Chemo group starting December 2014

akita - I would imagine the altitude is not your friend right now!  I think because chemo has an effect on all soft tissue there is impact on muscles, and that is compounded by the lower Hgb, causing rapid muscle fatigue and shortness of breath. The cumulative nature of side effects becomes more noticeable the deeper into treatment you go - and this is pretty consistent among patients, but it is interesting to me that almost universally among the folks I have communicated with on this board - the 6 week point PFC (post final chemo) is the turnaround point for both of those SE.  If the drug is causing a rapid loss of lactic acid it would seem to me that the recovery from that would be shorter than that six week period, and would have happened on earlier tx.  This seems to be a SE that becomes worse, or is noticed later in the process of treatment. It is possible that there is a cumulative effect even if it is from a loss of lactic acid, but I don't know enough about the specifics to hazard a guess. You might query your MO on stopping at four treatments - or doing a dose reduction if they insist on six.  Most of the people I have seen here do four or six, but the six tx is based on the number used in trial, which is a limited number of patients. Real world MO experience would seem to be more applicable, so I will be curious as to what your MO recommends.  I feel like that one positive node, and opting out of rads, will cause your MO to press for all six tx.

akitagirl

I feel the same way after #4, its been the worst.. still have to make that decision about radiation. I read the same article that you did and thought the same thing...maybe not. But I have a meeting with RO to discuss questions and I guess I will make decision based on percentage that it may add benefit. Wonder is anyone is told what percentage benefit it adds??

Akita

If you find out any info please send it my way!! I am sure when I go back in two weeks to meet with him if I have any info to fight getting 6 vs 4 maybe he would reconsider doing the 6. He felt comfortable with the 4 since he says its the standard with TC. The only ones that get 6 are maybe more advanced breast cancer? Not sure.

Special K and Akita..... I have to hit the "like button" on Akita's thoughts about your (Special K's) natural strengths in this arena! There is a great deal of information passed here. Special, you seem to pull it all together and spit it back out for the rest of us... "pearls of wisdom"... and I thank you very much for that!! Maggie

Maggie, you beat me to the punch!

Special K, you do have an amazing talent for digesting complicated information and putting it into language that makes sense. I am always glad to see your posts and especially so as I was initially sorting out my treatment plan. Seemed every time I got confused (one time in particular I remember, you explained the her2 estrogen receptor interaction issue so clearly), you would say something that helped me get it. As a physician that kind of "translating" is a huge part of what I do, so I know it is truly a skill you have well honed! I and I know the rest of us are very grateful that you continue to read and post here so frequently!

You guys are making me blush!  Truthfully, as I said above, it is gratifying to me to be helpful.  The surreal place we find ourselves right after diagnosis, and early in treatment, is an awful place to be and if I am helpful in any way - as ladies were for me - it is the "pay it forward" for me.  It is the same reason I chose to participate in a Her2+ vaccine trial - I felt the need to help advance the science that may prevent recurrence in Her2+ patients, and move the immunotherapy treatment concept into the discussion for all breast cancer patients. 

Does anyone know what to use for a very dry itchy scalp?  I had my last TC Feb 5th and am hoping it will start to grow back soon.  I have been wearing hats (sometimes two at a time when it is very cold) and I think this may have contributed to the dryness.  I have very dry sensitive skin anyway but this itchy head is making me crazy.  I already us a 2 in 1 head and shoulders and baby shampoo alternating every other day.  I was using olive oil but am afraid it may clog the pours and prevent my hair from growing back.  My mother bought me some baby oil but I am afraid it will do the same thing.  Does anyone have any ideas?

Interesting about the 4 vs 6 cycles. Of course, with my SEs, I really wish I could skip the last two cycles... BUT... I'm already doing reduced taxotere (not that it reduced the SEs at all!!! I figure I might as well be getting the whole dosage considering that I probably wouldn't be that much worse off). I wonder how the reduced Taxotere equates with the 4 cycles only?

And I agree with you all that SpecialK is just an invaluable resource in all these discussions! So much knowledge... and it really does help so much. This crazy world of bc would be so much worse without her input! --- Thank you so much for sticking around to help all the floundering newbies, like me, SpecialK!

---

My scalp... actually all my skin, has been dryer than usual these days. I've just been using a lot of lotion on it... Not sure what I'd start using on my head if I was trying to get my hair to grow back, since I'm still losing it and won't be growing any back for months, probably... *sigh*

Two cents on Rads and Her2+... then a question

Rads -----> Really wish older posts of mine were easier to find on this site.... I posted a more lengthy paragraph on this in December 2014... In essence the Head of RO at UNC-CH spent a great deal of time discussing partial vs whole breast rads approaches after lumpectomy with me and my better half. Boiled down, he isn't convinced as of 12/14, equivalency for lump/whole breast rads = mastectomy = lump/partial breast rads.... He spoke to margins and the fact that lumpectomies during the time frame of many clinical trials used as the basis for lump/whole breast = mastectomy, removed significantly more tissue than is current practice. He is waiting for new findings with much smaller margins before adopting partial breast rads (unless there are secondary health issues in the person under consideration). I am in good health, with Her2+ (3+)... he insisted on full breast rads for a four week cycle. The cycle length was based on my size (120 lbs, 5'3"). For once I am happy to be short!

Question for Special and Others... Ferritin blood serum levels... Have you had it measured? I was slightly anemic last summer and had a ferritin level of 68 microgm/dL. My nutritionist repeated the test last week and it is now 450 (1.5 times normal upper limit). Ferritin doesn't appear to be monitored during chemo (as best I can tell). So I am asking if anyone has experience with this....

Maggie - sorry - I did not see your question regarding the ferritin.  I am thinking of a couple of possibilities, could be from inflammation caused by chemo.  Or, could be from irritation to your liver - chemo drugs are generally filtered through the liver or kidneys, which is one reason function is monitored with a CMP regularly.  Do you have a recent ALT number? It would show your liver status. If the liver is irritated it may release its stores of ferritin into the blood which will reflect an increase in serum ferritin level.  Are you supplementing with anything that could raise your ferritin level?  What does your MO say about the increase?

So Special... think I have answered my question....

Elevated ferritin levels can either mean excessive iron in the blood or an acute inflammatory reaction.......

So after reading 5 or 6 abstracts and several full reports, the fact that serum ferritin level increased while available iron remained stable, is suggestive of the acute inflammatory response and not an iron load. C Reactive protein also measured higher at upper end of normal (2.9 mg/L 2/4/15 vs 0.8 mg/L 2/20/14), which was also statistically correlated with serum ferritin increase as an acute agent.

Thus I come to the conclusion... if NOT an iron function, then no need to find a mechanism to adsorb iron or secrete iron... and the serum ferritin measurements could make sense.

Hi ladies,

Just finished my 4th and last treatment of Cytoxan and Taxotere.I wanted to take a moment to thank you all for the good advice, suggestions and hopeful words. I don't post much, but follow all the posts. One episode of this journey is over, next is radiation.looking forward to hair growth now.

Good luck to all of you and we will win this fight.

Thanks.

ThinkingPos… - My last treatment packed the most punch, I was so tired right after coming back from chemo. Still taking things slowly and hoping to get better in a couple of days. Just glad to be done !!

Hello Everyone!

Round 4 and final round of chemo is finished - I am on day 16 and feeling not to shabby. My toes hurt...as do my finger nails. With my third round I ended up in hospital for 5 days with a fever of 38.9 and a mystery infection. Still don't know what happened.

I had a CT scan last Tuesday to get all set up for radiation...three little tattoos and waaaaLA! Now just waiting for the schedule.

I hope everyone here is doing good...it's been pretty quite...I hope it means we are all busy with our lives again!

Wow, no tattoos? That sounds very civilized!