can someone help please?

Options

Hello there - I am searching for information for a friend.  She was diagnosed with T2 (4.9cm) cN2(4/11) cMo invasive ductal carcinoma on her left breast back in April 2008.  At the time, she was 29 years old.   She was treated with modified radical mastectomy and prophylactic right sided simple mastectomy.   Her tumour characteristics were grade 11 ER/PR positive, Her-2 neu overexpression negative, resection clear.  Completed adjuvant chemotherapy September 3 2008 and radiotherapy November 11, 2008.  She was then put on Tamoxifen which ended this past September and Tritorilin injections to throw her into menopause.  In the past month or so, they just found small lesions on 20% of her liver after an ultrasound and the largest spot was 15 mm.  She got the original tumour site removed and they found it was the remaining tumour tissue and still waiting on pathology to see if characteristics have changed.  She is now doing a combo of taxol family chemo combined with gemcitibine on day one and then repeat Gem on day 8 then the cycle repeats itself in about 2 weeks.  After cycle 3, repeat scans to see how its going.  She inquired about a liver biopsy but they didn't recommend it. 

 We live in Ontario, Canada.  She would really like a second opinion on her treatment and options but is afraid to look herself because she doesn't like what she sees so she has asked me to filter through info for her and see if I can find a clinic/hospital/specialist in the United States that has more of a speciality with this.  We live in a smaller community and we do have a great cancer clinic, but we do not have any hem/oncs that are designated to one type of cancer.

 If anyone can share a similar experience, recommend a treatment centre in the US, know of an reputable specialist who specializes in recurrence of breast cancer, please let me know. Even if there is a website or specific discussion board you can refer me to.  You can either post here or private email to thesavors@shaw.ca  

 Thanks so much for your anticipated help!

God bless :)

Comments

  • barbe1958
    barbe1958 Member Posts: 19,757
    edited November 2010

    Canada has world-renown cancers centres. I suggest you check out some of them. Princess Margaret comes to mind pretty quickly as does Sunnybrook. You certainly do NOT need to go to the US to get treatment for breast cancer! The cost would be in the $100,000 of dollars!!!! Why would your friend consider the financial strain???? She can get free treatment here in Ontario with her OHIP. Of course, if she is not a legal immigrant she has the whole world open to her for treatment.

  • konakat
    konakat Member Posts: 6,085
    edited November 2010

    I have to agree with Barbe.  The chemo she's getting is pretty standard for Canada and the US.

  • dee467
    dee467 Member Posts: 3
    edited November 2010

    Thanks for the replies.  Even though Ontario does have some excellent treatment centres, from my experience with two of my own family members with cancer, I have discovered that in some places, there are "experts" in small centres, especially in clinics in the US, where physicians will only take on a limited number of patients and therefore, have more time to concentrate on research and give very individualized patient care and offer things that docs here may not be doing.  I do know if certain treatment or clinicial trials that are not offered where we live, OHIP will cover the costs if it is offered somewhere else but here if they benefit the patient.  For instance, my father has a refractory lymphoma and there is an excellent doctor I found online in New York City that specializes in refractory non-hodgkins lymphoma and is undergoing many clinical trials at the present time for such cancer, that are not offered here.  I was hoping to find a doc or clinic that is doing the same for relapsed breast cancer.  If there is any other options that people have here, please let me know.  In my experience 2nd, 3rd and 4th opinions are much better than just one.  Thanks again.

  • hmm
    hmm Member Posts: 2,183
    edited November 2010

    dee,

    Just want to say that if you are looking in the US that MD Anderson is an excellent choice.

    Wishing you the best,

    Pat

  • barbe1958
    barbe1958 Member Posts: 19,757
    edited November 2010

    I have a very rare breast cancer, Papillary Carcinoma, that is less than 2% of all breast cancers. There is just a limited number of combinations of treatments available. Your friend has to be confident that her doctors are doing their best. I'm pretty sure my docs wanted me to live. We're not a third world country up here. Elizabeth has attempted some trials in Toronto. They are there and they are available, but you don't get in a trial just because you want to. And remember, your friend could be getting the option that isn't the best for her. I'd rather know what I'm getting thanks.

  • konakat
    konakat Member Posts: 6,085
    edited November 2010

    Dee -- I was initially diagnosed in Boston and received treatment there for about 2.5 years.  I moved back to Canada and have continued my treatment at the Ottawa Hospital.  The treatment I received in the US is the same as one receives in Canada.  Both countries follow standard protocols. 

    The oncologist I see at the Ottawa Hospital specialized in BC and also is an editor for the Journal of Oncology.  To think there aren't very good, internationally recognized specialists in Canada is incorrect.  But if it eases your mind to get an opinion in the US, try Dana Farber in Boston.  BTW -- I didn't go there -- I preferred the more personal treatment at a regional hospital in the burbs of Boston.

  • hrf
    hrf Member Posts: 3,225
    edited November 2010

    I have to agree with barbe and Elizabeth. In Toronto both Princess Margaret and Sunnybrook are world renowed. Both have outstanding reserachers who participate in North American trials. While there are excellent centres in the US, I have no doubt that they are not better than what is available here. But if you want to spend $100,000 +, and contribute to the American economy I'm sure they will be happy to take your money. Best wishes for your friend.

  • LRM216
    LRM216 Member Posts: 2,115
    edited November 2010

    I have to agree with what is posted above my post.  I belong to two other breast cancer forums, both having a large group of Canadian ladies on each.  Two ladies in particular come to mind as they came to the states after reaching what they felt was a stalemate in their treatment after each progressed with many serious problems, and returned back to Canada after consultations here.  Each was directed to Sunnbrook, and each has seen a very good turn around in their situtations since going there.  I know one of the ladies swears by Dr. Rebecca Dent, I do not know who the other lady used.  However, both are doing well and are most thankful to Sunnybrook.  Perhaps you might want to look into that. 

    I wish your friend every success and the peace of mind that she is getting the very best treatment available to her.

  • 208sandy
    208sandy Member Posts: 2,610
    edited November 2010

    Like Elizabeth I was diagnosed while living in the U.S. and have had follow-up care here in Canada - the protocols are the same - Princess Margaret and Sunnybrook are both cutting edge but if you do want to spend money and support the U.S. healthcare system(?).....my sister was treated in Montreal 8 years ago with the same protocol used at NYC her doctors were Canadian and were working in both places!

Categories