Need onc suggestions 2nd /3rd opi for Triple Negative treatment

Deanna - Thanks for taking the time to look up Janice Lu. I agree she seems to have a good background. Turns out I'll be having surgery before my appointment with her, but think I'll still keep the appointment to discuss the best plan after surgery. Still not sure if just radiation is best, or if I should do more chemo. Sure don't want to, but want to do the best I can to knock this out now. I appreciate your input very much.

Hope999 - Thanks so much for posting! It's helpful to know that the "growth" could be because the chemo actually IS working. Have surgery Monday, hoping for good news on pathology.

Mel

Deanna - I am thankful for your thoughts, as my own are quite muddled these days.

The place I'm going for treatment operates in a similar manner, with all of the doctors and testing facilities in the same setting, and even operates an "Answers in a Day" program. They probably don't get quite the numbers that UCLA would get, therefore less experience with people like me (Triple Negative, large tumor, growth on 2nd chemo regime). This is why I wanted the second opinion, and was actually hoping for additional preadjuvant chemo as you mentioned, to try to shrink the tumor more before surgery. I felt that it was best to have the tumor to measure a response to new treatment, as once the tumor is gone, we won't really know if what we're doing actually worked.

My current oncologist disagrees, and is concerned that if the new chemo we try doesn't shrink it, then we could miss the window for a manageable surgery, as the tumor is still large enough that with any growth, that would be a real issue. They are setting up the surgery right away, as the tumor is fast growing and if I wait, I would have to wait another full week before the surgeon would be available again. I had measurable growth (self-measured by caliper) in a 5 day period this week, so they are right to be concerned about this. Also, my husband is totally on board with my docs in pushing for surgery as soon as possible.

My concern is more with any nodes or micro-metasteses that might exist. Prior to chemo, I had a lot of discomfort in the shoulder and chest on the tumor side. With the Taxol and Carbo, the tumor was shrinking and softening from week to week, and I had none of the prior discomfort in the shoulder. I could easily tell we were headed in the right direction. With the switch to A/C, not only did it stop shrinking, get harder, and then seem to grow, but that old discomfort came back in the shoulder and chest. I worry that just taking the tumor isn't enough, and then I've lost my best guide as to the right chemo regime. I'm hoping that like Hope, it is just necrosis and fluid build up rather than growth, but was looking for the 2nd opinion to help with decision making. I really wish I could've gotten an earlier appointment with Dr Lu, but so far no luck there. I was told initially that getting in within a week was pretty good.

Even if I did delay the surgery to take part in the UCLA multi-disciplinary program, I'd be running into payment issues, as UCLA isn't on my insurance plan. I was going to pay for the consult appointment if necessary, but wouldn't be able to manage the whole multi-disciplinary thing, including the surgery itself.

Sometimes things happen the way they do for a reason. Guess I'll just go with it and manage the things that I'm able to. The timing of the appointment is out of my control, and so is the crazy tumor and it's fast growth, and the surgeon's schedule. I'll still have the appointment with Dr. Lu, and will be able to consider her input in continuing treatment after the surgery.

Thanks again, Deanna, it's great to have the additional input, even if I'm kind of locked into a certain course right now.