Taxotere, Carboplatin and Herceptin
Comments
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Omaz, Try this link for a clear layman's explanation of the difference between absolute risk and relative risk.
http://www.annieappleseedproject.org/reriveabri.html
This statistical jargon shows that the old adage is true: it isn't always what you say, but how you say it.
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who_knew My onc initially said she wouldn't be doing more scans but they did spot something on my liver. They think it's something I have always had but just to be sure they will do a scan of my liver when I'm done… no other scans. I would think if you were a stage IV they might do more scans to see the response but I'm not sure. Us being early stage they won't see any response because there wasn't anything there in the first place.
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Omaz this (googled) sounded like a pretty good explaination:
Absolute vs Relative Risk Reduction
Imagine a subject having 10% risk to die during the next 5 years as a result of complications of high blood pressure.
If his or her risk will decrease from 10% to 7% after after taking a hypertensive pill during several years, then
The absolute risk reduction will be 3% (10% - 7% = 3%),
The relative risk reduction will be 30% ((10% - 7%)/10% = 30%)
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Thanks Bon and lago! Would you mind helping me out here some more -
Based on the Romond paper in NEJM 2005:
Disease-free survival at 3 years for those who got herceptin as 87.13% (12.9% had event) and for those who didn't get herceptin it was 75.4% (24.6% had event) with a hazard ratio from the survival analysis of 0.48. He describes this as a ‘52% relative reduction in DFS events' and a ‘12% absolute improvement in DFS' at 3 years (24.6-12.9%=11.7% rounded up).
How does this relate to an individual risk of recurrence??
Let's say we start with a 35% risk of recurrence over the next 5 years.
Does the 52% relative reduction mean I multiply 35% by 0.52=18.2% or does it mean that I subtract: 35%-12%=23% or maybe I cannot apply these research study numbers to the individual risk of recurrence...?0 -
Thanks Iago.
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who-knew - I didn't have any PET or CT scans before chemo.0
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Trying to understand the studies with doctor lingo is very frustrating! I look stuff up constantly and never can completely understand what it all means and I'm a pretty smart girl!
I too am wondering about testing after chemo and radiation. My surgeon said she'd do another mammogram after a year from my last which was in June. Doesn't that seem weird? Why wouldn't I get tested after chemo is done and before radiation starts? She said it's to make sure I'm healed so there are no false readings. Well, what about my other boob? The fear of things growing is super annoying and add to it that doctors want to wait that long to do testing...
I'm asking my onc about it next week to see if he has a different view. I would think they should test me before moving on to radiation. Mammogram or MRI or something right?
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michcon I would think they would wait till after radiation to test. First of all radiation should kill all the remaining cancer cells if you even have any. 2nd the Mammogram will not detect tumors smaller than an pencil eraser size. If you assume that your BS removed the tumor (which is a logical assumption) then at the worst there might be something microscopic. Not sure but I would think in most cases it would take about a year for those microscopic cell(s) to be big enough to detect… but don't quote me on that. I'm just thinking this is the case.0
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Thanks Lago, that does make sense! I just wonder about the other side. No one has paid attention to that since May. I hate the fear cancer brings. I used to be so sure I was healthy.
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When my onc gave me my treatment plan on that sheet it said:
General Health: Excellent
I still feel that way. As far as I am concerned they removed my cancer. All this chemo/herceptin/hormone suppression is just insurance. I will do my check ups and assume I am good unless someone tells me otherwise. The statistics my onc gave me (assuming I do all the therapy) that in 10 years 86% of us are NED and 2% of those who did pass did not pass of cancer. 88% is good odds in my book.
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When I had whole body scan before BMX, a focal absorption was found on my right 10th rib back position, when I met onc, he said it is not likely to be related to cancer but he asked me if I want to investigate it futher so I said yes. Just had PET scan to chest. Nervous now. Hope things are fine!!
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Thank you Lago - my diagnosis was very similar to yours and I am also in good health so 88% at 10 years sounds good to me too. My onc is not a numbers guy so he didn't go through this with me. BTW, Isn't the risk of being diagnosed with BC in the US 1/8 which is aboaut 13% so we are back to where we were?!0
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Well my original risk of having breast cancer at my age with my risk factors were actually less than 2%. Of course your risk does go up if you've already had it. I don't have breasts anymore so my risk of a new breast cancer should go down. I believe these stats are for both recurrence and for a new occurrence.
You are a stage IIa which should put you at an even lower risk… Are the same age? Being diagnosed at a younger age can increase your risk. Also this is based on not only surgery but also my entire treatment plan. I'm not sure if you are getting the same treatment as me.
Have you checked out cancermath.net ? I found it to be pretty close to what my onc said. That site does show 15 years out. Be sure to change it to survival from mortality.
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The onc. sure all have their own opinion. I had 2 tell me no to pets scans, they said no reason to think it was anywhere else. My thought is there was no reason to think it couldn't be anywhere else, it is sneaky stuff. I have seen on here all kinds of different scenarios, from ladies with no node involvement having mets. 1cm t with mets. etc. cancer coming back shortly after tx. I really don't see why the are reluctant to do full body scans initially just to make sure and peace of mind. My insurance pays for it. Plus both of my parents died because they had cancer spread to far when it was found and my dad was just 39.
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Hi Lago - I had lumpectomy and will have rads which should give same odds as mast. I don't know what my individual risk was - you are right though it goes up with age and the 12% is over a lifetime so that doesn't really apply I guess. I am about the same age as you, 51 and was completely pre-menopausal before this. I suspect our treatment plans are somewhat similar - TCH, H to complete a year, rads for me, Tam then AI or AI 5 years. Cancermath seems to only show mortality, it doesn't show recurrence. The survival appears to present the same mortality data but with a survival curve. It also doesn't include herceptin...0
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Sue - so sorry about your parents! That is so young to lose them.
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Omaz: I'm not getting rads. I was in a gray zone but my rad oncologist felt my current aggressive treatment plan would be enough. Tumors 5cm or larger most of the time to get rads with mastectomy. My margins were clear but close to the chest wall.
Since my tumor was 5.5cm and yours 2cm you actually do have a better prognosis than me statistically. Yes we are about the same age. I turn 50 in February. I was peri menopausal but not really feeling it too much. I haven't had a period in 9-10 weeks. Lost count at this point. Chemo just stopped it. I'll be getting Al for 5 years with Zometa (have osteopenia). Zometa has a benefit of also reducing bone mets. Those stats though were given to me before we new about my slight bone loss.
My onc is assuming I will not get my period back. She also knows my sister just finished at 53 and my mom went through this about the same age. This is why I will be doing Al. Also ask your onc about triple positive gals not metabolizing Tamox well. Some don't.0 -
Glad you are not getting rads, one less thing to worry about. My tumor was also close to the chest muscle and during surgery he went back and took a larger margin, I was happy about that as they were all clear. I will ask about the Tam - I have not had my period now for weeks and weeks and I must be done with that. Its all a wonder isn't it? I go for TCH number 5 tomorrow.
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Hello Everyone,
I found this website looking for information for my mother who was diagnosed with BC at the end of August. The information I have found on this site has been invaluable and I am so thankful to have found it. After reading your posts, I have been able to share with my mom what she should expect from surgeries and chemotherapy. Not knowing what to expect is so frightening and here I can find things that Drs and nurses don't tell you. Thanks to all of your for sharing your experiences.
Three weeks ago my mom had her first infusion of TCH. She had a few side effects, but overall they were quite managable. We had expected her to feel much worse than she did. The worst side effect was the rash on her hands. Her oncolologist prescribed a steroid and the rash cleared up after a few days. Is this something that she should expect every treatment or could it just be a one time thing? I realize that everyone reacts differently, but has anyone here had the rash occur with each treatment?
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Diane: I take steroids the night before, morning of and the evening of treatment. This is not that unusual. I also take zyrtec everyday. It's supposed to alleviate allergic reactions like what you mom had. Be sure to tell you mom to keep a diary of what happens and when. That way the next time she can take the medication before it happens. I get constipation but this time I took metamucil before it started and had no problems.
Omaz I just had tx 3 last Tueday. 3 more to go.
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Thank you for the response, Lago.
I'll tell my mom to take the zyrtec. I know she has zyrtec at home, she takes it in the summer for her seasonal allergies. That's a great idea about keeping a diary. She has her second treatment on Wednesday and I'll be sure to get a journal for her so she can start recording her symptoms. Mom also had constipation for a couple of days followed by horrible heartburn. Her oncologist prescribed Prilosec for the heartburn and I forget what she took for constipation. We're hoping that she tolerates the next 5 treatments as well as the first, but I don't think she'll be that lucky.
Thanks again!
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Diane - Taking the nausea meds regularly for the first few days made my hearburn go away. The chemo nurse said it is sometimes hard to tell the difference between heartburn and nausea. I never needed the prilosec after I started using the anti-nausea meds reguarly.0
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Tomorrow I go to see rad. onc. to get her opinion if I should have radiation or not.I had bil mx but one of the 3 tumors was right one the rib with just a 1mm margin so my onc. thought we needed another opinion. Anyone else have a similar issue?
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Thanks, Omaz.
That makes sense. Mom stopped taking her nausea meds about 3-4 days after treament and the heartburn started shortly after that.
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Diane1960 check with her oncologist before she take any drugs, even over the counter. BTW I do get constipation for a day but I know which day it comes. I start metamucil the night before, use a probiotic in my yogurt, eat lots of veggies and high fiber foods, drink lots of fluids and stay away from salty foods. Eating this way just before and during the first week is so important… granted I eat this way anyway. This last time I didn't have the constipation issue was very minimal.
Milk of Magnesia used to work for me for constipation but not on chemo. You mom might want to try that first.
I was on Prilosec for heartburn too but it didn't work for me. Never has in the past. They had to put me on a prescription for Pantroprazole. I definitely had heart burn not nausea. I've had heartburn/acid reflux years ago so I know the difference. I had nausea after my BMX from the anesthesia.
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Lago- I will share all of these tips with my mom. We will see her oncologist before her treatment on Wednesday, we can ask about the Zyrtec and Milk of Magnesia.
Thank you all for your responses. I'll probably be back with more questions after her next treatment.
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Had my rad. onc. appointment today. Wonderful lady dr. spent an hour and a half with me, she was really awesome. Unfortunantly she recommended radiation for me. She said that a margin of 1mm isn't even considered a margin. She said that was to close to my rib to risk the chance of cells being left behind, up to a 20 % chance, so I guess I know where I stand now with radiation. I was sure hoping to hear that she was a 100% sure no cells where left behind and that I could get on with life and just have herceptin every 3 weeks. I probably won't mind so much if tx was closer to home, it is 35miles one way and In Jan. Iowa winters can be horrible, last year we had a insane amount of snow. So just being able to make it everyday will be a trick. i am just a little bummed out, but sure I will survive this too.
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To the one that asked about other scans being done prior to chemo: If you had symptoms elsewhere, symptoms such as chronic headaches, back pain, etc, those could be nothing or they could mean the cancer had traveled and set up house elsewhere so your onc likely would have done a PET or CT scan of the other areas prior to chemo so as to know what they are dealing with. If you were symptom free during your intial consultation when they asked you all those questions then likely no other scan would have been done. However, if you did have other symptoms and they did not do other scans, that might be something you should ask your onc about to find out what their protocol is as it sure seems like every onc office does things different; medicine is a 'science' and not an absolute, but the variations seen in treatment among different onc offices and areas are just plain crazy.
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IowaSue44 sorry you have to do rads but I'm actually glad you are. In my case I will be getting hormone surpression therapy after chemo and Zometa. In your case no. Also sounded like you had several tumors. Sounds like doing rads will give you the extra insurance you need.0
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Herceptin # 16 out of 17 now complete! Yea!
20 days until done, and 25 days til deported. Double Yea!
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That's fantastic stlcardsfan!! Happy to hear you are getting your port out right afterwards too, wow that must be nice!0
