Starting Chemo in March 2014

My, surgeon, MO and the tumor board all thought the chemo first was the best course of tx for me because of the large nodes and the extanodal extension. They though the 6 wks for surgery and recovery was too long to wait for chemo, wanted to stop it before it had a chance to spread further. When I went to MO 1st time she only talked breast conserving lumpectomy, but yesterday she asked whether I was thinking lumpectomy or mastectomy. Then she said we should just be patient and see what the tests show after tx is done. She said I'll meet with the surgeon before my last chemo and we can figure it out together. It's kinda hard being in limbo, it seems just about everyone on these boards had surgery 1st. Guess I just have to take her advice and be patient.

I am doing chemo before surgery too. I have had 8 weekly Taxol.... US shows shrinking tumors however my breast is HUGE and red all around. My tumor was large and due to the biopsy I had alot of bruising and tissue damage but I am a little concerned. MO examined a few weeks ago. I'm going to have him look tomorrow.... Anybody have this happen?

jbdayton....did you do AC first then the Taxol?

Yeah, I had surgery first too. I had 4 small lumps with a biG swath of noninvasive cancer connecting them from the axillary area all the way up to the nipple. So I had to have surgery first which was a mastectomy and nipple removal too. On Monday I start Taxol for 12 weeks at weekly infusions. Little nervous as my last chemo infusion kicked my butt, granted it was harder stuff. LOL

Thanks everybody for your input, jbdayton, I think my plan is like you said, do the lumpectomy then if margins not clear the mastectomy, but I'd probably just get a double cause I'm barely an a cup and I just can't see reconstructing that. I'd just go for double with implants I think, might as well get something outta this s**t.

Hi everybody,

Jenw4kids- Glad the CT scan showed nothing, and anxiety meds are such an important part of pain management that I have no doubt they would help with breathing difficulties as well. I was also advised to take some ativan after next chemo because there is certainly a component of fear and panic when you feel like you can't breathe, which then makes you demand more. Bad cycle. That being said, I hope that no one feels that means they've "imagined" their shortness of breath issues. Nope. Those are real. The ativan is just to help not make it worse. I've had a well-meaning friend ask me (after explaining I was told to take ativan next go-round) "Oh, so the breathing complaints are not really real then? It's just feels that way because you get anxious?" NO! geez..  

And genny5775- I think you and I are on the same path. Neoadjuvant chemo, 2cm-ish invasive ductal mass in breast, plus a couple lymph nodes positive for cancer. Am doing the dose-dense AC + T (taxol), then surgery which.. I'm probably leaning toward mastectomy, but will see. I'm compartmentalizing- one step at a time. Too focused on getting through this chemo stuff to put much thought into the surgery yet. 

And finally when we get to radiation, I hope I can really help the board here. That's what I do for a living; medical dosimetry, which is in the med physics part of a rad onc department. I'm one of the behind-the-scenes people that do treatment planning and dose calculations for patients getting radiation therapeutically. Probably 30-40% of our treatment plans are breast cancer patients. Not every cancer center does things the exact same way, but I'm sure I could help with general questions, if anyone has them. But that's down the road.

TxPlanner I look forward to bending your ear on radiation.  It will be a whole batch of reading and learning curve. 

Hi Jodi040812,

So you're starting rads June 9th. I'm guessing you've already had your simulation appointment (treatment planning CT) since you know the exact date you start (unless June 9th is the date for the planning CT..?). I assume they are treating bilaterally, with the addition of supraclavicular node treatment on the right. Okay here comes the general info: The radiation beams are directed at a steep angle to the chestwall to minimize dose to normal tissue (verses aimed straight down at the breast, which would give dose to everything underneath it; lung, top of liver, etc). 

So basically the beam will be aimed across the skin surface, tangentially. Here's the thing about that: A beam hitting the skin surface at an angle raises the skin dose, as compared to a beam coming more directly into the chest, as would be the case for a lung cancer patient, for example. But even with the beam hitting you tangentially, the skin won't get too crazy red or anything. It's usually mild, and it's always gradual. We have a lot of patients that use Aquaphor, and some like to start putting it on right away, others like to wait until the first signs of drying or getting pink. 

Here's what I've observed and will caution you about: A tendency to be too liberal with the Aquaphor and/or putting it on right before coming in for a rad therapy appt. This results in some moistness still on the skin at the time of treatment which causes a bolus effect (raises the skin dose) and skin reactions in the treatment field ranging from tiny pink dots- like a rash, to a smooth reddening all over. So I'm saying be careful with the application. Not right before treatment ever. Put it on AFTER you've had your treatment that day. Your chest area should not look shiny when you come in for treatment.

Whatever product you're advised to use, and any others you hear about, make sure they don't have metals in them. Zinc and all that stuff.. it causes more skin reaction. Another caution- We're coming up on warm weather months, so be careful of any areas of the skin that are creased as the beam sees it (skin folds), for example your supraclavicular field on the right side will be aimed a little more front to back, (because it's at the top of the lung and above so it doesn't need to be tangential). However you're right arm will be up, and that will cause some natural skin folds between your neck and your shoulder. Look in a mirror and raise your arm up, you'll see what I mean- some natural skin folds around the base of the neck and top of shoulder. I would NOT put cream or lotion there, even aquaphor. Anywhere skin is touching skin you'll have a moist environment anyway, and a little higher skin reaction there, so don't add to it with more moisture. If anyone is getting rads after lumpectomy, skin folds are also present in the axilla sometimes and just below the breast as well. Best to keep those areas dry.

Hope this makes some sense, and sorry so long-winded..

Sinsin, my eyes are blurry too....and itchy.  I thought it was from all the crying I've been doing, but I have t had a good cry in two or three days and my eyes are still off.  Maybe it's the fatigue? I don't know but it helps knowing I'm not the only one.

I have my last dance with the Red Devil tomorrow!!  I am totally dreading it.  Gagging at the thought of another Popsicle!  I froze grapes and I'm hoping to send my mom for a slurpy or some sort of smoothly or milkshake instead....  I just popped two Ativan, hoping to sleep through the night because last night sucked.

Sweet dreams!   Jen 

thanks, Sinsin!  I will see you over at the weekly taxol thread!

genny, I have the eyelid twitching a lot.  I always think it must really look like I'm winking at the person I'm talking to.  Rubbing it makes it stop sometimes; sometimes it doesn't.  It's an off and one thing for me.  

Feeling a bit better now on day 6 after #3; went in for more fluids today.  My elderly mom is now very ill; don't know what's wrong with her; she's very very hot then suddenly very very cold.  Is being treated for thyroid but hasn't had a biopsy since 2010 since #s have been okay.  I am scared to death for her; I am also living with her and the stress from both of us on each other and both being ill is awful.  If something happens to her, I don't know what I'll do or how I'll get through or recover from this.  She's been my best friend my whole life and I feel like I just can't take anymore.  Anyway, thanks for listening about that--it's probably for another thread, but I just threw it in here since I'm not here much lately; not feeling well enough.

TxPlanner- thank you! ct is June 4th. Wonderful advice about skin folds!  Thank you so much for that warning.  

Hang in there Lovemysons! No growth is better than growth, so yes, that is something to be grateful for. And at least they scanned you just after 2 doses so they can change you to something more effective quicker so you're not undergoing unnecessary treatment. As to carboplatin, I'm not too familiar with it but if it works, then good!

jmg  Im glad to hear from you.  My mom is not doing great either, was hospitalized for day and came out ok. Ugh I too, feel like I cannot lose her now.  Have you started Taxol?