need advice

becky1 · February 2010

need advice

becky1 · February 2010

I posted in IDC but since I was told I'm atleast stage 3A or more, figured I'd try here. I am currently being treated with pre-surgery chemo to shrink 8cm tumor that ulcerated the skin. I'm constantly inflammed and on and off antibiotics to control that. I'm finishing up A/C chemo tomorrow and onco. wants me to do the Taxol routine after. My surgeon feels comfortable doing masectomy now but will make final decision after PET on Mon. yet onco disagrees and wants to continue to shrink it with the Taxol and feels continuing this treatment will better ensure no recurrence and long term survival, the surgeon disagrees. Shouldn't they agree and stop confusing me, who knows nothing about what the best route to take is? Isn't it better to get the cancer out? The decision in the end is mine to make, I know that and will wait until PET results, but was hoping for some advice. Continue with Taxol, then surgery, yet fear the cancer will spread regardless of treatment or Surgery then radiation? Onco keeps saying once you stop theres no going back? Please help me to understand.

everyminute · February 2010

Well - one thing that I have learned along the way is that medicine is not an exact science but more of a "practice" - so different docs have different opinions and reasoning. My feeling is that if they dont agree - go for a 3rd opinion!

Let-It-Be · February 2010

Hi and welcome!

I did neoadjuvant chemo as well. I am thinking that if you are having a good response to the chemo, that is, if they are feeling a reduction in the tumor size, then to continue with your onc's advice. I did both AC and taxol first then surgery. I was not worried about cancer spreading it was reducing, I could not feel it anymore. I'm sure if you were not having a response, your onc would recommend the surgery right away.

Hope this helps you. Best of luck,

Christine

karen1956 · February 2010

I had my bilat first then chemo, so don't know about neo-adjuvent chemo....but as everyminute said, maybe get a 3rd opinion....maybe from another onc....as my gf says....medicine is not a science, but an art!!! Good luck......

lexislove · February 2010

Hi Becky,

I can only tell you what my onc told me....I did neo adjuvant chemo too. Tumor was 8cm...and grew fast, real fast. I started with AC as well. The tumor responded fast. It shrunk to about 1/2 after the first AC.

Before I started chemo, my onc told me that if my tumor wasn't responsive to the AC after 4 cycles, then we would do the mastectomy before starting the Taxol. I didnt question him at the time, what his reasoning was, I was such in a panic state from being diagnosed.

Is there another oncologist you can ask? Third opinion? If not, I would tend to listen to the expert, your oncologist. But, thats just me.

I guess the question is.....is your tumor shrinking and how much?

becky1 · February 2010

I was told that the tumor is liquifying..so yes it responded as far as I know to the a/c. I will have my first PET on the 15th and a follow up ct scan, i guess that will let me know how much of a response. I've been battling an "infection" on my breast(from the cancer) since Oct. and throughout my body for a long while that presents it self through my skin. I will weigh all my options but I don't want the anxiety of wanting the cancer OUT to cloud my better judgement if that is to proceed with the Taxol.

KerryMac · February 2010

Becky - I just would like to welcome you aboard as well.

I had surgery before Chemo, so i didn't face this issue. But, from what i have read of others experiences, some do 1/2 chemo before surgery, then finish up after, others do the whole lot first. So, as others have said, there is no "right" answer. What I don't understand is why your Dr's seem to be at odds with each other....

Isn't the purpose of neo-adjunctive Chemo mainly to shrink tumors enough to get clear margins at surgery? If the cancer is still in your skin, maybe the Onc wants to continue with Chemo for that reason?

I would tend towards a 3rd opinion, if you can get to see someone fast enough. If you can't then I would maybe go with my Oncologists opinion too, they are the cancer Dr's after all.

hope2 · February 2010

Hi Ladies,

i had a very large tumour also and the bs felt that it was growing so fast and causing so much damage that she wanted to get it out, chemo had 60% chance of working and for 20% does nothing and for the other 20% it can actually grow on chemo. i also had the infection issues and was on 12 antibiotics a day to clear the infection, considering in the previous 34 i had never been on any, i was also on antiinflamotires as had an abcess the size of an orange in a very small breast. i took antibiotics for the week before the surgery so that i would be infection free for the operation, the surgeon had to cut extra low to get the margins and leave a very tight wound as they thought the cancer was in the skin and nodes from the scans but they were swolen from infection and not cancer.

i am happy with the decision that the cancer care team made for me as i was at my strongest for the opeartion and the chemo takes a lot out of you, especially the taxanes. my tumour was over the 8cm and a very small margin to the chest wall, too small to measure but present none the less. after the op results they said i could now consider myself cancer free and that is such a boost to your bruised ego. Best of luck with whichever you decide, research has shown the outcomes are the same for both methods in terms of five year survival rates, but i did hear of a girl lately that only had to have a lumpectomy after having chemo to shrink the lump and of course there is the advantage of knowing if the chemo is working on your cancer or not. I was to have a modified radical mascetomy anyway and they took the view of gettting it out as quick as possible.

Pure · February 2010

Sounds like a 3rd opioun is needed-what state are you in? Try to find a doc with a really great reputation -think about someone who specilaize in Triple Negative. At UNC-Dr. Lisa Kerry (I think) my chemo brain is failing me He treats Elizabeth Edwards and he specilaizes in triple negative. He is one of the best.

Welcome to stage 3-keep coming here for support!

Gayleebug · February 2010

Becky, from what I have heard, triple neg cancer such as yours is very responsive to chemo, which is probably why your chemo onc wants you to continue. I personally had a complete response to neodjuvant chemo before my surgery, which is what everyone is really hoping for... The next best thing, of course, is maximum shrinkage then wide clear margins upon surgery. I agree with some of the others that your two docs should be working in concert with each other and since they are not, I would go for another opinion. And, yes, your PET should tell you and your docs a lot, and give you more to go on in order to make the decision with the best info possible. Can you proceed with the Taxol until your PET?

A big hug to you!

Gayle

jenn3 · February 2010

Before I had rec'd my path report and found out I was TN, I had made the decision to do a bi-lat masectomy. My onc didn't tell me what to do, I had already made up my mind. But....... he did say when my case was presented to the board it was unanimous they all agreed I should have an immediate bi-lat, with chemo and radation.

I hope that you can find the answer you're looking for, it seems a lot of us go different routes so it's hard to say what's right or wrong. But what I can say is you need to feel comfortable with the decision you make and with your doctors - yes they should agree and not put you in the middle.

(((HUGS)))) and know you can come here for support.

need advice

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