A new triple negative friend

I'm done with radiation!  Hurray!  I did develop a grade 2 toxicity after the 25 whole breast radiation (3 weeping blisters) but I was switched from biofine to compresses with Domeboro  (astrigent solution)  three times a day for 15 minutes and that did the trick.  I had some irritation of the nipple during the booster rads due to the location of the tumor but it is getting better (back to biofine three times a day). BTW, I found that in a clinical trial in France (stage III) that they found carandula (a cream made of marigold) to be much better (significantly better) than biofine and I told my rad oncologist about it but it was too late for me.  You may want to talk with your doctor about it before you start your radiation.

In two weeks I start teaching for the summer session so that will keep me busy but I'll be checking the boards.  I want to thank all of you who helped me these trying eight months of my life with your postings.  In particular, I want to thank Sadie and Twink since they were the first respondents:-) who had also done neo-adjuvant chemo.  I learned a lot from you.  I need to reclaim my life at this point and I hope that we will all post good news from now on.  As Dr. Lisa Carey said in her on-line conference, chemo protocols tend to be very good for the first three years and if triple negatives' tough window is indeed the first three years, then we should all be having great optimism

With much appreciation,

Christina 

Hi to all and Happy Mother's Day for tomorrow!

Thanks for sharing your experience with your plastic surgeons, Sadie.  I'll wait for a year and see how things shape up and how I am and then take it from there.

And thanks for the wishes, Twink.  I hope the move goes well and that your new place also serves as a fresh beginning for you after the year you had. 

Hi, jdash, thank you for the congratulations, and congratulations to you for the complete pathological response.  As for your comment why they don't do pre-operative as a matter of course, my understanding is that pre-operative chemo is rather complicated.  It seems to benefit women younger than 50-55 the most, according to the latest report (and there was a conjecture that it is because this is the age group that tends to have the triple negative) and even then, they said that there has to be a multidisciplinary team in place to have it done properly, so it is not as clear cut as one would hope. And of course the percentage of those getting pCR is not that high, unfortunately, but let's see how the recent trials that have added avastin will do.  Many surgeons don't recommend it unless the tumor is bigger than >2 cm (see also MD Anderson's guidelines) because the surgery after pre-operative chemo is trickier (harder to obtain clear margins because of the way the tumor shrinks unless one achieves pCR), although more and more women are requesting it to test the tumor in vivo.  And many surgeons will cite the statistics that there was no overall survival difference between the two arms of women doing pre- versus post-operative chemo... The thing that they don't admit unless you press them is that not all variables were controlled and not all women have the same biology so who's to say with certainty that there is no difference.  One oncologist told me that although they want to recommend  pre-operative, they "don't know what to do" with those women that don't respond very well because they are aware that they don't have a chemo-sensitive tumor.  Some people may argue though that they would rather know upfront that their chemo is not working so that they can have a chance to switch protocols.  Others may not want to know that. Ultimately, it is a decision that one has to reach after careful consideration of all the facts. 

--Christina 

Dear sofeemay,



I'm sorry to hear that the pre-operative chemo didn't work for you as well as one would hope. I'm wondering why they continued with the treatment if the tumor didn't respond with whatever protocol you were on (usually they can tell after the first 2-3 treatments) and why another protocol wasn't tried. But to try to answer your question, I don't know and I don't think anybody knows for sure... Sometimes a type of cancer may be very aggressive that may not respond to different chemos and that's why we have so many trials going on right now with all kinds of new drugs.



I hope all goes well with your treatment now. It is imperative that you focus on your getting better and not on the past (although I know that this is easier said than done), but you need to try. Different women have different biology and although we may all be triple negative, not each one of us will respond to a particular treatment the same way. Your story though is instructive about the use of pre-operative treatment and how it may fail (it may fail after surgery as well) and that's why it needs to be closely monitored (which is the recommendation that the most recent article I read makes about its use).



Best of luck,

Christina

Davita,

Lets us know how things are going with you.  I, too, hope that it's a false alarm.

--Christina 

Dear Cindymontgomery,

I'm sorry to hear about your mom's diagnosis and all the issues involved with your sister.  It may be best to talk to your mom about it if you think it will help the situation.  If you think it would be best that she doesn't know, then maybe you can try to be as encouraging and supportive as you can possibly be without making her feel too apprehensive.

Good luck with handling this rather difficult situation.

Best,

Christina