Efficacy of Adriamycin
Comments
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Hi! I am new to the forum so hello to all! I had CAT nearly five years ago for bilateral IDC (I was 35) and while I was warned of the possible side effects I didn't have a muga b4, Doc's view was we don't need to look unless there are symptoms.
My Mother was diagnosed 2 years after me at age 60 and she had CAT as well although in a different state with a different doc and she didn't have a muga either.
My sister in law has been battling for 11 years with mets and she has had adria 3 times. The did a muga on her each time and she was fine, however she had congestive heart failure last year and while her ejection frac is now at 41% at the time it was 21%. But hey, she just saw her grandbaby born so she would probably say it was worth the trade off!!
I guess like any of this, you have to weigh the good against the bad.
In my (non-scientific) opinion, the red devil is still a good treatment for BC. I did have a muga for a different reason about 6 mnths ago and I got a 52%.
On a totally different note, I sure wish that I had known about this site while I was going through treatment. Maybe we can all start asking our onco's if there is a way that they can let patients know about this site?? -
i had my breast center add this site to their new patient binder they give out in the support section.
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my doctor tells me to weigh the benefits vs the risk. the benefit of adriamycin is greater than the risk of heart disease so i did the drug. i am glad i did.
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Hi to all,
I've had a quadrantectomy in august last year, a benign tumor with "pinpoints" of malignant tumors in the surrounding area, then a second op to take out more as they had found these pinpoints near the edge of what had been removed earlier. To cut a long story short,tumors max 3mm, triple negative, no lymph nodes, but I was advised to do only radiotherapy. which I did, 6wks, and I seem to suffer with what alot of you are suffering after chemio, chest pains, heart beating in a strange way, causing serious discomfort. But whats nagging at me, as I feel that I've had the wool pulled over my eyes, is was it right that i did only the radio? (I was told my chances changed from 82% to 80% if I didn't do the chemio, and that it wasn't worth putting my body through it - found out later the trip neg meant 67% - am I wrong? you all know more than me- and does that change if you haven't had chemio?)Does anyone think that they took into consideration the fact that they were small tumors max 3mm, that the lymph nodes were clear? or were they wrong. Please give me your ideas and don't hold back, I'm fed up of the "be postive/don't think about it" I want to know!
Thanks everyone and best wishes to you all, -
Christina --
Chemo is a systemic (i.e. whole body) treatment, used if it is suspected that the cancer might have spread. Given your node clear status and tiny tumor size, I'm guessing that it is unlikely that the cancer spread. That's why the recommendation was just for local treatment (i.e. surgery and radiation).
If you are worried, check out www.nccn.org. Go the patients site, breast cancer, and then look for the decision tree. It will take you through its recommendations for different cancer scenarios.
You can also get a second opinion! It would be worth it for your piece of mind ...
Hugs,
Hillary -
From what I have read if the tumor is less than 1 cm you don't get chemo. Since you are ER- you can't do hormones. You got the standard care as far as I know.
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I forgot to add with such small tumors I would guess your odds are much better than in the 80% prob. 90 +
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I had 6 rounds of chemo and am just finishing up my 35 rads. My tumor was 1.05cm stage 1 but I had lymphovascular/venous invasion present. (No lymph node involvement) so I did chemo. Also, triple neg pushed towards chemo also. Had my protocol checked by MD Anderson and Duke and both agreed to 6 rounds of taxotere/adrimycin/cytoxan. I dont pay much attention to percentages but I think he mentioned something about it in the 90's.... I am working out 3 days a week and drastically changed my diet. Hopefully, it will help in keeping the darn cancer away and get my heart strong and healthy. It's always hard to compare yourself with others when it comes to treatment. So much goes into the decision making. I researched absolutely every piece of my pathology reports and made the decision jointly to do such an aggressive treatment plan. No 2 people are the same! I would do it all again but hopefully wont have to!
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Christine,
You might want to put your question in a seperate thread so that more see it. From what I understand the 1cm rule is a bit old and the more they learn about triple negative they more it seems chemo is the preferred treatment. If it is small it seems they tend to treat it with a milder chemo (CMF) versus the big guns. Please get a second opinion from a major hospital with a breast center. Preferably a teaching hospital. You want to get your opinion from a hospital where the doctors are setting the new standards not just following the published standard of care guidelines for breast cancer. -
thanks Mrs smith,
I couldn't work out how to start the new thread, I'll try again, I wonder why the oncs say I can't have chemo now, it's too late - they give chemo to shrink tumors, whats the big deal giving it to me now? I really don't know what to think anymore. the 11th I'm going for my first mammogram, and then a genetics test, and then I'm going to push for a mri scan.
Big hug to you, thanks for your help, tell me how are you?
Chris -
sorry, I didn't realise there were other replys.. _THANKS!!
first thanks Hilary,I will definitly go to to the web site, I've done about as much is humanely possible on the google pages!! But I didn't find that one! thanks
And thanks Joanne Elisabeth, it was my hope too, I didn't put in the first part though that I lost my mother to breast cancer 30 yrs ago, so maybe unduly fretfull.
And last of all thank Watergirl, the protocol here in Italy is that I should have done the chemo.
On one hand I feel a fraud in that a 3mm no nodes seems to be nothing to what most of all of you are going through.
On the other I am worried that I have compromised my situation.
I'll let you know in the coming months the results of the next tests.
Thinking of you all and that you all found the time to write, it's so nice to communicate with someone who knows what you are talking about, and understands.
hugs from Italy to you all! -
I just spoke to my doctor about the Adriamycin issue. He said that he is now giving women who have no positive lymph nodes 4 doses of the Taxol and Cytoxan, instead of the four doses of Adriamycin and Cytoxan. Still, Adriamycin is being given to women with positive lymph nodes. I think this is a terrific step forward in the research because the Adriamycin is the nastiest of the nasty, causing hair loss and terrible stomach sickness.
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Hi,
My wife has just started Taxotere and will then get AC so I'm interested in this thread. She's in a study that intends to use molecular analysis of pre and post biopsies of the tumor before and after Taxotere to see if they can predict response to Taxotere based on the very first biopsy in the future. However, they do plan to give her the Adriamycin and I wonder if there are any studies comparing it to other chemo regimens that run after a Taxotere dose. Such as T + AC versus T + FEC. Anyone? -
I think they are all pretty nasty drugs; when you start to research this stuff, you think to yourself, why am I allowing poison to be injected into my veins?
I had no lymph node involvement, but there was vascular invasion, and who really knows how long the invading organisms have been conjuring an uprising? Every day, something new is discovered; I had my chemo completed less than a year ago, A/C x 4 and 12 months weekly Taxol finishing the last week of August 30th? 2006.
Now you are saying Taxol is the new Adriamycin?
The nasty part of all these chemo and radiation therapies is their ability to cause other cancers elsewhere. That has been the most aggrivating experience causing endless worry with every little pain (or big pain).
It's a very difficult decision to make regarding any of these treatments (surgery, radiation, chemo, hormone therapy and others), but chemotherapy is an extraterrestrial translation from galaxy oncoland...unless you are a scientist, physician, ocology nurse, pharmaceutical specialist, it's definately "outer limits" terminology and then some!
I'm not sure if I'll ever recover from any of the side effects; but if I live a little longer than if I'd not had them, I suppose it's worth taking the chance (er, spaceship ride?}.
Indi -
This is interesting info.
I was diagnosed in April 2005, Stage 1, 1.8cm, Triple neg, no nodes. I was 35 at the time.
I did some research and knew when I went in to meet my Oncologist that I wanted AC+T. I received 4 AC and 4 Taxol plus Rads. I understood the risk of heart damage, but I weighed it against the fact that without it, my current odds might be worse than the future risks. I wanted to hit the cancer hard and I feel like I did. (I sure felt awful enough!)
I think we all just make the best decisions we can with the info we have available. From what I understood, the AC+T was the best option for triple negative women. Adriamycin worked best for hormone negative women... so I went with that. I'm very comfortable with my decision which I guess is a good thing because I plan to live with it for a looong time.
Anyway, it's awesome to be able to come here and read up on what's new. If there is a better way to treat this dreadful disease, I know that the women here will be talking about it.
Just don't worry about whether or not you should have done something different... hindsight, as they say is always 20-20. Try to move forward and do healthy things for your body as best you can. I truly believe that cancer is just a crap shoot and some will get it and some won't.
Many hugs to you all! You're such an inspiring group of women! -
I had only 2 rounds of A/C since my blood totally tanked on it but after the 2 rounds my 6.5cm tumor was completely dissolved...gone. Thanks to GOD and PRAYER and the A/C.
God Answers Prayers
Teresa44 -
All,
I found my answer after a lot of research. The latest in chemo for triple negative is dose dense AC-T or T-AC (every 2 weeks). This is considered third generation chemotherapy and is 15% better in survival compared to 2nd generation (T-AC non-dose dense) which was 25% better than the original CMF. There are other third and second generation chemos but the T-AC or AC-T dose dense seem to be the standard. Latest research from Dec 2006 trial indicated that having the Taxotere before the AC was superior because fewer patients had to reduce their dosage with the T before the AC than with AC before the T. I also found that a trial of A-C-T was equally effective (same survival rate) than ACT but the sequentual had fewer/less severe side effects. Most of this I found on Medline looking at the San Antonio annual breast cancer conferences. Sloan-Kettering hospital in NY appeared in more clinical trials than others relating to triple negatives. I thought I'd share what I found but encourage you to verify my findings and share anything you find.
Jeff -
Jeff,
Your love for your wife shows like a shining star!
The San Antonio annual breast cancer conference is a highlight for most oncologists and surgical oncologists, updating the medical community with the most recent trial results and research. MSK and Anderson are two clinical trial hospitals were any patient (and spouse) should feel in excellent hands, albeit there are many others too.
Good for you for cutting to the chase under pressure to seek your answer. And thanks for posting your insight and adding the caveat. I wish your wife well in her treatment and thereafter as I do everyone else with triple negative BC.
Tender -
I just got out of the hospital after being diagnosed with congestive heart failure. Four years ago I was taking Adriamycin for breast cancer. My cancer came back on the oher side so now on Taxotere.
While in the hospital I began to wonder about the Adriamycin and if this is what caused my heart to fail.
We'll probably never know but it concerns me. -
I found an article online in researching my wife's next chemo (A) and it appears recent research suggests avoiding iron prior to treatment. While this study was done in India using rats, and there isn't always a correlation to humans, the evidence was strong enough to be published in the Journal of the American College of Cardiology. Find the article by Google "Potentiation of Doxorubicin Cardiotoxicity by Iron Loading in a Rodent Model". I'm throwing out the pre-natal vitamins (high on Iron) and moving my wife to a non-iron vitamin and avoiding red meats. I am currently looking for non-medical (medicines or blood letting) means to lower iron intake. I wouldn't be as nervous but this finding has just been reported (7 June 2007) and I fear our doctors here won't react to a study on rats and will wait until a human study is done which may take years. Another paper I found titled "Doxorubicin induced cardiotoxicity and its modulation by drugs" concluded that taking Aspirin and Melatonin significantly reduced heart damage from Adriamycin. I plan on asking her medical oncologist ASAP but I'm not waiting on reducing her iron intake and may start her on aspirin and melatonin as soon as I clear that withthe oncologist. Not taking iron can't affect the chemo, but I don't know about aspirin or melatonin.
Jeff -
Jeff,
Might I suggest that unfortunately, Adriamycin kills normal cells, such as red blood cells, as well as does an excellent job in Adriamycin sensitive breast cancer. As anemia (low blood count) often results from chemotherapy, greatly contributing to fatigue, and potentially to higher pulse rate as well as other cardiovascular functioning, it may be wise to not completely cut off your wife's iron intake, which will be needed to make new red blood cells. Otherwise, Erythropoiten shots may be recommended to raise her red blood count, which is another medication and shot, and iron stores will be needed for it this medicine to work well. I believe the article points to iron loading, which is the act of ingesting too much (a load) of iron, and sounds best avoided under most circumstances. Yet some iron (and protein as found in meats!) will be needed to help your wife during her recovery. I'm sure you'll check each step with your oncologist, as it can become very complicated if not everyone is on the same page during chemotherapy, radiation therapy, hormone therapy and surgery. It's wonderful that you are so attentive to your wife, and I'm sure with her doctor's approval or disapproval of specifics, a great plan will evolve.
Gainok,
So sorry for your recent troubles with congestive heart failure. How are you fairing? Is your energy coming back? Are your new medicines settling in?
I will post below a link to an article on CHF and Adrimycin by Sandra Swain, a well known NCI cancer specialist. Among other, she found that CHF occurs with greater frequency and at lower dosages than previously reported. Go figure, right?
http://www3.interscience.wiley.com/cgi-bin/abstract/104532687/ABSTRACT
Tender -
Keep this baby going! chimes, rings, song of love and life!
Baby bumper bigger buggy bumper wheels (booby bigger bumped bugger bumper boyant breast bloated bilab boobie bells)
be well, be loved, and life is beautiful....
Indi -
Tender I am doing much better, thank you for asking. Still trying to get my strength back but improving everyday and believe the new meds are definitely helping. I have a check up today so we will see.
My onc told me last week the he really didn't think the CHF came from my previous Adriamycin since my dosage was not quite high enough to be in the danger zone but left the possibility open. I imagine they are separate issues but we can't help but wonder. Also the Taxotere I am on is not supposed to affect the heart. -
Here's a link to a clinical trial that is testing the efficacy of AC vs. Taxol and cardiotoxicity. I'd be interested in seeing the final report. God is able, Stephanie
http://www.nsabp.pitt.edu/B-31.asp -
Darnitstocking Triple Negative...missing you so much!
Wish you were feeling better...setbacks stump the head.Heart and memory, prayers and hope, know you will
bounce back vibrant beauty, we need your intellectual insight and postive shouts: "We can beat this monster!".
Be well, be loved, go shopping for fall clothes and a ndew anythinthing; particularly the new you; healthy =, happy, and NED/
(hugs)
Indi -
I have always thought better to have a heart attack than BC until it happened to me.
My mother and paternal grandmother died from BC, and I just discovered that I have the BRCA gene, tbut so rare it was not picked up in last year's test. I have just been notified it is so rare it only exists in 14 families. This time it is my maternal grandmother. I can tell you all that one is not better than the other.
I have had a couple heart attacks and 5 cardiac arrests...now Ilive with a pacemaker. You have no idea what a problem that is to BC.
I just completed my 3rd and last TC tx prior to surgery Sept 26th. Even this surgery is freaking out my BS, PS, and Cardio Surgeons. My PM surgeon wants to operate on me first, to move the PM out of the way for breast surgery. Sounds easy right....NO. That would require me to wait a couple months for my mast and of course the cancer would be growing like crazy. So the only other choice is to perform the surgeries together...8+ hours. I am fightening for that, but my PM Dr is still giving us trouble.
This is not even addressing the issue of ....did the PM cause the BC? It appears to be very likely that it may well have made a very small undetected cancer cell go crazy, growing from nothing to 6 c in a few DAYS, and following my excisionary biopsy, spreading into my lymphnodes within DAYS. My PM has gone off over 165 times in 80 days. I had a clear mammo before this tumor appearred out of no where.
People with heart conditions don't just DROP DEAD, that usually happens with undetected heart issues. We suffer for many, many years. Once a heart condition is DX you change your life to live the way your heart Dr tells you. Which can be, rid your self of everything in life you enjoy.
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My wife has finished 4 DD Taxoteres and starts AC 9/19/07. I can only hope that the AC will do something because the Taxotere did nothing we can detect (tumor exact same size as it was to start with 7 weeks ago). We were told that if AC doesn't work then post op chemo might be Gemzar and carboplatin. My wife is also in a study to determine who might in the future benefit from Taxotere (molecular study). Hopefully the dose of Adriamycin will be low enough to not risk heart damage but will kill this large tumor (T3N0M0).
Jeff
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Jeff-
My screen name use to be boobbuster and I actually started this thread discussing the efficacy of AC. Forgot my password and s you can see my new screen name is TripleNeg (long story...)
Why don't you have the tumor board review your wifes cases and ask about the AC? If I recall I think you have some time between treatments to get second opinions about the course of treatments. If they (the tumor board) don't recommend it as beneficial you can skip the AC all together and go directly to the Carbo/Gemzar. It's time to pull out the big guns! God is able, Stephanie
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