Chemo before surgery????

My SIL who was diagnosed w TN bc last fall had chemo prior to her surgery. The tumor responded very favorably and shrunk a quite a bit prior to her lumpectomy, which was a very good thing indeed. She is retired, so I'm not sure if she could have worked during chemo or not, but it seems from reading here many people do, or at least they are able to work a modified schedule.

Hi, TAngel and big hugs to you.

I had 6 cycles of chemo every 3 weeks and this is how it went for me. Tuesday's were my infusion day, so I missed a total of 6 days (which wouldn't have been necessary to miss the whole day if the center was more efficient and on time LOL). On Wednesday after treatment, I had to go to the center to get a Neulasta shot, so I was able to do that during lunchtime. On each Thursday and Friday after treatment, I started feeling like I had the flu and that lasted through Sunday. I was able to work remotely from home on Thurs and Fri, but I remember that on one of the cycles, I was unable to work those days. All in all, I missed 8 days, with 10 remote working days. Make sure that you let your onc know that you want and need to work, so that they can accommodate an optimum treatment schedule that allows you to recuperate on the weekends... and manage side effects. My onc was very supportive of me working, in fact she insists that her patients keep a normal schedule.

Now, all that said, I am not single. My husband took care of everything.....household duties, shopping, food prep, etc.so I could rest. If you do not have people who can support you, clean house, shop for you and bring meals, that may affect your ability to work. By the end of chemo, I was so tired, but I made it through and the non-chemo weeks were pretty easy except at the end when recuperation from chemo week dragged out a few more days.

I hope this helps. It is one person's experience and you are a unique and special person....Above all, be good to yourself and put your health first.

I had a lumpectomy. I had the surgery on President's Day which was a company holiday and worked from home for the next 2 weeks, so I didn't miss work for that. I was very able to work....the issue was that I couldn't drive and I was unable to dress appropriately for work until the incisions healed enough.

I hope your employer and/or your job allows you to work from home.

:Love, MsP

T100angel, hugs. Once I had my plan in place, I felt oddly energetic. I hope you are able to tolerate the medicine and that you can juggle your job responsibilities. This is the toughest time, for sure. I remember cleaning out all my closets just to keep busy and not be thinking about the unknown so much. That helped (and my closets were so organized!)

MsP

t100, If you have to have the Neulasta shots like me and MsP, you may be able to give them to yourself. My MO let me. That saved a day of going back in. Just a thought.

Neulasta is a shot given when your blood counts drop. It helps to reduce the risk of infection.
MO = Medical Oncologist. Here is a link to abbreviations that may help you on the boards.

https://community.breastcancer.org/forum/131/topic/773727?page=1#idx_1

Not everyone needs Neulasta. But in case you do, I just want you to know it's an option to self inject. They teach you how and it's very easy, and it also saves you taking more time off work.

I'm also a chemo before surgery person. Actually I'm a chemo and then radiation and then surgery person. My tumor is too big (more than 9cm, starting to protrude out side of nipple etc) and there are are too many "involved" areas under the arm to not attempt to shrink it first.

I was all psyched up for surgery then was told, nope, have to wait. Then I psyched myself up for AC first and then nope, weekly taxol for three months then AC the following three. All this has done is shown me that I can't make any firm plans and things can change. I still have my appointment to see about hereditary screening which may change up surgery plans. Sigh.

I just finished week 7. My tumor is softening and shrinking a bit. My oncologist doesn't think it will shrink to nothing but it is getting softer. The part that was growing out making it look like I had a second nipple is gone, although my nipple still doesn't look normal and is still inverted. Overall I'm happy knowing there is progress and that this hell called chemo is 'worth it'.

PET scan showed that pretty much every node in my upper right contains cancer, although only 3 under my arm are palatable. The three have not softened or shrunk at all yet and my Dr says that the volume of node involvement will make radiation and surgery more intense so I don't mind delaying them.

So far I've been able to work through treatment and be single parent to 6 year old twin boys. I am off every Monday for treatment and work is accommodating (for now). I'm slower for sure. I am capable of working though, but if I wasn't a single parent with no other income I would benefit from being off.

hello,

I am so pleased to find an active triple negative thread!

I had my surgery first about four weeks ago (BMX due to a positive BRCA1 test) and will start chemo on Monday. I was told that the tumor was quite small so they there was no need to shrink it. Also, they could not tell if it was in my nodes until surgery. They strongly thought the nodes would be clean, but sadly, two had been infiltrated,

Adarkadapted - I will get the same chemo regimen as you, four every other week of AC and then 12 weekly Taxotere with Carboplatin. How has it gone so far?

I haven't found anyone who has gone through the weekly TC and am quite curious/terrified of the unknown.

Wishing everyone well with whatever stage you are at!

Well, it seems that my gung-ho attitude was misplaced/premature. HA! Yeah...

Days 2.5 through about 6 were pretty rough. The fatigue/"woozy" feeling was very mild on chemo day and the following day (i.e., Neulasta day), but by that second night, I was already feeling lethargic. The next morning (day 3), I felt like I'd been hit by a bus. I was warned that I'd be fatigued, but this was like no fatigue that I'd ever experienced before. The Ehlers-Danlos has me in a perpetual state of low-grade fatigue and whole-body pain as it is; the chemo magnified that to the point where I couldn't sit in front of my computer for more than about 5 minutes at a stretch because my body/brain/psyche were all screaming for me to lie down. I drifted in and out of a weird fugue-like sleep/wake cycle all day, every day, for about 4-5 days. I couldn't get anything done except the bare minimum–showering, drinking loads of fluids, taking heaps of pills, and eating the few foods that I could stomach. I dreamed vividly, and felt very disoriented–kind of like that feeling when you have the flu with a fever. Though I was never actually feverish, I also noticed what I'm guessing were chemo-induced "hot flashes." I envy you lot who're able to work through the chemo; I couldn't even *think* properly. The smallest chore became a massive effort that seemed, suddenly, to be utterly unimportant (clean dishes/clean clothes/clean apartment: who needs 'em?").

I noticed some freaky things during that chemo-induced forced "imprisonment":

-My EDS causes my feet and hands to be cold/freezing in any air temp below about 65F. During the 4-5 days after my infusion, my hands and feet were actually warm to the point of discomfort!

-Any food, beverage, or utensil that was even remotely metallic-tasting caused an immediate gag reaction.

-I couldn't move very fast, no matter how forcibly I willed myself to do so. I felt like I was 80 years old and slogging through molasses.

-The brain/body/psyche "fog" burned off around the 6th night without warning–I was suddenly wide awake and mentally clear, with my chilly hands/feet back to normal.

-And then, of course, I couldn't sleep.

Some DOs from Round 1:

-Take Claritin (or generic loratadine) to thwart the Neulasta-induced bone pain. I take loratadine for allergies anyway, so this was a no-brainer. I felt a few twinges here and there, but the pain was pretty much nil (whereas my poor mom, who'd had Neupogen with her chemo all those years ago, felt like her limbs were being hit with a baseball bat).

-Drink prune juice!The stool softener that I was advised to take kept everything...erm...pliable, so to speak (*barf*!), but did nothing to address the lack of feeling the actual need to go, as it were. I happen to love prune juice, but I'm pretty weird, so...

-Use biotène dry mouth rinse and toothpaste. Not as breath-freshening as mouth-scorching brands, but scorching your tongue/mouth tissues is the last thing you want during chemo! OY.

-Practice obsessive hand hygiene.

-Eat stuff that's palatable so that you get at least *something* in your stomach. Though the powerhouse Decadron and Compazine (never needed to take the Zofran) kept the vomiting totally at bay and the nausea to a minimum, I didn't really want to eat anything. I suddenly had a bizarre craving for fake mashed potatoes and uber-salty jarred gravy (stuff I'd normally not touch with a 10-foot pole!), so dutiful DH made a special trip to the g-store so that I'd have something to eat. I was like a carb fiend! Blech.

-Get outdoors when you feel well. My brother just got a small-ish boat, so I've "allowed" family to take me on short boat trips in the fresh air (even though I was close to napping the whole time during those first days).

-Keep your port area covered while outdoors, as the area/scar will easily get sunburned.

-Wear a hat/sunglasses and use high-SPF (preferably natural) sun protection when outdoors, because everything is going to be way more sensitive than usual and a sunburn's going to make you feel even more crappy than you already do!

-Eat iron-rich foods because the chemo can cause anemia.

And some real DON'Ts:

-Alcohol. Really, just don't.

-Spicy food. O.M.F.G. PLEASE don't eat the spicy guacamole and the jalapeños when you're feeling better and suddenly wanting to devour your favorite foods (like I did).You probably WILL pay for it (like I did!) with GERD and tongue/mouth sores. My onco nurse yelled at me when I told her.


Round 2's scheduled for the 21st; here's hoping! I'm perpetually anemic due to hideous uterine fibroid-induced heavy monthly bleeding (read: more like a monthly hemorrhage), so my onco doc's interested to see what my counts'll be like when my labs are drawn on chemo day. I just hope that they won't have to transfuse me...

Peabrain: I've only just completed Round 1 (of 4) of the bi-weekly AC (Adriamycin + Cytoxan) chemo. I'm still terrified of all of it! I won't be starting the weekly Taxol (+ possible Carboplatin) until around September...

Chemo before any other treatment is thought to be the best way to treat TNBC. TNBC as opposed to other breast cancers is very vulnerable to Chemo.

I am BRCA1+. 1 in 40 people of Ashkenazi Jewish Descent have BRCA1 and/or 2 Mutations. 1 in 600-800 people in the general population have BRCA 1 and/or 2 mutations. I was tested because I had TNBC and I am half Ashkenazi Jewish. I am, however, the only one, so far, on either side of my family who has ever had Breast Cancer. My Aunt died of Ovarian Cancer in 1992. I was diagnosed on Apr. 11, 2013 at 55 years old. I began my first dose of what was supposed to be 6-8 rounds of dose dense Chemo on May 12, 2013. A few days after only one dose of Taxotere and Cytoxan, I was taken by ambulance with unbearable pain as if someone was taking a sledgehammer to my legs, spine, and arms. It also felt as if someone was pulling out my ribs in the front and back of my body with pliers. I ended up in the hospital with 105 degree fever, double pneumonia, hallucinating, in excruciating pain. I died twice and had to be resuscitated. I only remember the Hallucinations and the pain.

Within a week I lost every hair from my head to my toes AND all of my fingernails and toenails. Apparently, I was allergic to the Chemo and had been OD'd on meds in the hospital. The medical staff told everyone that I would not survive. I fooled them. I did recover within two weeks, but I am still experiencing terrible side effects from the one round of Chemo. My side effects from that ONE dose of Chemo are terrible and are keeping me from doing most of the things I love. I am completely alone and rarely get out of my house because of unbearable pain throughout my entire body. I am unable to drive. I cannot to walk for more than 10 minutes without excruciating pain. I have severe peripheral neuropathy and ridiculous Chemo Brain. My brother called it "Long Term Loss of My Short Term Memory". I used to be extremely active and social. I was a Fitness Trainer and Personal Chef. I was very involved in community theater as a dancer, actress, and singer. I love to walk, hike, weight train, entertain, camp, garden, etc. So far, all I can manage is a little gardening. The doctors don't know when or if the side effects from the chemo will subside. All of my friends and family say it's too disturbing to see me like this, so I am alone most of the time. The nurses in the hospital warned me that this is all too common. No more Chemo for me, so I had better stay Cancer free!

However, within 4 weeks of that one dose of Chemo, the tumor could no longer be felt. I had a lumpectomy on Aug. 12, 2013 and it took hours for them to find where the tumor had been. They finally found the wire marker that the original pathologist had placed near the tumor during my original biopsy. The tissue and the lymph node that the surgeon sent to the pathologist were clear with a 10 mm margin. So far, I am still cancer free and it has been over 2 years since diagnosis. I switch between a mammogram and a Breast MRI plus blood work every six months. I also, see my Oncologist every six months.

Good Luck!