TNBC - Chemo? - Hair Loss? - PET Scan?
Ladies,
I hope someone can help me out – you all sound so wonderful and informative and think this discussion board is a great outlet/inlet for all us in this fight.
I had my TNBC verified by pathology following my bilateral mastectomy on 8/7/13. Prior to surgery, my surgeon did inform me the initial pathology was showing TNBC and that meant the “after surgery” drugs normally used would not be used, and radiation wouldn’t really be an option since all the breast tissue was being removed – that would leave chemo as the only option available to me.
OK – post surgical follow up and review of bilateral mastectomy and sentinel node biopsy (both sides) showed IDC much more extensive than originally suspected and the right sentinel node tested positive for isolated cancer. My surgeon said he did speak with Oncology and said chemo was “likely and would probably be over a 4 month period”. Met with his office staff and got my Oncology appt on 9/16/13.
All that said…he said “likely” – is chemo ALWAYS used? I’ve read online that not all chemo causes hair loss – how am I to know if the chemo they use on me will cause hair loss? My family doctor said they might do a PET Scan – is that always done when a sentinal node comes back positive? Surgeon said “nobody can tell if the cancer has spread elsewhere” – wouldn’t that mean I SHOULD have a PET scan? If you know you will have hair loss – do you get a short hairstyle right away to help with transition (but here is where I’m frustrated because I don’t KNOW if I am getting chemo or if those drugs DO cause hair loss)? I’d like to get back to wearing my natural hair as soon as possible following chemo (if in fact I have chemo and hair loss-I don’t know that as I sit here today) which means I’d likely have an easier transition if I got a short hairstyle right now, purchased a wig that is in a short hairstyle, then being able to wear my hair naturally after chemo sooner than if I started out with my shoulder length hair. But what if I get a short haircut, then go to Oncology and find out they will not be doing chemo?????? I really do not like short hair on me (seems so stupid to be worried about my hair when I’m sitting here fighting cancer!) but want the transition to be as smooth as possible. I don’t want to get a short hair cut before returning to work now and then find out I didn’t need to do that if they decide no chemo so hoping some of you out there can help me out.
Gosh, I just re-read all that and do I sound conflicted and confused! Hope to see some responses soon.
Comments
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Unless you have a tiny tumour (well under a centimeter), NO nodal involvement, and/or complicating medical conditions, it is highly likely you WILL be given chemo. The chemo regimens commonly used for early stage breast cancer do in fact cause hair loss. It's a hard thing to come to terms with, but once you have a treatment plan laid out with your onc I am sure you will start to feel better about it.
I had quite long hair, which I had cut off about a month before chemo. I sent it away to a place that made it into a partial wig I could wear under ballcaps and scarves. I also bought a wig that looked (sort of) like my old hair which I wore to client meetings. I used scarves and hats a lot. Just before my second chemo, I had my sons (20 and 17) shave my head (my husband shaved his too) because I didn't want to see hair falling out randomly. It was a measure of control I could take. About 2 months post-chemo I had enough hair to ditch the hats and scarves, and believe it or not, everyone said I looked great in short hair (which I never had in my life before!) and I have recently cut my hair short again. It's very hard to lose your hair, but TN does respond well to chemo so you have to remember that!
There are boards here for chemo (organized by the month you will start) and some general topics on hair which you may find useful.
Good luck with your appointments and treatment.
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Luah,
Thanks for the info. You kind of verified my own thoughts that chemo IS in my future as I do have node involvement, tumors exceeded 1cm and I have no major health issues that would prevent my receiving chemo.
Your info on the hair loss also helps me greatly. In fact, just after I read your post I called my Hair Stylist and scheduled an appt for this Friday to go in and get that short hair cut which seems to be what a lot of women do to "take control for themselves" over the hair loss issue. I was incredibly surprised at how fast you were able to wear your natural hair after chemo; from what I was seeing online it appeared that women were posting their hair growth to be about 1-1/2" to 2" 7-12 months following end of chemo. So you give me great hope.
Thanks again for your input - it is greatly appreciated (I also posted my questions on the Chemo discussion Board hoping as many woman as possible would see it and offer their responses).
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Lili: My hair is naturally thick and fairly fast-growing. It started growing back when I was on taxol (several women have found this), and 2 months PFC I could go "topless" -- sorta like an extreme summer pixie cut -- though I'm sure I still looked like a cancer patient. Everyone is different though with respect to hair growth. Wishing you well.
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There are options to save your hair with Cold Caps. I used them and my hair thinned but it was still there and I looked normal. I did lose almost all of the other hair on my body so I know without the cold caps I would have lost my hair on my head too. Sorry you have to go through all of this and chemo. Good luck!
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I was told not to wear a cold cap as any cancer cells located there would not necessarily die.
Losing your hair is awful. I lost mine. It was past my chest. I waited as I thought maybe I won't lose it. It started coming out in handfuls. My stylist came to my house and shaved the rest off.
Today I am cancer free! My hair is about 1 inch. My last chemo was may 15th. I've dyed my 1 inch long hair platinum. I've had so many compliments. Most who don't know me think i chose this! My sig other loves the edgy fierce look and asked me to keep it for a while! Change can be good!
I could not wear a wig. I wore soft hats as my head was soooo tender! -
Lisa, I got a free wig from the American Cancer Society in my area. Call the national number and they will put you in touch with your local ACS. They give caps, wig stands, wigs, and other such items you may need. i was given a very nice brush, a bar of soap, caps, a wig, a wig stand, and hair nets. I believe you will definitely have chemo. My TNBC tumor was 6mm and I'm having it. God bless you. Trust will get you through it all.
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Thank you so much for the info! I will definetly contact them. It's so nice to have this forum where we can all connect and be able to share information with one another.
Good Luck with your therapy. May God Bless you as well! And we WILL all get thru this.
Lisa
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Regarding the cold caps, there is much information and many doctors are not informed. I suggest if you consider them to read the articles about them and be informed as you make your decision. They are not for everyone, but they are an option. I read the articles and from what I read there was no increased rate of scalp mets for those using cold caps and those that did not. Many doctors simply don't care that patients have to lose their hair and they won't take the time to review the literature. My MO office had cold caps on site. If they created risk, why would they? More and more hospitals/MO offices are getting freezers for cold caps. I believe you have to make your own decision and see if this is something right for you but in making that decision at least read the literature to be informed.
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Hi I would think by now you are well into chemo treatment My hair started to fall out after 3 weeks so I had a friend shave it off .It was pretty devastating. I had bought a wig before my hair started to fall out but that is not a good idea as it was too big once I had no hair.As a suggestion , try on different hairstyles now is a great time to try all those new hairstyles! I looked great in a style that I would never have tried and now that my hair is growing back (its about 1ins) and it grey and I actually love it and will keep it short.I used to be light brown.Don't worry about being confused it is perfectly normal and if you are like me you will probably stay like for a while .There are just so many changes in yr life rt now.Good luck with the chemo it is not always bad I sailed thru mine
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winnieg - Actually, I am not well into chemo! I just had my PET Scan done today as well as EKG. I just finally met w/MO last Monday and chemo starts in 2 days - Thurs 9/26.
I know, obviously know about the PET Scan as I had it today. And I know I will have hair loss due to my chemo regimen (listed as public below).
I've started a nice collection of caps/hats/scarves and have a fitting for wig on Friday. Although I don't know that I'll wear the wig too often as I've read a lot about scalp sensitivity - so I have my alternatives already in place.
I opted for no port - then I started getting info from ladies at other threads of how toxic the Adriamycin is - well, I'm still trying it via IV and if I need a port, I asked for info on an arm port (that others also have talked about). Then someone popped in to tell me about a PICC Line.....Talked w/nurse at MO and the arm port IS the PICC line but very bothersome in that it is partially external and requires daily flushing. Although I had been adamant I was not going to allow anyone to cut into my chest again so soon (it took 6 weeks to heal from BMX!!!); I'm not going to be so foolish and stubborn and burn my veins if they are having issues administring chemo - I'll get the darn chest port and be done with it.
I too have my hair sylist on call to shave me at day 10 as I'm told the AC is like clockwork and I can expect the hair to start coming out in clumps on day 14 - I want to preemptively shave before that happens. Got a short haircut 3 weeks ago to get used to not having longer hair ..... so I feel I've prepared as best as possible.
Thanks for the info! I hope I sail thru mine!!!!!!!!!! Gosh, I really HOPE I do!
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Hi Lili Will be thinking of you.I went the IV way and I am petrified of needles.Had no problems except for the last 2 by then the veins had started to collapse but got thru them-it really was not as bad as I had expected. I wore my wig all the time when I went out- it is a little bit warm but looked great. I am so much braver now if I had a choice I would go for a funkier hairstyle.We need some fun in our lives!Good luck for the chemo I hope you sail thru just think of all the bad cells its killing!
Thought for the day- Don't wait for the storm to pass rather learn to dance in the rain
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winnieg - thanks for your experience about IV. I hope my experience goes as well.
About a funky wig - you know, I'm a real wallflower. But, I think once my hair falls out....being a wallflower is going to be difficult. I think it's just natural that people look (unless, of course I opt for the wig full-time).
So I'm wondering, too, if it might not be time to "show off" a little w/perhaps an inexpensive funky wig once in a while? Who knows? So many changes, in such a short amount of time, and all our lives have been alterted in ways we never imagined....so like you said, why not have some fun with it!
Thank you as well for that thought of the day. I'm keeping that in my mind for the days ahead! Truly I am - I think that's a reminder I needed to have (I've always loved that quote but had forgotten it!)
Thanks again,
Lisa
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Hi Lisa
Talk about being a wallflower I am also very quiet.I never went out in public without my wig as I am just too shy. Just try on all sorts of wigs before you buy you will be surprised.Today I had my first haircut felt like I had won the lottery! Last chemo was end of March My hair was always light brown(fair) but it grew back steel grey I have had loads of compliments and will keep it this colour and fairly short .Used to tint my hair so maybe it was this colour for years! The time for wallflowers are over we must live life to the fullest! After you have finished all the treatments you wont care what people think about your hair so just be hyappy.
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Has anyone tried this?
If you see my picture you can see that I am a pretty conservative looking 60-year-old. So I have been thinking...why not have some fun with this before going bald?
If I continue to have the guts to do this I would get a real short hair cutjust befoe I start chemo (think crew cut) with enough mousse for spikes on top. Something totally out of character.
For once in my life I am not working and don't have to look respectable. So why not rag on this?
Ellen -
ellenkc - go for it! If you're not worried about having to maintain a "professional" look, have some fun. I keep hearing that over and over - and your post makes it clear you are certainly up for it, so I say do it.
It's all just temporary anyway; but if you read enough posts you will see that many women end up liking the new fun look so much, that's what they return to when your hair grows back. They try something completely out of the norm of what they would do under "normal" circumstances and find they love the new look and get many compliments.
Go for it! What have you got to lose? From what I can tell....nothing!
Hope that gives you a little more confidence in carrying thru on something you sound like you want to do! If you opt to go that route, please post your new picture so we can all see the "new you"!
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Hi Ellen Go for it!! I am 63 and quite shy so I bought a wig as close to my own hair as possible.I really liked it until my hair started to grow. All those spikes so I combed them flat because I am not that brave yet. and it was totally grey I loved it and so does everyone else. I will never grow my hair again -well maybe a little longer its probably about an inch long now after 6mths This is your chance to have fun. I am told that grey is very fashionable at the moment .
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Well, I went and did it. I start chemo on Tuesday 10/29, so I figure I have about 3 weeks of hair left. Really fun afternoon at the hairdressers with a friend to cheer me on. First time in about 50 years that I don't need to look like a proper schoolgirl or a professional!
The results: -
what a beautiful haircut .... And that face will still be pretty without hair. Glad you had fun. -
you look fabulous! Good luck for the chemo -
EllenKC - I have to tell you, you look fantastic! I'm so happy you did it....you know, so many years having to be concerned about professional appearances. Now you don't have that worry, you entertained a bit of a funky look, and you went for it! Might I also add the face that goes with the awesome hairstyle if very beautiful as well!
I read a posting you had on another thread and wanted to extend my sympathies on the loss of your husband. I, too, am TNBC which is what lead me to the other thread that had the info.
I started chemo, finally, yesterday after 3 delays. I was supposed to begin 9/26 but issues came up w/concerns on PET Scan and ECG, then surgery to remove another lymph node and needing time to recover.....but I finally got chemo started.
You are starting chemo rather soon after surgery - 20 days? Did you have a quick recovery from surgery? I think it's great that you get to start next week...the way I see it is if we set our minds that it's the best route to take for our situation, the sooner we get it started the better. I wish I had not had to wait so long, but that's in the past and I finally started so that's all that matters.
You know, you read so many things at the different threads here and get so much conflicting info at websites and from medical professionals....I was told that hair loss was like clockwork and began specifically on day 14 after first treatment (I have a diff regimen than what you have). But I also have contacts on BCO that are nearly 4 weeks and just now beginning to lose their hair. Then there are the websites that say "between day 2 and 21....." - really? Think they could narrow that down a bit? I'm just curious as to why you say "3 weeks left with hair" and what you are basing that on. Granted, I only know what I read so you very likely could have received info that makes you confident in the 3 week time-frame. I'd just like to know if it has something to do w/your regimen or if you were told that or what? And are you OK shaving your very beautiful hair sooner than what might be necessary? I'm torn on what to do - my plan had been to shave it all off on day 10 following 1st chemo but now I'm not sure another lady who has gone for almost 4 weeks!
Well, I guess it goes with everything else we have to deal with.....what happens to one person does not necessarily happen to others and there and no firm answers in many things!
Keep in touch with us on how your chemo goes. And I just love the "wild" look you chose; it complements you very much!
Lisa
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Turns out there is a really neat follow-up to the hair story. My hairdresser called me yesterday to thank me for the privilege of being able to participate in the event of doing something wild with my hair. (My friend and I were kidding around so much, pretty much the whole salon was participating by the time we finished.) In addition, my hairdresser offered a free haircut if I need it before we do the full shave (she suspects I will need it because my hair is so thick). Wow! Didn't expect this to touch others in such a way.
I also used the picture to post to Facebook as a gentle/fun way to let a broader circle of friends know what is going on. I keep ending up in uncomfortable conversations with people who ask how my husband is doing, and I have to explain that he died, at which point the other person just wants to vaporize/disappear. So I figured I would let folks know before I hit the bald stage.
Lisa: let us know how you are doing after the first chemo. My recovery is pretty fast because I just had lumpectomy, 2 nodes removed (no spread) and the two incisions for the port. The node incision looks a little more rough, but the others just look like a small scratch from a cat. When I saw my doc this week, I said I wanted to get this over ASAP -- I hate waiting -- and he said "How about if we start on Tuesday?". So here we go.
On the 3 weeks for the hair, that's just a guess, though the nurse for the medical oncologist said that usually by the time I would show up for the second treatment (on a 3 week schedule) I would likely be losing hair. Will take it step by step in any case, particularly with such a cooperative hairdresser who has also agreed to do the final shave in private.
Ellen -
Ellen,
I'm having some issues w/chemo. Strangely enough, I left chemo feeling exactly the same as I felt going in. No change, not SE's to complain about, no "weird" taste in the mouth when they flushed the port, nothing. Last night, however, I started feeling sick to my stomach which I found weird since they gave me, what seemed to me, massive amounts of anti-nausea meds in my IV prior to chemo. And I took the oral anti-nausea as directed as soon as I got home. Well apparently feeling sick to my stomach just before bed was far from just my imagination - I awoke at 1:00am and have been up since feeling very nauseated. Took the meds I was directed to so it seems perhaps I need a diff anti-nausea med for at home. I'm waiting for the infusion center nurse to call me back to discuss.
I've also developed swelling in my legs - no clue what is up with that except maybe water retention from steroids? Have a call in to my PCP and awaiting nurse to call me - hoping one of them can tell me what's up with this.
I'm exhausted, cranky, feel like I could vomit, my head is killing me, and I have to get my Neulasta injection this afternoon so my mood is not likely to improve. Oh well, that's why I scheduled my chemo on Thursdays - gives me the weekend to deal w/what should be the worst days and hopefully be recouperated enough by Monday to return to work.
Didn't mean to sound like I was complaining there; I'm not. I had hoped to eek by with few side effects and given what I am dealing with....they really are few when you look at everything that COULD happen. I'm thankful for not having any of the really bad stuff so please don't take it as complaints. Just setting the stage for how my first time went. And I'm dose dense so I get to do it all over again in 2 weeks yippee! And if SOMEONE would call me back, I might get a change to my meds so I would feel a little better. But hey, haven't we all gotten used to the waiting game at this point - I know I have.
I think that's great what your hairdresser offered. I'm fortunate that way too; my hairdresser owns the shop and told me to call her cell phone to bypass her employees. She will have me come in any evening I choose and shave me in private, when it's dark out, so I feel as comfortable as possible. We all know we have friends in this world, but I tell you what, these little gestures mean so much to those of us dealing w/cancer and treatment, that I cry when I think of all the wonderful, kind, and thoughtful things those around me have done to try to make my life a little easier in these times of dealing w/such a horrible disease. I am truly a very blessed woman.
Let us know how your first chemo goes. You take care, Ellen!
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I chose to have a nipple-sparing double mastectomy on Oct. 7 after I found a 2.2cm lump in my right breast (7.8 cm away from the nipple). I am brca2 positive and triple negative. My 5 page pathology report days after surgery revealed no lymph node involvement (5 were removed and tested) clean margjns. Clear labs! I was so relieved. Then I followed up with an oncologist who recommended 3-4 chemo treatments. I was floored. The female doctor was frigid and rude. I am so frightened. -
TG: Chemo is the only systemic treatment for TN at this time, so it is pretty standard practice for oncs to recommend this for all but the tiniest TN tumours. While clean nodes and clean lab reports are a great sign, it is unfortunately, especially with TN, no guarantee that cancer cells are not circulating elsewhere. I know this is scary and depressing to hear -- we have all been there! -- but chemo is your best shot at a future free of disease and it IS manageable. I'm sorry your onc was frigid and rude, no excuse for that... it may be worth being referred to someone else, as you will want to feel completely comfortable with your onc as you move forward. -
thank you for your response Luah, you are right; I did not want to hear that lol. I read last night on another post, someone said they looked at the treatments as an additional immune system. It made sense. xxoo -
I agree with Luah also TG. Do the chemo offered to you. I had to make a similar decision earlier this year. My tumour was 1.8cm and it was removed with clear margins but the two sentinel nodes both contained micro-mestatis. I had to have an ALND to have more removed but these were clear. I am not BRCA positive. They told me there was a 50% chance I was cured with surgery but those odds weren't high enough for me being 44 yo. I did 6 months of chemo and 6 weeks of radiation treatment of which I still have two sessions left.
I don't have any regrets about doing the chemo.
Hope you are feeling a bit better now Lisa. I found each treatment effected me differently. The worst was my 3rd dose of AC where I virtually stayed in bed for 3 days but the 4th dose was a breeze after I had psyched myself up for another terrible few days.
One day at a time ladies!!!! xx -
hello..may I ask where you sent your hair to be tailored Into a headband? I am seeing an oncologist on Wednesday and she may recommend chemo:( I am very scared of chemo:( but I want to plan ahead and I want to do the same with my long hair if I have to cut it off. I hope you are doing well. Xxoo -
This is what I used: http://www.hatswithhair.com/Wig-Made-With-My-Own-Hair-1.aspx
Best decision I made before chemo: cutting and sending my long hair off for a hair piece. I had a wig too (for work), but with my own hair, worn with a cap or little scarf, I felt like me. BEST feeling! -
I hope you changed doctors. You need someone kind at a time like this.Please don't be frightened. I met my terrific and kind lady oncologist last Tuesday, had my PICC inserted on Wednesday and had my first chemo after that. The nurses in the chemo suite were lovely. I can't say enough about the wonderful care I received. Good luck to you.
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