How’s everyone weekend? Hope everyone didn’t suffer any major SE.

Jay - I started my radiation last Thursday, so far I did two session, 28 more to go. I don’t have any SE for now, I’m praying this will continue this way.

Hope - I had surgery before chemo, also I have 2 positive lymph nodes. I trust my doctors so I just follow what they recommended. This journey is not easy but is doable.

hope, I think that means has not spread BEYOND the lymph node. yours is in the lymph node but has not spread beyond the lymph node

Hope99, that’s a nice link. What is FEC?

Hope, you posted earlier that your doctor took a biopy of your lymph node and it was positive for cancer. So now they want to give you chemo first to try and kill the cancer and then do surgery to get rid of anything that is still there.

Thanks Hope, I had to follow the yellow brick road (links). This should make it easier

FEC chemotherapy

In this guide

1. Overview
2. Who might be offered FEC?
3. How FEC works
4. How FEC is given
5. Common side effects of FEC
6. Less common side effects of FEC
7. Sex and contraception
8. Travel and vaccinations

Meeting Coverage > SABCS

Study: Two-Year Extension of Aromatase Inhibitors Is Long Enough

No extra benefit from 5-year extension in breast cancer patients

by Ed Susman, Contributing Writer, MedPage Today December 07, 2017

SAN ANTONIO – Women who took the aromatase inhibitor anastrozole (Arimidex) for an extra 2 years beyond the current standard 5 years of treatment, for purposes of preventing breast cancer recurrence, received the same benefit in disease control as women who took the drug for an extra 5 years, researchers reported here.

Among women who stopped extension treatment with anastrozole after 2 years, 71.1% were alive and free of disease, compared with 70.3% of women who stayed on it for 5 years (P=0.925), said Michael Gnant, MD, of the University of Vienna, in reporting results of the prospective, randomized Austrian Breast and Colorectal Cancer Study Group-16 trial.

In his oral presentation at the annual San Antonio Breast Cancer Symposium, the only difference Gnant observed was that women who continued on anastrozole for 5 years experienced a slight increase in fracture rates that fell just short of statistical significance – 6.3% of women taking the drug for 5 years versus 4.7% of the women who discontinued after 2 years (P=0.053).

There was no statistically significant difference in overall survival. The overall survival from time to randomization to death of any cause was 85.4% of women who were assigned to the 2-year extension with anastrozole and 84.9% of women who were assigned to 5 years of treatment with anastrozole (P=0.947), Gnant said.

"After 5 years of standard endocrine therapy, 2 additional years of anastrozole are sufficient," he suggested. "There is no benefit of continuing/escalating endocrine treatment beyond 7 years."

Gnant said the study was initiated because even 5 years after endocrine therapy breast cancer still recurs. "More than 50% of breast cancer recurrences occur after the first 5 years of follow-up after initial treatment of breast cancer," he said. "Since the risk of recurrence persists, extending adjuvant therapy is appealing."

Currently, more women diagnosed with hormone positive breast cancer are treated with tamoxifen or aromatase inhibitors for 5 years, but Gnant said the optimal duration of extension beyond that is controversial, and was the aim of ABCSG-16 to define.

The researchers enrolled 3,469 women who were recruited from 75 centers in Austria. All the women had completed 4-6 years of therapy with either tamoxifen or an aromatase inhibitor or both. The researchers assigned 1,731 women to 2 years of treatment with anastrozole and 1,738 women to 5 years of treatment with anastrozole.

Gnant said a deep dive into the data found no subgroup of patients who did better than others, including specific age groups, tumor stages, nodal status, receptor positivity, or previous chemotherapy. Any way the data were sliced, the results were the same – no significant differences between those treated for 2 years or for 5 years.

Gnant and colleagues also examined adherence factors in the trial, but again there was no outcome difference depending on the level of adherence.

What is needed next, he said, "is translational research that may identify molecular characteristics that indicate benefit of prolonged extended therapy."

In commenting on the study, session moderator Carlos Arteaga, MD, director of the Harold C. Simmons Comprehensive Cancer Center at the University of Texas Southwestern at Dallas, told MedPage Today, "This was a negative study, with positive news. We should be looking at ways of shortening therapy. We can't just keep extending and extending and extending. We need to come up with better ideas."

"For a long time we have treated too many women for too long a time," Arteaga said. "We should give deescalation of therapy a try at least in hormone-positive breast cancer. In triple-negative breast cancer we are still escalating treatment but it has a very positive result."

However, he cautioned that de-escalation should be performed in the context of controlled clinical trials. "In the process of de-escalating, we may be depriving someone of treatment, so we have to be very careful about that – such as the studies presented today," he said.

PauletteK






Glad you're doing well with radiation. As you know, it's the drive, and prepping that takes so long. I did really well. I had, and still have my expander in. I was worried that my expander might lose it's shape, but it was all good. Are you having any fatigue? My fatigue didn't hit me until the last week, and I did not have much of an appetite. I lost some weight, then all of a sudden that changed. I have cravings all the time. So, the weight started creeping back up.
Sometimes, I wonder if the tamoxifen contributes to that.

jaymeb - We do the one long walk every morning, Our back yard is a couple of acres fenced so they play out there during the day. I train the younger 2 in agility so we are usually practicing different things during the day too. Terra is the oldest dog we have had. I think the average life expectancy of the breed is probably 13 years. They do keep me busy but it's s good busy. How old is your daughter? Dogs are a big commitment!

bravepoint






Reece is 14, a freshman in high school. She, for the most part is a responsible girl. At my place, we have two cats, Nicole and Mary. Nicole is named after her favorite 5th grade teacher. All through elementary, and middle, she went to Catholic School. When she was in kindergarten, a kitten showed up at her school. In the busy car line, one of the teachers was trying to see if someone would take her. Well, we did. She is now 9 years old, and weighs 24 pounds. Wonderful cat, although she can barely jump up. At her dad's, she just lost her cat a month ago. As you can imagine, she was very upset. Of course, our pets are very much family. Her dad told her if she commits to taking care of a dog, he would consider it. They are looking at German Shepherds. We'll see. Sorry about my essay, I get a little carried away.

Today I did my #1 chemo, FEC protocol, I feel numbness in my both hands, I feel my head is heavy, also I feel a little numbness in my right feet, I think it will start to spread in all legs! I'm scar and feel so bad. also I can not taste well . did the numbness need to call emergency to find out solution?

before two hours I feel plapitation, I used home pressure meter and I foound it 170/100, heart pulses is 120 . the pulses low to 100, but blood pressure is fluctuation. no idea how to do in these side effects sister.

Hope if your in Canada FEC-D is very common here i did that as well & had 8 positive nodes. I trusted my doctors in what treatment plan i was given. I am now onto radiation which i start on Thursday. With respects to the SE i did not fair too bad, had the usual ones we all have. The bad taste in your mouth will go away after a week or so, it will get better, by the 3rd week you will be feeling alot better then unfortunately you have to get ready for the next dosage but you will know what to expect. Try to drink as much water as possible, if it tastes bad put ice in it found that i drank more when it was colder & lemon. With the numbness if you continue to have that get it checked out, call your oncologist to tell them how you are feeling. Listen to what your body says & rest if you need to rest don't over due yourself. If you are up to it go out for a walk every day helps your body. Stay strong you will get through this, i know its scary, it will get easier.

grandma3x

Thank you for responding. You're right, there was DCIS present. I'm just wondering, how does EIC, and DCIS intertwine? I didn't ask my onco too many questions about my pathology report. He just said everything that was on my pathology report was sent to genomic testing, hence, it came back with an onco score of 14. Although I had one lymph node positive, he told me I didn't need chemo. I saw you skipped chemo due to a low onco score. If you don't mind me asking, were you pre, or post menopause at diagnosis? Also, is EIC something I should be worried about? Thanks so much

Ladies,

Hope you all that are starting treatments, are in treatments, or finishing treatments are holding up well.

jaymeb- LOL I am sure she will wear him down. Just don't get a puppy at Christmas.

The Day #3 of chemo ( FEC ) :

Generally I feel OK, not good, not bad, something in between. the first day is hard to me. I did feel heavy head during and after infusion. Numbness in my both hands made me fear, but the feeling is acceptable generally . also I experienced palpitation in the first day only. taste change and constipation kill me . I do not know how to manage this SEs .

Also I feel tired and sleepy all the time . I need to fight with my children with no reason, my mind not OK .

Now I use "MOUTH WASH ", red bottle, bad taste, gargling then Swallow, not spitting as usual ? its written for external use only but my doctor told me to swallow it!!

My treatment :

- Embed 80 mg .

- Dexamethasone 4 mg.

- Kytril 1 mg.

- Esomeprazole 40 mg . ( for stomach before eat, 1 a day )

- Docusate Na 100 mg .

- Senna 12 mg ( for constipation ) .

- Mouth wash, swallow, not spitting !

most of these treatments make constipation, I can not avoid it . Hope I will find out something help me .