Calling all TNs
Comments
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aww mine was 1.6
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Not specific to TNBC,
Chemotherapy Sequence Affects Early Breast Cancer Outcomes
Elsevier Global Medical News. 2011 Jan 7, B Jancin
SAN ANTONIO (EGMN) — The sequence in which paclitaxel and anthracyclines are given for treatment of early breast cancer makes a big difference in long-term outcomes. That's the conclusion reached in what is believed to be the largest-ever retrospective study of the clinical impact of the sequencing of taxanes and anthracyclines. The study involved 3,010 early breast cancer patients who were treated during 1994-2009 and entered into the prospective online database at the University of Texas M.D. Anderson Cancer Center, Houston. The clear winner was paclitaxel, followed by anthracycline-based therapy with 5-fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide or 5-fluorouracil, epirubicin, and cyclophosphamide, Dr. Ricardo H. Alvarez reported at the San Antonio Breast Cancer Symposium. Starting with paclitaxel rather than an anthracycline-first regimen led to better long-term results in the settings of adjuvant chemotherapy and primary systemic (or neoadjuvant) therapy. The adjuvant chemotherapy analysis included 1,596 women, three-quarters of whom received paclitaxel followed by anthracyclines. The 5-year relapse-free survival rate with this regimen was 88.8%, compared with 79.5% when anthracyclines were followed by paclitaxel. The 10-year relapse-free survival rates were 81.8% and 73.5%, respectively. Five-year overall survival was 93.1% with paclitaxel followed by anthracyclines, compared with 83.2% for the reverse. The 10-year overall survival rates were 83.9% and 65.6%, respectively. In a multivariate analysis that was stratified for potential confounders, including age, clinical stage, hormone receptor status, tumor grade, and era of diagnosis, the anthracyclines-first sequence was associated with a 67% increased risk of relapse (P less than .0001) and a 2.5-fold greater risk of mortality (P = .001), according to Dr. Alvarez, a medical oncologist at M.D. Anderson. Among 1,414 patients who underwent neoadjuvant therapy, the 5-year relapse-free survival rate was 79.0% with the paclitaxel-first regimen vs. 61.2% with the anthracyclines-first regimen. Ten-year relapse-free survival occurred in 61.7% and 50.5%, respectively, of these patients. Overall survival was 84.2% and 66.2% at 5 and 10 years, respectively, in patients who received paclitaxel followed by anthracyclines, compared with 71.3% and 53.4% in those who got anthracyclines first. In a multivariate analysis, the anthracyclines-followed-by-paclitaxel sequence of neoadjuvant chemotherapy was associated with an adjusted 49% higher risk of relapse (P = .01) and a nonsignificant 28% increase in risk of all-cause mortality (P = .17), compared with the paclitaxel-first strategy. The mechanism that accounts for the increased efficacy of taxane-first regimens for treatment of breast cancer is unclear, according to Dr. Alvarez.0 -
Tifj, of course be happy about not having the BRCA mutations. I was BRCA negative and pleased for my daughters, but my Onc, who also has a PH.D in genetics, says my daughters still have an increased risk of breast cancer because there is so much we don't know about the genetics. I've been told this also by my MSK onc. and my oldest daughter (age 23) has been told by her GYN that she must be extra vigilant and she recently was sent for a breast ultrasound.
There is much we just don't know and I'm just mentioning it because as a mother I'm sure we all want the best care for our daughters.
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I had T and C at the same time. I wonder how that compares.
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HeidiToo: Thanks for sharing all of this!
Claire: I had the same TC x 6 and was wondering the same thing!
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Well, I was told the A was mostly given if you were node positive, so I'd think TC together would still bode well for us. But, who am I to say?
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Babs37: My onc told me not to take Tylenol cause it is hard on the liver. She told me it is best to take Alieve.
Teka: I am doing Avastin. The side effects are mild thank goodness. I have been tired and do get nosebleeds. My onc told me to use a saline spray for my nose and rub vaseline on the inside to keep it from not getting dry and it has really helped. Everyone is different though as we all are finding out.
Tifj: Yeah for being negative. What a blessing. To not worry about our children and cancer. Which once you have it you cannot help but worry no matter what.
MBJ; so far my liver has been coming out good. I will check on the milk thistle. I am doing chia seeds they are amazing. Get for being regular has lots of fiber, proteins, omega 3's, vitamin B's, calcium, copper, zinc high in antioxidants. People who have heart problems should not take these. You can put them in all your foods and cook with them they keep you hydrated. They can replace 1/3 of the fat in your recipes. Amazing stuff. Just thought I would share.
Have a wonderful day....TNBC Sister
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Thanks for posting that HeidiToo. Those differences are so significant I would think practice guidelines may change. Sadly, like most of the others here, I got AC first, then taxol.
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I had adrimycin/cytoxan first and then taxol. I wonder why my Med. Onc. did not know of this information, that is to give me taxol first.
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yup, AC first and then Taxol here. Hmmm...
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WRT T before A: Ya know what I think? I think if we wait another five minutes they'll change their minds.
I'm such a cynic...
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Mitymuffin- you are absolutely right! While my dr. says we will treat the "variant of unknown significance" as negative- you never know if it will someday become something. When my daughter grows up i will certainly tell her about this test and what it means and will strongly recommend that she starts early detection.
EB Ann- Thank you!
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Heidi..you kill me really! I had ac first then taxol..a whopping 18 months ago..."they" said that they were bringing out the "big guns" first..then the taxol to wipe out anything left...and now it is WRONG!
Like you said...it's just like watching a pee wee league baseball game..confusion! ...I almost can't wait to see the onc in a couple of weeks...I'm going to throw a few studies at him and see what he says...I think it will be a short appt!
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"Why don't they just say "nodes matter.... sometimes.... well, maybe once and awhile...sh*t, it's a crap shoot, we just like doing studies" LMAO. Yes, this is about right. Completely random thought. Seriously random - but this reminded me of it. Was in a museum in athens a few years ago. There was bust on display with a tag that read "Julius Caesar or a priest." One of my friends said "They should just say we don't know who the F this is."
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Yes IRR..you've got it.."random" is the key word here..like drinking is ok for tn's but not the positives, biotin is good..but not really, nodes are good, nodes are bad, small tumor good, big tumor bad but they respond to treatment better, stage one is bad because chemo may not work, stage one is good because..it is stage one, stage 3 is good because it responds better to treatments, stage 3 is bad because it is close to stage 4..give me a BREAK..sometimes I could just scream..which is good because I'm letting my agressions out but bad because I'm allowing STRESS into my life, which causes cancer or might not..my head is spinning
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Yes, the conflicting information is incredible. I truly believe that my docs mean well, but don't really have a clue. Not because of any lack of skill on their part - no one has a clue. I will never forget my onco telling me, right before I was to start chemo, "If it comes back, it comes back." Way to show your confidence in this crap.
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Gotta love your onc IRR..my Onc just kinda turned his back and said "I think that you will be OK"...Ok..well that is good...I think???? They really don't know..and they are doing their job..but I wouldn't want that job for any amount of $$$....
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Don't get me wrong. She is great. That was her way of telling me not to worry and stress about it right now. But what I heard - which is never good for a control freak like me - is this is completely out of your hands and, oh by the way, we have no idea if this treatment is really going to work. She is extremely easy going and laid back. I am not. It has produced an interesting, and at times hysterical, relationship.
I agree. I could never do what they do. It would be too depressing and it would absolutely drive me nuts trying to treat people when I have no real way of knowing if what I am doing will work.
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I asked my onc when he would think of me as "cured" He said ten years. F*ck that; I'm sticking with three. Maybe. Maybe not.
And so it goes...
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It's all a roll of the f'ing dice, no matter what they give us, what our stats are, whether we have nodes or not, etc., and we just go through hell - first with the diagnose, then the treatments, then whatever damn testing we may need (and go through hell and back again waiting for results), and then for the rest of our lives, sit and wait and wonder if the other shoe is going to drop. I'm ending this now, before I put myself into a major depression.
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For some reason I don't find any of this depressing. Confusing and inconsistant, yes. Beyond that I put it out of my head with an "Oh well" attitude. None of it is carved in stone, and none of it will change my future. I figure I have as good a chance as anyone to survive and the "alternative" is simply not acceptable, so I put it out of my mind.
Denial? No, I don't think so--- just healthy reality. Works for me.
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HeidiToo - I am also like you, I am a perfectionist by nature, so not having my questions answered is frustrating, very frustrating, but I am not depressed about all of this anymore. I have a "oh well" attitude too. Right now, I just want my hair back. I am shiny bald, as my last taxol was 14 days back. I am just waiting for the damn thing to show a tiny little growth, but it is not showing yet. And tomorrow I have to deal with the fact that my med. onc. wants to prescribe Aridimex and Zometa to me. Zometa is for bone loss which is caused by Aridimex. I am TN, with 2% progesterone positive. I am wondering if any of you TN's took any hormonal drug and something like Zometa (which seems to be a serious drug given by infusion to people who have bone metastasis). I don't have any metastasis or node positive at this time........
Any TN's taking any of these medications, please do tell me about it. Will this make money for my med. onc.? He never explains anything to me, nothing, for instance, what would be my risks versus benefits. I hate having to make these types of decisions.
I am like a guinea pig. I never used to take any prescription medication, and now all this? I hate Side Effects.........I don't know what the hell to do.
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Heidi: I agree with your philosphy and for the last two years have been able to handle it all well, just been a rocky road lately with recurrences - many on the TNBC board and all of us within the same time frames. The old "first three years" rule seems to be holding true. I, of course, realize we are all individuals with our own specific outcomes, but it tends to rattle the chains a bit. I've been in this "dip" before, and it too shall pass.
LovelyFace - sorry, unable to give any help re the hormonals, other than I have heard of gals having very low percentages of hormone response, and being put on them as well - to cover all the bases. I was totally negative on all receptors across the board. Wishing you the best.
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I shaved my face !!
I couldn't remember if a year ago I had that much fuzz, and I read where someone else did it, so.....thank goodness I didn't get razor burn because I realized I didn't hav anything resembling shaving cream, so used a nice lather of soap. Made one swipe in the same direction (not against) and it was gone! The best part was my forehead, right above my eyebrows. They've come back bushy and uncontrollable, so I got rid of the 'overbrow'. Now I can quit looking in the mirror obsessing if I have too much facial hair!0 -
I took prilosec otc yesterday for indigestion and acid reflux...felt great all day. Today, I woke up, took the prilosec and now I have HIVES! I took an antihistimine since it was hours before the docs office opened up. Anybody else get hives from this? I looked it up and it is a common side effect! Who knew!?!?!?
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Titan: You kind of just summed it all up for me-thanks!
HeidiToo: It is a crap shoot in many ways, isn't it?
Lovelyface: You must ask your Onc what those percentages are and what the side effects are so that you can make an informed decision. No one else can do this for you and if he can't answer your questions then I would consider changing Oncs. It's your right to know about these very serious treatments we are getting! Your hair will start growing before you know it!
TNBCRuth: I had to shave the "fur" off, too. Really strange looking before.
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Hi girls!
Just wanted to drop a note and say YAY for Melissa's shrinkage...
On Cats:
We have 1, and he runs the house. He's 12 now, got him at 6 weeks (free to a good home). Big part of our family!On closeted boobie feeling:
Um, yep, me too. Can't see how any of us aren't feeling around in that area 24/7...LOLOn order of chemo:
Seriously? I'm w Heidi, in the "they'll change their mind next week" camp.On PhD in TN BC inside 2 weeks
LOL--OMG me too
I never learned anything so quickly or so well. I'm a pro now For me:
Port and Chemo same day on Jan 18th.DH bought me the 8 pink bracelets from TLC catalog. I'm going to remove one after each chemo session I finish
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slcst12, thanks!!! I love the pink bracelet idea...may have do this too...Im going to take all my hospital bracelets and burn them when i finish....such silly things....but they make us feel better...
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I had my six-month followup with my oncologist today and it went well. He had a helper lady doctor who is about to graduate as an oncologist in four months so she gave me the breast exam. She was so gentle and thorough and all felt fine to her. Whew!! I'm glad that appt. is over. I see him again in six months and will get my repeat mammogram in March because they are watching something on my good boob that they saw last Sept. Lol..I told him my recent bout with food poisoning over the holidays made me feel worse than "his" poison did and he thanked me for my backhanded compliment. He's very nice and I'm happy to have him for my doctor.
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Great Sugar - it's nice to have a good appointment.
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