My Case and help needed.

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green tea - 15 Jan 2004 05:09 GMT

Thanks all, especially Tim and bartalo.

My doctor told me that I should only take 3 time of Chemotherapy just after
the operation (in Nov.,2003), but now the suggestion is that I should take
more 3 times. Well, she didn't give me any reason. I guess (just guess) that
the side effect seemingly not serious as she expected: my hair losing is
very slight, and though feeling tired very often, but looks good. My white
blood cell rebounce quickly after a kind of injection, etc.( I feel sick and
weak seriously as a whole) So she insist on that I should take more. As a
matter of fact, the word she told me is that "if I do not take the other 3
times of chemotherapy, I should be responsible for the in case recur in the
future". That word are really uncomfortable.

I just wonder on what situation that Bartalo's doctor consider that there is
enough chemotherapy? Is there any serious side effect on you, Bartalo? So
that I can reconsider my situation. Thanks.

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Tim Jackson - 15 Jan 2004 09:34 GMT

> Thanks all, especially Tim and bartalo.
>
[quoted text clipped - 12 lines]
> enough chemotherapy? Is there any serious side effect on you, Bartalo? So
> that I can reconsider my situation. Thanks.

I see. You are saying you have had six doses altogether already, but with
surgery in the middle, that your oncologist originally said you would get
six doses (six doses at one month intervals is pretty much standard) but now
is saying you need six doses -after- the surgery in addition to the three
before.

Was there a gap in the chemotherapy at the time of surgery? This may have
resulted in some cancer cells passing right through their reproductive phase
without exposure to the drugs. How long a gap might be allowed depends to
some extent on the cancer pathology. So either the oncologist might have
expected chemo to restart sooner after surgery, or she might have found
something in the pathology which made her feel that any intended gap was
unacceptable. Or maybe she feels that your risk of recurrence is so high
that you would benefit from an extended course of treatment, but could not
prescribe that until she had seen how you were coping with the therapy.

You could always ask the oncologist for what reason she has changed the
prescription from six to nine doses, or you could ask another oncologist for
a second opinion, but as you are in the middle of treatment that would have
to be done rather quickly, it would not make sense to stop treatment while
waiting for a second opinion.

Tim Jackson

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green tea - 15 Jan 2004 12:56 GMT

Hi, Tim, thank you very much for the quick answer. maybe I didn't explain it
very clear. My oncologist suggest me to take 3 times of chemotherapy after I
finished my operation, which is to say, she got all the result of the
operation (include some result that came out days after the operation)
before she told me that I should take 3 times of chemotherapy. And just days
before, she told me that I should take another 3 times of chemotherapy.

I began to take the chemo-treatment only a week after the operation.There
seems no intervals of all the 6 times I have already took. From midddle of
Nov.2003 to now, you can count the days of each circle of chemo treatment is
just about 3 month. And during the three month, I didn't took any other kind
of exam. So that I guess if it is because my side effect is not as serious
as she expected as a reason.

What kind of infomation can support if I have enough chemotherapy or not?
Any more professional details that I need? I am really afraid that if I took
the extra ( which is not known), my body will get bad that the treatment
can't meet the compensation.

news:77tNb.24192$qx2.2654177@stones.force9.net...

> > Thanks all, especially Tim and bartalo.
> >
[quoted text clipped - 41 lines]
>
> Tim Jackson

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Tim Jackson - 15 Jan 2004 17:38 GMT

> Hi, Tim, thank you very much for the quick answer. maybe I didn't explain it
> very clear. My oncologist suggest me to take 3 times of chemotherapy after I
[quoted text clipped - 12 lines]
> What kind of infomation can support if I have enough chemotherapy or not?
> Any more professional details that I need?

Your pathology report. The names of the chemo drugs you are getting, and
whether all 9 cycles are of the same drug cocktail. If you are getting the
last 3 cycles of a different drug combination that would be the best
treatment and wouldn't add to the cumulative damage to your body. Typically
something like Doxrubicin/Adriamycin + Cytoxan/Cyclophosphamide first,
followed by Taxotere. This (split) regime was only introduced fairly
recently so maybe your oncologist only became aware of its benefits and
suitability for you after you had started, and so changed her advice.

They only do neo-adjuvant chemo (that is, chemo before surgery) if the
cancer is advanced (technically "locally advanced"), so you would want to
get the strongest chemo regime available. When chemo is done before surgery
I don't think 3+6 cycles would be that unusual, but I don't know of many
people who have had that for breast cancer.

>I am really afraid that if I took
> the extra ( which is not known), my body will get bad that the treatment
> can't meet the compensation.

Your oncologist should be taking that into account. Ask. Phone the
oncology nurses, if they can't answer maybe you can get another consultation
with the oncologist to answer your questions. She is the best person to
explain her reasoning to you.

Tim

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bartalo@webtv.net - 15 Jan 2004 16:13 GMT

>I just wonder on what situation that Bartalo's
> doctor consider that there is enough
> chemotherapy? Is there any serious side
> effect on you, Bartalo? So that I can
> reconsider my situation. Thanks.

Green Tea, please don't base your decision on what happened in my case.
I do not understand why I was only given the 4 myself. He never
bothered to tell me and at the time I was so uneducated about this stuff
that I thought some people just get 4 and others get 6 Chemos. Frankly,
the Chemo made me so sick with nausea and fatigue and I was concerned
about my heart (taking Adriamycin) that I just thought he felt my body
had had enough.

He seems to think I have done well with my treatments. When I mentioned
"my cancer" at my last office visit he seemed to get very annoyed with
me and said "You DO NOT have cancer any longer! It is gone and now we
will try to keep new cancers from returning by giving you the
Tamoxifen." So I guess he feels it was enough that I got surgery, 4
Chemo treatments and 35 radiation treatments for this bc bout. I hope
and trust he is right.

But please remember that even though I have no idea about the pathology
of my particular tumour and the one node which was maglinant, I have to
hope my doctors who treated me did and they did the best for me. We in
this discussion group can share our experiences with you and folks like
Tim seem to have a lot of helpful knowledge but in my opinion only your
medical team is qualified to make the important decision about your
Chemo. Then whether you want to accept that decision and do it will be
up to you. The consequences of your decision will also be on you.

I don't know enough about Chemo treatments to know if you have time
between treatments to get the 2nd opinion but your doctor could tell you
where you stand on this. Good reputable doctors should not mind your
getting a 2nd opinion if you have time.

Best of luck to you on whatever you decide to do.

Bea

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