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Medical Forum / Diseases and Disorders / Breast Cancer / November 2004

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Questions about mets/chemo/general

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Jayashree Iyer - 15 Nov 2004 02:34 GMT
Hi,
As I posted earlier; my mom was just diagnosed with bone, lung and
probably liver mets too; a year after her first treatment got over.
Seems like the cancer just waited for the chemo to get over before
starting to spread again.
The oncologist gives her one or two years.
and the worst part is mom keeps asking me whether she will be here for
my younger bro's graduation; and be alive enough to be a grandma too;
and it hurts so much to answer that.
Anyway, I have the following quetions:

the first time, she had a lot of trouble with chemo; and felt it to be
very painful. Is there anything that I can do to relieve her pain and
discomfort this time? anything that would help her?

2ndly, when she had her initial biopsy; she was her2+; but after her
surgery and chemo (she had chemo b4 surgery); she was her2-ve
so would it make sense to test again to see if she could have
herceptin?
she is er/pr -ve, so it rules out other hormonal treatments.

Our oncologist says the only option right now is chemo. is that about
right? are there any other avenues that I should be exploring?

Lastly, along with all my sadness/shock/anger, Im predominantly
feeling guilty.
I feel that I couldnt even keep my mom safe for so long; and that she
has to go through all this mess again; and there seems to be nothing
that I can do to make her feel better. Im feeling extremely guilty
that she is going to face all this pain alone.
Is that a common feeling? if so, does the feeling ever go away?
Sorry if I sound silly. I didnt know who else to ask..

Thanks all for being there to support at this time.
God bless
Jayu
Kaye301 - 15 Nov 2004 15:29 GMT
<< I feel that I couldnt even keep my mom safe for so long; and that she
has to go through all this mess again; and there seems to be nothing
that I can do to make her feel better. Im feeling extremely guilty
that she is going to face all this pain alone.
Is that a common feeling? if so, does the feeling ever go away?
Sorry if I sound silly. I didnt know who else to ask..

>><BR><BR>
Kaye301 - 15 Nov 2004 15:37 GMT
I am sorry to hear about the cancer recurrence that your mom has been dx'd
with.  However, one important fact that one of my oncologists told me --when
people talk about the cancer coming back--where did it come back from?  the
pathology lab?  In other words it was already there.  
There is nothing you could have done to prevented her from having metastases.
The  cancer had already seeded and the chemo she had did not take care of all
of it.  There are a multitude of different chemo regimens that might be tried.
Some centers only give a  maximum of 3 different regimens.  However, I recently
read of one gal for whom it took 5 different regimens before one was found that
worked for her.  
My suggestions is that if you want to do anything, have your mom get at least
one other 2nd opinion at a major cancer center--preferably not far from where
she lives.  Check into possible clinical trials that she might be eligible for.
Although the median time for survival after mets is discovered used to be 2
years--my understanding is that it is now 5 years--so am a bit concerned about
the dim prognosis given---although that may be based on her individual
characteristics (i.e. being er-).  I would definately have her rechecked for
Her2+ and would even consider having pathology slides read at a different
facility for a second opinion as well.  I am guessing that if at one time she
tested her2+ and then again tested her2- that she was at least mildly her2+ the
first time and possibly still her2+ the second time but not enough to be
considered for treatment with Herceptin.  However, now that the cancer has
returned at a measurable level, it would definately be worth having
re-evaluated.
My best thoughts are with you, your mom, and family at this difficult and
challenging time.  Wishing her all the best.  {{{Hugs}}}
C. Falise - 15 Nov 2004 21:40 GMT
> Hi,
> As I posted earlier; my mom was just diagnosed with bone, lung and
> probably liver mets too; a year after her first treatment got over.

this is never good news.  i'm sorry you are in this position again.

> Seems like the cancer just waited for the chemo to get over before
> starting to spread again.

sneaky devil isn't it?  seriously, her first treatment obviously did not get
all of it.  there have probably been small microscopic metastases for some
time.

> The oncologist gives her one or two years.
> and the worst part is mom keeps asking me whether she will be here for
> my younger bro's graduation; and be alive enough to be a grandma too;
> and it hurts so much to answer that.

be honest with her, but try to stay positive.  nobody ever knows for sure
about time left.  there are always exceptions to every rule.  what i try to
do it hope for the best while preparing for the worst.  it's a hard line to
walk sometimes.

> Anyway, I have the following quetions:
>
> the first time, she had a lot of trouble with chemo; and felt it to be
> very painful. Is there anything that I can do to relieve her pain and
> discomfort this time? anything that would help her?

was she given any pain medications?  what kind of pain was she experiencing?
often accupuncture can be helpful also.
a discussion of pain management should be in order with the oncologist and
any other parties involved.  if pain is properly managed, it is possible to
retain a very good quality of life, which at this point, is very important.

> 2ndly, when she had her initial biopsy; she was her2+; but after her
> surgery and chemo (she had chemo b4 surgery); she was her2-ve
> so would it make sense to test again to see if she could have
> herceptin?
> she is er/pr -ve, so it rules out other hormonal treatments.

retest for her2neu if possible.  herceptin is a promising drug.  she may be
able to benefit from it.

> Our oncologist says the only option right now is chemo. is that about
> right? are there any other avenues that I should be exploring?

the oncologist is probably right.  radiation treatment may also be useful to
her if one of the tumors is causing a particular problem.  if she is truly
hormone-receptor negative, then hormonal treatment would not be useful.
it never hurts to look into complementary therapies that can be used
alongside the chemo.  keeping the immune system strong, eating a healthy
diet etc. can go a long way.

> Lastly, along with all my sadness/shock/anger, Im predominantly
> feeling guilty.
[quoted text clipped - 8 lines]
> God bless
> Jayu

jayu-
again, i'm sorry you have gotten this news.  it is devastating at first.  i
have lung and liver mets also along with dozens of bone mets.  it's scary,
but it can be stabilized for long periods of time.  try to have hope that
treatment will help her in some way, even if it is to make the best of what
time she has left.
as far as guilt goes, yes, imho, it's pretty normal.
my mother died of lung cancer when i was 25.  i felt so helpless and also
very guilty.  does your mom live far away?  no matter where she is, she does
not have to go through this alone.  there is great support available to us,
whether that be from support groups, newsgroups, friends, family, work
associates... whatever.  it is important that she be in contact with other
women who are going through this.  i know it has helped me enourmously.
i don't know what i can say to ease your sense of guilt.  all i can say is
these things happen and there is nothing any of us can or could do to
prevent it.  just do your best to be there for her now when she needs you.
try to be strong and understanding and patient.  and understand there are
just things in life that we have no control over.  all we can control is how
we deal with it.
i wish you all the best with this.  it may take some time for the shock to
wear off,  then there will be some more difficult emotions.  you can get
through this.  together.
make the best of what you have today... it's all any of us really have
anyway.
you are both in my thoughts.
:)
-christina
Guess Who - 15 Nov 2004 22:07 GMT
Sorry to hear about you Mom the others have given you good advice.
 
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