Calling all TNs

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  • moth
    moth Member Posts: 4,800
    edited May 2019

    kber - I finally had time this morning to check out those links and do some additional readings on melatonin and TNBC. Fascinating. I have used melatonin occasionally in the past and I'm considering adding it to my regular routine. I did note some of the studies i read were talking about very large doses compared to the 0.5-5mg that is common for jet lag or occasional sleeplessness so maybe the regular small doses won't help much but it's worth a try anyway imo.
    thx kber!

  • kber
    kber Member Posts: 394
    edited May 2019

    Hi Moth.  Yes the dosages are closer to 15 - 20 mg.  My personal experience - you need to ramp up slowly and be prepared to ramp down slowly if you don't tolerate it well.  For me, Melatonin led to very vivid, but not unpleasant dreams.  I'm at 15 mg a night right now.

    You also need to time when you take it pretty carefully, especially at higher dosages.  It takes about an hour to kick in, at which point, I am pretty sleepy!.  However, when I was traveling internationally quite a bit and taking a prescription sleep aid for jet lag, etc, it was much more powerful than melatonin is for me.  

    There is some other research that suggests that if you use melatonin long term that your body reduces the amount you make naturally, which can lead to sleep and other issues, so there's that to consider as well.   

    I am working with my MO on the dosage, etc.  He was supportive of me adding it to my routine and does monitor the side effects, etc.  

  • ucfknights
    ucfknights Member Posts: 102
    edited May 2019

    hi ladies.

    My mom is about to start taxol Monday. We are doing a masectomy after treatment. I was wondering. How do follow up appts look for you ladies done with treatment?

  • moth
    moth Member Posts: 4,800
    edited May 2019

    ucfknights - you might want to check out the ASCO survivorship care guidelines to see what your doctors should be organizing for you: https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21319

  • notdefined
    notdefined Member Posts: 286
    edited May 2019

    Hey there ladies, I am in the middle of Taxol going through some really dark places, and the latest is reoccurrence.  Does anyone know what the statistics are for reoccurrence for TNBC? Every where I read just says it is higher within the first 5 years over other breast cancers, but I don't see how much higher.  Also, did you factor the chance of reoccurrence when deciding on lumpectomy v. mastectomy?  I am going to have a mastectomy on the right side, but now I am reading that TNBC is higher risk for reoccurrence in the other breast.  I'm thinking maybe do a mastectomy on both sides to reduce risk?  I know that it doesn't eradicate all possibilities of reoccurrence since it can still appear on chest wall, but doesn't it reduce chances since there is less breast tissue for it to form in?

    Thank you for your insight.

  • PiperKay
    PiperKay Member Posts: 173
    edited May 2019

    Hi notdefined, I have been to some dark places too, but luckily not too often. That doesn't mean it isn't scary when you're there.

    I haven't done intensive research on statistics, but when I first met with my breast surgeon, she said lumpectomy on a tumor like mine (see my bio below for details) had an equivalent survival rate to mastectomy. We weren't 100% sure that I was TN at that moment because the first test for HER2 on the biopsy tissue came out equivocal. But after a FISH test, TNBC was confirmed, though I didn't know that until after surgery. So far I have not had second thoughts about the decision for lumpectomy. I would say that since everyone has a different set of circumstances, I wouldn't bet on trying to find someone with exactly your situation to model yourself after. Rather, look at how people reach their decisions, not on their results. Otherwise I think you'll just head down the rabbit hole way more than is healthy. Bottom line is that you are not a statistic!

    Best of luck with the chemo and avoiding the dark places. As my wise father has always said, worrying is worthless: if what you're worrying about doesn't happen, you've wasted your time. If is does happen, worrying didn't help. So just keep going...one step at a time.

    Anne

  • MountainMia
    MountainMia Member Posts: 1,307
    edited May 2019

    PiperKay (Anne,) wise words. Your diagnostic description sounds much like mine, though my tumor was somewhat larger. I'm about to begin 4 rounds of TC, and will follow with radiation, again similar to yours.

    How many radiation tx did you have? I'll meet with RO on Friday for the first time. Wondering what to expect. Thanks.

  • notdefined
    notdefined Member Posts: 286
    edited May 2019

    Thank you for sharing PiperKay. I know you are right, and I've never been a big worrier. I'm more trying to figure out what will give me peace of mind, and after visiting dr. Google started questioning my decision. My surgery will be in August, so i have time to change what I do. I'm sitting at the dr.'s office right now for my check up, so i will probably will ask my ON as well.

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited May 2019

    Recurrence rates on TNBC for stage 2/3 depend a lot on the result of neo-adjuvant chemo. Patients with a pCR have about a 10% rate of recurrence. Patients without pCR, more like 30%. After five years the rate of recurrence becomes extremely low. (For early stage people with surgery first I do not know those stats.)

    I was told LX + Rads has same survival as MX with TNBC.

  • notdefined
    notdefined Member Posts: 286
    edited May 2019

    Thank you Santabarbarian! You have been a wonderful resource on these boards, and I want you to know I really appreciate your responses.

    Hope everyone is doing well!

  • moth
    moth Member Posts: 4,800
    edited May 2019

    notdefined, my MO kept repeating several times that recurrence in the breast wasn't really the problem as we can treat it and with the increased surveillance of us we'd catch it early, and a mastectomy doesn't prevent metastatic recurrence which is the one that they really worry about.
    I didn't have neoadjuvant chemo so I have no idea whether my cancer responded to chemo or not.
    You could try to calculator at Predict. https://breast.predict.nhs.uk/predict_v2.1/ for an idea of what the large scale trends are.

    I kind of know my #s and I also kind of don't - in the sense that I pretty much forget them very quickly. My cancer blog where i kept friends updated is called "never tell me the odds" (a Star Wars quote). There's a point where they don't matter & it almost seems binary: it either will happen or won't. I'm assuming it won't and trying to do whatever evidence based info there is to stave off recurrence but mostly I keep very busy and I try hard to not have time to obsess about this.

  • notdefined
    notdefined Member Posts: 286
    edited May 2019

    Thank you Moth. I get it. Admittedly, i am a numbers person, and I just wanted to know what my odds are. The dark places I would go is would I get to see my kids graduate from high school/college, get married, have children, or would i live to enjoy retirement. I think Taxol helps get me to these dark places, and hugging to the odds in my favor helps. I know these numbers don't mean anything to individual cases, and they are likely old data. It is a way for me to feel like I have control, even if it's an illusion. It may be silly, but whatever helps me stay in the light right? I also think I have had too much time to think about things, and I am working on that. I don't feel anxious just gloomy, and these thoughts don't keep me up at night. They seep in during the day in the quiet moments.

    I appreciate your reply.

  • MountainMia
    MountainMia Member Posts: 1,307
    edited May 2019

    notdefined, I think I get what you're saying. But while Taxol helps drive you into the dark places, it's also driving you back out. As my MO said, chemo always wins over no chemo, for risk reduction.

    Best to you.

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited May 2019

    notdefined, thanks for that sweet comment!

    To banish worry, I am focusing on the things I KNOW correlate with fewer recurrences, and doing those things. That's the best we can do, and there's a certain amount of luck involved too, but it makes me feel I am proactive to do these: 1. Low Fat, Low Carb diet (that leaves mostly vegetables!), 2. exercise 5-6 x per week, 3-6 hours 3. Metformin, 4. Melatonin Those four all have stats of lower recurrence rates per reliable studies.

    Also I do a bunch of supplements, and I think those have helped me lower inflammation which is also good for cancer protectiveness. (I used to have quite a few aches and pains (hip, knee) and now I am pain free.) The supplements came from an integrative MO and he told me they would be good for post treatment too.

    I figure that by doing the above I will be at the max of what I can do to help myself, and the rest I have to let go!

    I had totally stopped alcohol during treatment, but now i have a drink occasionally (maybe 1-2 per month), and I am a little less hardcore re diet, but I think it makes sense to stay on a basically clean program though the peak recurrence window .


  • notdefined
    notdefined Member Posts: 286
    edited May 2019

    Thanks MountainMia, and I agree.  I am committed to finishing this regimen, and then do what I can to reduce my exposure.

    Santabarbarian-I was assuming I would need to change my eating habits.  I was thinking of doing the Paleo diet or something similar.  I also intend to do intermittent fasting, as I think I am able to do the 18/6 hour fast without upsetting my stomach.  I'm trying to implement exercise during chemo, but I'm only partially successful. I do enjoy a glass of wine to wind down at the end of the day, but I haven't partook during chemo.  I will try to give that up and reduce to a few times a year.  All those changes can also be depressing.  I am a carb and sugar addict (especially fruit).  I have been a lot better during chemo, but I think chemo is helping with that. I've read how sugar feeds cancer, so I know that is the route I will need to take. 

  • moth
    moth Member Posts: 4,800
    edited May 2019

    I think it is a myth that sugar feeds cancer. Cancer cells do consume a lot of energy but the fact is that your body *makes* sugar all the time. All our cells run on ATP which is made from glucose by mitochondria. In the absence of dietary intake of carbohydrate, our cells can make glucose from other things like fat and protein (see gluconeogenesis https://en.m.wikipedia.org/wiki/Gluconeogenesis )

    I think being overweight is a problem. But complex carbs and fruit are fine IMO.

    https://www.cancer.ca/en/prevention-and-screening/reduce-cancer-risk/make-informed-decisions/myths-and-controversies/sugar/?region=mb

  • notdefined
    notdefined Member Posts: 286
    edited May 2019

    Thanks for sharing Moth. It would be much easier to give up simple carbs and sweets as long as I could still have some carbs and fruit.  There is so much conflicting information out there, and it makes it hard to know what to follow.  I plan to meet with a dietician after chemo, because the truth is that I could use a lot of guidance.  

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited May 2019

    A Naturopathic physician with experience helping cancer patients is another option. Naturopathic physicians know a lot about both diet and supplements.

  • kber
    kber Member Posts: 394
    edited May 2019

    The nutritionist at my oncology practice is a fan of the Mediterranean diet, for what it's worth.  However, her advice during chemo was to eat what I could keep down.  I've tried to make healthy choices but some days it was cheerios and a banana for dinner and nothing else.  

    I also enjoyed red wine and asked if I could partake during treatment.  My MO just looked at me funny and said "Well, yeah, I guess so.  If you want to."  And the truth is I really really DON'T want to.  I am looking forward to being able to enjoy a glass again soon, but 2 weeks after my last session I'm still fighting nausea.  

  • PiperKay
    PiperKay Member Posts: 173
    edited May 2019

    Wow, a lot of good discussion here in the last 24 hours. Your comment, notdefined, sparked a lot of thought. As for your question about my radiation treatment, I've got 16 regular treatments (whole breast) to do (#12 today) and then 4 "boosts" which are targeted just to the spot where the tumor was. This is called a "hypofractionated" schedule which really just means it's a little shorter than a "conventional" course of treatment with slightly larger doses of radiation. So far I have no real significant side effects although my areola on the treated breast seems to be a little more red/pink than the other. I have no burning, itching, etc. - yet? Have been liberally applying Aquaphor as soon as I get home from treatment and then again before bed. Because the appointment is at 3 pm and I can't apply it before then, I go without the Aquaphor from after my morning shower until after the appointment. And as I said, so far so good!

    And I have to chime in about the alcohol consumption. Of course I know it would be healthier for me not to drink at all even regardless of the cancer, and most seem to recommend avoiding or limiting it during actual treatment (chemo, radiation), but I do still partake fairly regularly, though I have really upped my hydration levels. I do this because I believe in the motto "everything in moderation" (except hydration now). I also don't want my entire life to be turned upside down by this disease. I am still in charge. So kber, you WILL enjoy your glass of wine again - when your nausea subsides and, it you're like me, when your taste buds return to normal. Cheers!

  • notdefined
    notdefined Member Posts: 286
    edited May 2019

    santabarbarian-I have Kaiser, and I am not sure if they have Naturopathic physicians.  I will have to look in to that.

    Kber-The Mediterranean diet sounds achievable.  I like that it includes red wine :) 

  • moth
    moth Member Posts: 4,800
    edited May 2019

    I drank very little before dx (because I begrudged booze the calories - I'd usually rather eat a cookie; but I liked a G&T and green wines during the summer and a single malt whisky in the winter) but I will definitely never drink again. Alcohol is a Group 1 carcinogen & according to large studies, there is no safe level. http://www.euro.who.int/en/health-topics/noncommunicable-diseases/pages/news/news/2018/09/there-is-no-safe-level-of-alcohol,-new-study-confirms

    but I know this is hard for many


  • MountainMia
    MountainMia Member Posts: 1,307
    edited May 2019

    moth, I've seen some of this information before. I'm like you, a few years ago I decided to cut back from my 4-5 drinks a weeks to 1-2, largely because of the calories. And I do like my single malt Scotch! I've cut back even more since then, mostly from not even thinking about it. I'm sure I'll still have a glass of wine now and then, a beer, or a swallow of tequila. Or the shot of whisky. There are a lot of things I do that aren't 100% safe, and this is one of them. For me, the important thing is that it's a specific decision I make to enjoy a drink, rather than something I do without thinking. Thanks for the link.

  • Mncteach
    Mncteach Member Posts: 274
    edited May 2019

    MountainMia, my husband is a single malt guy! I on the other hand never have been able to tolerate alcohol so I didn’t have to change that. I do need to watch the carbs and sugar though! Those are my weaknesses. I’m not going to be crazy strict, but am going to be conscious of my decisions. I have always been of the mindset that what will be, will be, but realize I need to live life a little more cautiously

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited May 2019

    I too love scotch whiskey!

    Mncteach, You might want to try to eat clean 5 days a week, and give yourself some wiggle room on the weekends...? It's a matter of finding a 'plan' that you can stick to, enjoy, and not feel too deprived. I think it's sometimes easier to give up a forbidden food altogether that to eat a limited amount. But over the long haul, I want to get invited to other people's homes for dinner, so I do not want to be the guest who has a whole list of dietary no-nos...

  • A4ggy
    A4ggy Member Posts: 54
    edited May 2019

    Hi everyone,

    I was catching up on the boards and saw that someone mentioned metformin and lowering recurrence. I am 16 mo post surgery! Seems crazy to believe it's been that long. I have recently been figuring out if I want to start taking metformin to prevent recurrence. My oncologist didn't seem to think it was necessary but I've read it can help. Does anyone have any experience or thoughts on this? My endocrinologist said she is able to prescribe it for me. Im open to any and all thoughts!

    While I'm posting, I figure I"ll ask if anyone has any discomfort with their implants. My non cancer side irritates me from time to time and of course worries me. I think I slept on it wrong this week and it's causing some discomfort near the edge of the implant. Now I'm incessantly touching it and feeling around which I'm sure is only irritating it. A vicious cycle. Any input on that is also appreciated! Thanks everyone!!


    Anne :)

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited May 2019

    I am on metformin... When I asked my MO during treatment, he prescribed it. I take 1000 mg - in two 500 mg doses. I notice zero SEs. I do not have any problems with it even though I don't "need" it per glucose.

    I also take melatonin 20 mg at night (worked up to that amount). To me both of these interventions are unnoticeable and they both have good stats...

  • A4ggy
    A4ggy Member Posts: 54
    edited May 2019

    Thank you for your input! I wonder why my oncologist didn't seem to want to prescribe it. I didn't push it too much. I'm 41, almost 42 and don't have any glucose issues either, however wouldn't mind losing 10 lbs. Did it help with weight loss? Thank you :)

  • anotherNYCGirl
    anotherNYCGirl Member Posts: 1,033
    edited May 2019

    A4ggy, -my onc didnt think the metformin was for me, - not sure why not, perhaps there arent enough studies on it? and yes, my implants are usually uncomfortable. The degree of discomfort depends on if I bumped into something, slept on it, etc.

  • Cathytoo
    Cathytoo Member Posts: 667
    edited May 2019

    HI LADIES...I guess I could be considered an “old timer” here. It’s been almost four years for me. But, I have a friend who hadn’t been helped by anything...double mastectomy, chemo twice and now radiation. Her MO suggested enrolling in one of the clinical trials at MD Anderson. Anyone have any personal experience or info?

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