Questions about 2nd opinion, chemo choices for TN?

formygirls

Questions about 2nd opinion, chemo choices for TN?

formygirls

Hi ladies,

I am a newly diagnosed TN. Just got my biopsy report yesterday. My cancer is grade 3 and turned out to be TN. Spent the whole day crying but am back again to fight this. I have been reading the TN boards all night and have leanrt a lot from you ladies already. This is a very strong group. I hope to share this journey with you.

I have some questions on my chemo.  I am getting dose dense A/C then surgery them more chemo. I have read about carboplatin given with T? Can you shed some light on which patients are good canditates for it.  I have a 7cm tumor in my right breast which was removed during biopsy. I will have a mast + lymp node removal after the A/C treatments. Since my tumor is no longer there, I do not know how they will check if the chemo is working. I also have a possible mets on the liver. The MRI found a 1.5 cm spot on the liver which they said could be hemamgina? or could be mets. My onc does not want to do biopsy during chemo.

Also how do I go about getting a second opinion? 

Thanks.

dklaus

Formygirls,

     Wow, what a ride you've been on these past few days. To start, we are here for you. No question is too weird or gross.

     Your DD tx AC is the best way to start. The adriamycin is the best first line defense. Hopefully your tumor will respond to this and shrink down to nothing!

     Second line defense has been the "taxanes" and "platinums" if the AC doesn't get it.  The "T" and the carboplatin you talk about.

     The reason for the continued chemo is the fact of tumor size, grade, stage, and triple negative. Triple negative does not have continuation medicines like the hormone positive or the Her2 pos. tumors. We HAVE to rely on chemo. Removal and chemo is our best defense.

     If that spot on your liver is metasticized breast cancer than your best treatment is probably the taxane and carboplatin.

     I will be startine Taxotere and emzar(a platinum) next week. You are not alone.

     I went for a second opinion when I was diagnosed with my recurrence. My doctor welcomed the second opinion and encouraged it. How I did it was to pick a doctor with a good reputation in the area or you can go to a major city. I made an appt. and told the sec. that this was for a second opinion. She told me what I should bring (my path reports) and she was able to obtain the surgical report from the hospital and then she gave me her opinion on chemo yes or no? what type chemo-taxane and platinum. I compared her recommendations with what my normal onc. said and made decisions from there.

     Remember YOU are in charge of your medical treatment. SEEK answers to your questions. Be comfortable with your decisions because you really don't want to do the what if game.

     Good Luck.     Debbie

CalGal

Formygirls -

I'm sure you are reeling with your dx ...  Once you get a treatment plan worked out, it does get better ...

Since you've just been dx'd, you probably haven't started treatment yet.  I'm a huge believer in 2nd opinions as there is rarely one correct answer ...  Since 12/05, I'e done a ton of research on the specifics of my case ...

As with any profession, some oncologists are better (more informed on the latest) than others ...  Some are bc experts, some are more general onc's ... even among those who focus on bc, many are not that familiar with trip negs or BRCA1 (my case).

You may want to ask for a PET Scan.  On a PET scan, any active cancer cells basically end up "lighting up" due to the solution they use and how the cancer responds to it (metabolic response).   That way, short of a liver biopsy, you will have a much better idea about whether it is cancer or not.  I would also ask about a liver biopsy before you start chemo or get a 2nd opinion and ask about a liver biopsy, chemo combos and a PET scan.

I just had my second liver biopsy on 3/14 ...  As I got to NED after being dx'd with liver mets - due to dose dense AC and then RFA (radio-frequency ablation), in Feb., I was dx'd with likely liver mets (again).   Let me add that on my recurr & mets dx, my then-HMO did not even mention RFA and when I asked about it, I was denied 3 times.  It took an outside opinion that I was a candidate for it to convince my HMO.

My liver was clear for almost 20 mos!  

Even though I was NED after the RFA, I did Taxotere & Carboplatin.  The "platinums" are good choics for us trip negs. 

Best to you,

CalGal 

formygirls

Thanks for your input. My treatement started two weeks ago and I have alrady had one dose of AC. My second chemo treatment is in 2 days. My doctors refuse to do a biopsy now saying it has too many risks during chemo and they will just repeat the MRI after 4 AC chemo cycles and look at the liver again. My liver MRI said that the spot looked like hemamgiona but liver mets should be investigated. Part of me wants to know for sure but a part of me does not want to know as I do not know if I can handle more bad news now. I will ask my onc for a PET scan on Tuesday. I am also going for a second opinion in 10 days at the local Moores cancer center to get their input.

FloridaLady

formygirls,

They also found a spot in my liver with my first CT scan.  By onc. who treats all kinds of cancer and took one look and knew what it was. And old virus that damaged my liver, I could have been born with it. But he said we would watch it.  That the chemo would suppress it why we treat the breast area cells.  He also did not want to stress the body with a biopsy in chemo.  Two years later it is still there and has not change one bit.  All new doctors see it and start 2nd guessing again.  And I will not go there...PET does not light up I'm happy.

Living in hope,

Flalady