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Jan 8, 2010 09:30pm otter wrote:
navygirl, I'm so sorry to hear about your heart problems. Whether or not they resulted from your chemo, your onco should have made the SE's clear before you started. As you said, it's important that we have all the information we need to make the decisions that are best for us.
My story started out a lot like yours. There's a long history of heart disease and strokes in my family. I'm on BP medication and a statin myself. In addition, I have mitral valve prolapse, and one of the long-term complications of that, as well as heart disease in general, can be left ventricular failure. Just great!
So, when my first onco told me I would be getting AC (Adriamycin & Cytoxan), I was concerned. I already knew Adriamycin could cause long-term heart problems, because I'd had 8 weeks to research the issue while waiting for my Oncotype DX score. But, when I mentioned my concerns about my family history and my own risk factors, my onco blew off my question. He literally brushed his hand to the side and said, "Oh, I'm not worried about that." He told me I needed to trust that the decisions he made would be in my best interests. And, he said I "read too much."
Because so much time had elapsed since my surgery, my onco said he wanted me to start chemo "ASAP". I asked if there would be any pre-chemo testing, and he said he would order an echocardiogram and blood work right away. (He said that was standard procedure.)
For a variety of reasons, I fired that onco and requested a different one. I met with my new onco 3 days later. She told me she was advising chemo as well, and she, too, would recommend AC. I asked her about the cardiac effects, and she said she didn't normally worry about those unless the patient was older (she said "in her mid-60's") or had pre-existing heart problems. I mentioned my history of high BP and mitral valve prolapse, and my family's history of heart disease. She replied, "Yes, those things would make me reconsider whether AC would be the best choice." I asked about TC (Taxotere & Cytoxan), and she said she thought TC would be an appropriate alternative for me. She did warn me, though, that the short-term SE's from TC tended to be worse than those with AC, even though TC had fewer long-term effects.
So, I was very fortunate to find an onco who would work with me and let me participate in the decisions. I'm also very lucky that she encourages me to read journal articles, and she likes to talk with me about clinical trials and research results. What if I had never protested the way my original onco was handling things? BTW. both those oncos work in the same department of the cancer center where I was treated. It was "against policy" to assign me a different onco in that same hospital, but my breast surgeon (also a terrific doc and a wonderful person) listened to my request and got the policy overruled on my behalf.
Dx IDC, Stage I, Grade 2, 0/3 nodes, ER+/PR-, HER2-