Calling all TNs

Oooops again I forgot something.  (It's chemo brain....and I'm sticking to that excuse)

I had my biopsies yesterday.  One core biopsy and 4 skin biopsies.  I have so many holes in Righty, that if you could hook up a garden hose to my breast............I could make a hell of a lawn sprinkler!!!!!

Hi Bunnygirl, 

Wow, I can not believe that 3 different people did not raise a red flag at the bump.  Although I do think doctors follow the symptoms to find a problem, and we tend to start first with thinking it's a problem and work backwards.  I too would have been suspicious!

Metformin works by controlling glucose in non-diabetic as well as diabetic women and it also lowers androgen receptors - and it is in several trials right now to test effectiveness when administered with chemo, or without chemo, with diabetics and without diabetics and currently it has made it all the way to Phase 3 of the trial.  Metformin works by reducing circulating insulin cells which they feel can be very beneficial to TNBC women.  Metformin induces cancer cell death at the earliest stages of development via metabolic pathways. It can help stop or slow the spread of metastases if the person has a high expression of CD24 positive cells.

Metformin has been on the market for 25+ years and they discovered that women who had been taking it had much lower incidence of breast cancer.  With TNBC, current theories are that we need to keep low fat and low insulin levels.  There are studies right now of it in regards to TNBC.  Because there is not a standard targeted treatment for TNBC, many Physicians and Oncologists have prescribed it, because of the potential benefit to risk ratio (very little risk associated with Metformin).  Tamoxifen, what ER+ women have as targeted therapy, was originally a contraceptive drug. 

If you would like to PM me your e-mail address, I have several articles and attachments that you can read for further understanding. I also have a lot of other TNBC information on the e-mail (nutrition assistance, etc), as I have numerous requests for additional information.  Each attachment is saved with a file name that makes it easy to determine what you are reading, if you only want to read about Metformin.

It was the women here at bc.org who first told me about this, and I collected a lot of research on it before moving forward to ask my Onc and PCP about going on it. I have now been on it for about 6 months - and I'm at the trial dose as well. 

While it has not been approved for taking as preventive measures for bc, it can be written off label.  Off label means taken for a reason other than what the FDA approved it for.  (Much like how birth control pills are prescribed for someone who has acne - that's not the original purpose of birth control pills, but it helps control some people's acne). 

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

• Phase I:Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
• Phase II:The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
• Phase III:The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
• Phase IV:Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

I have literature from the TNBC Foundation that could be helpful to you and your family in understanding TNBC - it's written in a very nice easy to follow PDF.  It explains a lot, talks about what you can do now and for your survivorship, etc.  On page 33 it states...

Page 33 -  "Most women
with triple-negative breast cancer never have a metastatic recurrence or a new
cancer."

I feel that is important to reflect upon that statement because we are only a small group of women on here.  It's estimated that 15-20% of women who are diagnosed are diagnosed with TNBC, so that would be about 35,000 women each year diagnosed with TNBC (232,000 women with IDC x 15%).  Very few of these women are on the boards, so it's important (if you have a bad day or read something depressing) to remember that there are many victors out there - we might just not be hearing from them on the boards.

Just keep taking it day by day, and we are all here to help and support you! 

Hi everyone,

Is hydronephrosis related to the effects of chemo? Secondly, does chemo cause liver damage? And the final question, is ascites from chemo, cancer or something else entirely? 

Fighting OvCa kept me away from bco and I was saddened to read about Dawn and Karen. I hate FC!

Hi All, 

Just stopping by to wish everyone support.

Inspired, I take krill oil instead of fish oil for omega 3.  I just like the idea of krill being lower on the food chain and therefore, hopefully, less toxins.  

Tekwriter, I had a hard time eating on AC, particularly at the end.  Organic peanutbutter on organic multigrain toast became my "go to" food when I couldn't cope with anything more.  I did lose weight while on chemo, but my MO was okay with it.

Twelve days to my surgery and counting.  I'm feeling better each day as chemo works it's way out of my body. I'm now 18 days PFC (but who's counting LOL).  

I meet with the RO this Wednesday for the first time and I'm very glad about that.  I want to know from her what she thinks about possibly having implants replaced at the time of my surgery and whether it could cause problems with getting the radiation I need.

Inspired - I'd be very interested in seeing the Metformin research you have that talks about it's effect with Androgen receptors.  

Journey4life - it's good to see you.  I'm going to try and answer your questions, BUT they are all complex questions that are better answered by a doctor who has knowledge of your specific case.  I have a feeling if your coming here to ask the questions, then you must feel you're not getting the information you need. I did some checking to make sure I could give you accurate answers.  Again...please remember these are best answered by one of your doctors

Does chemo cause liver damage? Almost all drugs are broken down in the liver. (Some are excreted directly through the kidneys).  Chemo drugs are very toxic and yes they can be damaging to the liver.  That is why part of your blood work during chemo is evaluating your liver enzymes so doctors can monitor how your liver is tolerating the chemo drugs.

Is hydronephrosis related to chemo.  The easy answer is no, but the answer is more complex than that.  Hydronephrosis is caused by urine/fluid being trapped in kidney and damaging it.  Urine flows from the kidney...through the ureter....into the bladder....and out the urethra.  Anything that causes damage to any of these structures can cause hydronephrosis.  There are MANY causes but some are kidney stones, bladder dysfunction, scarring from infections, various results from surgery in the pelvic area and the effects of radiation.

Is ascites from chemo, cancer or something else?  This another complex question.  Ascites is a symptom not a disease.  Ascites is simply fluid collecting in the peritoneal cavity.  It also has MANY causes.  The most common cause is some type of liver disease,  Other causes include severe heart disease, damage to liver's venous output, kidney disease, malnutrition and cancer (primary or metastatic)

I hope this helps Journey.

Sounds like you're doing the best you can right now Tek.  My only suggestion would to be to add another shake in daily if need be.

Simple - I'm glad to hear that you will be able to get your questions answered by the RO before your surgery. BTW, I love your picture.  Yes...you do look like a demented elf......but a very beautiful elf.  

Hi Kathrynn,

Here are a few articles:

" For example, metformin, an insulin sensitizing agent that also helps to reduce excessive androgen production, promotes weight loss..." From the article below:

http://www.lef.org/protocols/female_reproductive/polycystic_ovary_syndrome_01.htm

http://www.ncbi.nlm.nih.gov/pubmed/24267731http://www.sciencedirect.com/science/article/pii/S1526820913001869 - Title: " Metformin Decreases Circulating Androgen and Estrogen Levels in NonDiabetic Women with Breast Cancer"

And this final article is not really about your question - it's just an interesting article on how Metformin came into existence for the prevention of cancer and general information about it.  http://www.lef.org/magazine/mag2012/nov2012_metformin-makes-headline-news_01.htm

Thank you Inspired.  Since I'm the Queen of Androgen receptors (99%) the Metformin may actually be helping me.  (*throws PCP to floor and kisses soundly*)

I was thinking you had mentioned that when I was reading your request!  I'm so glad to hear that!  I also want to hug my PCP.  Maybe we can make this "hug your PCP day". 

Kathy I would put food first any day. Stuff the rest at my age.  You and Titan haven't turned up yet.  Those cream cakes will be going off and I don't care if you come in your birthday suit (though a bit windy today) as long as you both come. lol  

Just stopping in to say "hi".  I'm 19 days post final chemo and 11 days until surgery....just enjoying the relative calm between the two.

I'm also trying to get my Vit. d levels up.  I take D3 supplements, but does anybody know if it does any good to lie in where the sun comes through a window in the wintertime?  I tried that yesterday with bare skin.  Didn't know if it helps any, but I felt nice and warm....like a cat lying in the sun. 

Simple I don't know whether it does any good for vitamin D by lying in the sun by the window but it sure sounds good.  Hope you have got a good book, some music playing softly  and can nod off.  Lucky girl.   

Simplified, I am taking AC now and finishing my cycle in two weeks.  I am to start taxol then I think how is it?  what was it like compared to AC?

inspired - I just got my 25-hydroxy vit d levels tested and I am at 68 - I was at 41 a year ago - so I am quite happy about that. I take 5000 units of Vit D3 every day, 3000 units in the morning and 2000 units at dinner time. We have to pay $65 to get this test done - do you have to pay, or is it covered by your health plan?