all find peace no matter what life hands us.

i don't have a vested interest in "prognosis" anymore ............. i choose to vest my interests in "me" .............. and i have no plans to quit any time soon lol! 

TenderIsOurMight

Member of The Club,



Thank you for starting this thread. The comments I read strike me as gold, frankincense and mir from wise ladies on cancer perspective and offer a methodology and wisdom for moving on...



This is a wonderful holiday thread, a gift to your sisters just in the reading!



Joyfully,

Tender

Member_of_the_Club

Thanks so much no surrender . . . this seems to contradict the other study, but maybe the message is that the combo is more effective, which I'll take since I had that combo. Any news on dose-dense? Last time around they thought it wasn't all that helpful, so I'm wondering.

NoH8

When I was making my treatment decision my oncologist told me that chemo probably only hopes 20% of people but they can't be sure which 20%. I knew I wanted it anyone. He went on to say that because I was er/pr - and her2nu +3, grade three, I would likely be in the 20% it helped.

Like JellyDonut said-

You made a decision based on what was known at the time.  Obviously, as time evolves, all things change.  You can't now beat yourself up now for what wasn't known then.  And that goes for every facet of medicine.

Fitztwins

At Stage IIIC, I will take 8%.

Janis

ravdeb

Shel..long term se would be aggravating or even moreso than getting really sick but surviving and being able to move on. I dont think I've got any long term se yet from the drug so I feel lucky. I feel badly for you. I survived it. You are suffering NOW from it.

But Janis..you are right. When they told me that I may have only a 3% raise in my recurrence/survival rate according to the charts..I took it. So, here I am, feeling fine, and getting angry over 8%.

Nah..I'm not upset anymore and only hope that one day they figure out which drug it is that cures the cancer with NO side effects!

NoH8

Janis, I was dx in 2001 and I guess at the time 20% was the best information they had. I would have done it at 1% I think. My biggest motivating factor at the time was never having to go back and ask myself, if I had done X would my cancer still have returned. I don't think I would feel the same if I, for example, got leukemia as a result of the chemo-- because I'd probably never know if the chemo actually caused it.

gsg

i refuse to freak out any more over studies and statistics because tomorrow another study comes along that contradicts whatever is published today.

they gave me adriamycin...it completely sucked...but after 4 DD rounds, the tumor was almost completely gone.  what is, is.  i just feel like it's out of my hands and i have to trust that my doctors took care of me in the best way they knew how with the information available to them.  if it was offered to me tomorrow, i'd take it....if you could get it more than once.

abbadoodles

gsg, the nice thing for you is that if it shrunk your tumor you know for sure that it was effective for you.  Yay!

Tina

DebbieB

It is upsetting but I realize there is nothing I can do about it now.

However, I am one of those people who developed serious left ventricle heart damage from the adriamycin.  It's serious and it can sneak up on you.  I had 4 rounds of the "red devil" 6 years ago.  Been doing great until May 2007.  That was 5.5 years out before I developed any symptoms...and they came on quick and they got worse over a 4 week period until I ended up in the ER with congestive heart failure.  Now I'm on 6 meds and waiting to see if I can get my ejection fraction up from 20%.  If not the cardiologist said I will have to look into a heart transplant!  So there are definitely trade offs.

The cardiologist definitely attributes my heart damage to the adriamycin.  I have no blockages, my cholesteral is great, my blood pressure is great, I don't smoke or drink and am not overweight.

My understanding from information I have found regarding heart damage from adriamycin is that it typically shows up around 5-7 years later and it affects a small percentage of women.  It appears I have hit the jackbox twice!

wishiwere

So then? What are they saying should be prescribed when A/C is the offered treatment?  I'm in a Trialx program and was randomized for chemo+ hormones and now wondering if there were another chemo choice that should have been offered by my onco?  Does anyone know what they say about that?  Are they saying it only works in 8% and what are those 8% people?  Is it a certain type of characteristics, or what?  Is there another chemo that offers a greater help?  Anyone?  I'm set to get my 2nd round on Dec 27th, and now worried it's not worth it if down the road I'll have these extreme se's !

Anonymous

Wishiwere (love that name), from what I remember reading the chemo of choice would be TC.  Someone MUCH more knowledgeable than I will come along and answer that question. 

I do believe their is a link to the report is on the homepage of this site. 

Shirley

wishiwere

Thanks Shirley, I'll look for it

gsg

alicesuzy:  you're the first person who has EVER referred to me as sane.....ever.  LOL.

Tina:  you're right that mentally it was good for me to feel my tumor shrinking.  I guess they usually give chemo AFTER surgery cuz it's supposed to have better outcomes with regard to recurrences, but they needed to shrink mine first in order for me to be a lumpectomy candidate.

since they usually give adriamycin along with cytoxan, i'm wondering why nothing is being said about cytoxan...or is it and i just haven't read the studies enough.  my mind usually shuts down after the first or second sentence of study results.