Stage3A - Treatment Dilemma

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balachandra77
balachandra77 Member Posts: 4
edited June 2014 in Stage III Breast Cancer

Hello All,

First of all, I have no words to "THANK YOU" for sharing your experiences, positive notes, success stories.

I should start this post saying "We are probably in one of the toughest situations of LIFE" !!

Everything was looking so beautiful till April 2011. We are expecting our second baby and everything was going smooth. I remeber that nightmare day when my wife found a lump in her left breast and we were told that it's "Malignant tumor" !!!

My Wife was in her 5'th month of pregnancy when diagnosed and she was dignosed with triple negative "Infiltrating Duct Carcinoma" stage3A. Today is her 31'st B'day and I write this with tears thinking of the trauma she went through during diagnosis and MRM. She completed her second AC chemo last week. 5/16 mymph nodes had CA cells.

Her Onco has asked her to complete 4 cycles of AC (3 week gap) till 33 weeks followed by c- section and continue radio therap and 12 doses of paclitaxal.

2 AC therapies and Nuepogen has caused her enough fatigue and other known side effects to start wondering "Is it really Worth?". She was wondering if we should "STOP" after 4 AC doses and turn down "Radiation" and "12 cycles of paclitaxal" !! May be we can check Alternative Therapies/exercise/diet after the pregnancy. She/I has following concerns..

She has to start Radiation may be 2-3 weeks after the child birth and start 12 rounds of taxol after 6 weeks of c-section. The concern is:

      - Unlike normal situattions, body will be weak for 3-6 months post pregnancy/c-section.

      - During lactating, body's behaviour seems to be different compared to normal times (When our first child was 11 months and she was breast feeding, she took a pill for terminating a unplanned pregnancy. We wre thinking that could have caused CA !)

In such situations, by following the onco's advise "Are we getting into some other challenges in near future?" !!! While study shows Radiation improves RR and OS, it has chances of getting into lung CA/Heart problems !!

Taxol seems to reduce RR by 15-17% !! Is it worth to go through the side effects of it (Neuropathy, losing remaining hair, nail fallout, more toxicity) ? The difference in AC vs AC->T seems in terms of DFS in 5 years seems to be 52 vs 65 (something like that !!).

Is radiation after 3-4 months of surgery still effective?

Is 12 cycles of taxol after about 2 months from first cycle makes any difference?

While I'm convinced that RT+Taxol are definitely beneficial, I'm not sure how to answer these genuine concerns !! In most of these studies, pregnancy factor doesn't seem to be considered !!

PLEASE HELP ! I'M REALLY CONFUSED. NOT SURE WHAT ADVISE I CAN GIVE HER.

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Comments

  • jennyboog
    jennyboog Member Posts: 1,322
    edited July 2011

    It breaks my heart to hear this has happened to your family especially during what is suppose to be a joyous time.  Breast cancer isn't easy for anyone but being pregnant complicates things alot more.  I was not pregnant at diagnoses (dx.) my youngest was 18 months but I know there are a few women on here that were pregnant at dx and I'm sure they'll be along soon to share more info.  I didn't have a c-section but I did do my bilateral masectomy (BMX) and started radiation (rads) one month later, so it's not unheard of to start soon after a surgery.  Is it worth it....I think so, they are giving your wife what they have seen work based on the pathology of her cancer.  I'm almost a year out and it was tough at times but I'm now NED (no evidence of disease).  I felt my tumor shrink and saw my inflammatory breast cancer go away during chemo.  None of us know what will happen tomorrow but I feel at least I gave it my all.  It does get better, there are many triple negative women (TN) on here that are several years out.  My prayers go out to your wife and family and please come here as often as you need to, this a wonderful site.

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  • pupfoster1
    pupfoster1 Member Posts: 1,484
    edited July 2011

    I am so sorry you all are going through this.  It is NOT fair.  But it is what it is, and you and your wife need to do what you have to do to be there for your baby.  There is another lady on the Stage III boards who was pregnant during her dx (is that you Pure?) and now has a beautiful baby and she's doing well too!  I wouldn't be surprised if you hear from her soon.  I can't speak from personal experience in your wife's exact shoes, but Taxol for me was much more tolerable than the A/C.  If she gets through this part I think things will be A LOT easier!  The A/C is what makes you lose your hair, not the radiation, mine actually started coming back in while I was in rads.  And try not to remember your wife is not a statistic.  Hopefully she's been in good health and is strong, she'll make it through this tx!  Remember, this is temporary and things DO get better.

    Prayers and good vibes coming your way,

    Sharon

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  • Letlet
    Letlet Member Posts: 1,053
    edited July 2011

    balachandra, your post made me tear up and struck a chord. I was 31 when I was diagnosed last year, my daughter was 5 and my son was 2. My husband was and is by my side every step of the way and he has been completely heartbroken over what has happened and feels helpless that he couldn't do anything to "take it away".

    Anyway, I'm just trying to see what input I can offer. I had E/C (same as AC) and Taxol. The EC was really tough, I was very tired and fatigued all the time. My energy levels got better on Taxol but I did get bone pain and neuropathy. My oncologist was able to work with me each time to manage my side effects and I made it through. My hair started growing back on Taxol and my neuropathy is gone now (I am 5 months out from chemo) I never lost my nails, they just got darker and they are fine now.

    I don't know where you live but you may be near a chapter of the Young Survivor Coalition, your wife may draw strength from other women her age going through something similar. All the best, please keep us updated on your wife's progress.

    I had my last chemo Feb 3 and started RT on March 28th thereabouts, almost  2 months out. This was because I had shingles and my exchange surgery and needed to recover from them.

    My RT said that the radiation is very specific and wont hit my heart at all. I had RT to my clavicle becaue I had positive lymph nodes and she said that it would hit the very top tip of my left lung and that it would show up on future exams but did not say that this would be harmful  or result in damaging my lung.

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  • balachandra77
    balachandra77 Member Posts: 4
    edited July 2011

    Thanks Jenny, Sharon,Letlet for your kind response.

    We are from India.I'm not aware of Indian chapter of Young Survivor Coalition, but I will try to find out. One another thing that bothers me is the gap between first round and second round of chemo cycles. She will complete her 4 cycles of AC by mid of August and she will be in her 33 week of pregnancy then. Even if we plan an early delivery of the baby at 36 week/37 week, there will be almost 3 months gap between AC and Taxol treatments. Any one has an idea if this gap has any negative impact on chemo effectiveness?

    -Bala

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  • Pure
    Pure Member Posts: 1,796
    edited July 2011

    I was diagnosed while 3 months pregnant. I went through treatment which was FEC every 3 weeks. ( I also had a masectomy while pregnant) I then gave birth and had 12 weeks of taxol with zometa every 3 weeks. I then started radiation. I am 2 years out-baby is perfect. Did a TON of research and was treated at Duke.

    I would say the chemo plan they have in place doesn't make sense. I was diagnosed even earlier then you and had fec every 3 weeks..Then delivered at a ful 39 weeks. We followed the MD Anderson protocal which they are the only hospital that has studied tx for pregnant women with BC. I I got a LOT of chemo and honestly i am happy about that. 

    If you would like to talk call me anytime 919-649-3147

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  • Pure
    Pure Member Posts: 1,796
    edited July 2011

    FYI all the babies studied and followed at MD Anderson ALL are perfect and NONE had any effects to date..I think the babies are into their 20's as of now.

    Dr Lisa Star is one of THE leading researchers and doctors treating Triple Negatives here in the states. She is at Duke as well.

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  • AnacortesGirl
    AnacortesGirl Member Posts: 1,758
    edited July 2011

    I hope you can connect with Pure since she has done so much research.  There was another lady on the boards from California, Billynda, but she hasn't been on the boards since last October.  She also did very well with her chemo and pregnancy.

    The taxol will still help.  Remember that chemo is fighting the cancer systemically.  If there are any cancer cells left after surgery the intent of the taxol is to zap them.  And try not to worry about the side effects until you get there.  Many women handle taxol very well.  I wasn't one of them (I'm in the minority on that) but the nasty ones such as neuropathy don't hit overnight.  As she goes through the taxol infusions she'll be watched for problems.  If the neuropathy starts to become an issue than they can stop the chemo.  It is very rare for the nerve damage to be permanent.  Especially if it's stopped before it gets severe.

    When it's time for radiation they so a simulation.  That's when they line up the direction of the beams, the position of the body and the areas that had cancer.  At that time they will find out if there are any concerns about the beams being close to the heart or lungs.  With the level of radiation technology we have now I have not heard of any women having heart or lung problems.  It's a very precise technology.

    I wish you all the best.

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