Progression Should be a 4 Letter Word. Need advice.

YamaMama

Hi Everyone... A few questions for you all. I've been thru all of the hormonals, and last winter I did 12 weeks of taxol. I then did Afinitor and Faslodex. I did the Faslodex because Aromasin had already failed me. 

I've had bone and liver mets since diagnosis 5.5yrs ago. I've now got some pretty major progression with multiple tumors in my liver (some fairly large) and my bone mets are pretty much everywhere causing pain in my back/hips and legs causing me pain.

Now my questions.. I've got to start on something soon, and several have been mentioned by my onc (Abraxane, Halaven, Erubicin).  Also since I'm fairly chemo naive (only having done the taxol) one of my onc's is looking into clinical trials. 

I've requested a biopsy of my liver mets if anything is in a good spot to biopsy. 

1. I think after being on hormonals for so long, my ER,PR +, Her2- status could have changed. How likely is it that a biopsy would seed more cancer since the liver bleeds so easily?

2. My onc will give me the final say as far as which chemo to use next. Any advice?

Thank you~Yama

JeninMichigan

Hi Yama

I would definitely want the biopsy.  This happened to one of my friends and she had a 7 cm tumor on her liver and the pathology flipped to Her2+.  She had gone through the hormonals and they were not giving her much hope.  The her2 change allowed her to add Herceptin to her chemo which gave her 5 years NED.   I think it is worth the risk 

Jen 

diana50

I would want the biopsy too.  Did the taxol work for you?  Sometimes after a break oncs can return to a chemo that worked.  Maybe taxol could work again for you if it worked earlier   My chemo nurses have said that sometimes returning to earlier chemo can work before a new one   Just a thought  

Ohmydarlin

What about doing a biopsy of one of the bone lesions?  I had a bone biopsy when I was first diagnosed and it was relatively 'easy'. Forgive me if I am way off base as I only have bone mets. I did 6 months of Abraxane. It was very effective and tolerable. We all react differently, just my experience. Hugs and prayers!!

Bestbird

I totally agree with Jen and Diana about getting a liver met biopsy, as liver mets can be particularly fickle in changing their ER or Her2 profile. 

In addition, perhaps you might consider sending off a biopsied sample for chemo sensitivity testing?  The tumor would be tested
against different chemos and combos to see what it may be susceptible to, and what it may be resistant to.  This is still considered controversial and many doctors do not believe in it, and it may not be covered by insurance.  However, several people have indicated that it has helped them and that it was superior to the hit-or-miss approach to chemo that is used today.  If you are interested, two viable places are Rational Therapeutics http://www.rationaltherapeutics.com/  and Weisenthal. http://weisenthalcancer.com/Home.html  Dr.Weisenthal has been doing this since the 1990s, so he has extensive experience.

In addition to systemic chemos, there are many liver-directed therapies you may wish to discuss with your doctor.  An excellent overview is at: http://www.beatlivertumors.org/Liver_Directed_Therapies.html

Good luck on whatever you decide!

YamaMama

Liver biopsy tomorrow. It will be interesting to see if after 5.5 years on hormonals, and one 12 week run of Taxol my receptors are different. 

I'd love to find out Herceptin is an option now....

I'll let you know what I find out.!

jojo2373

Update for all who knew Yamamama - she passed away on 5/5/16. She was diagnosed with mets at her dx in 2009.