Calling all TNs
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Interesting read...
Two Studies Find Beta-Blockers Help Combat Breast Cancer Progression and Metastasis
Elsevier Global Medical News. 2011 May 31, J Smith
Beta-blockers - safe and inexpensive drugs used for 4 decades in the management of cardiovascular disease - have shown surprising promise in inhibiting breast cancer progression and metastasis.Two retrospective observational studies, published May 31 in Journal of Clinical Oncology, offer the latest evidence that the drugs, which have a role in neuroendocrine signaling pathways, lower the risk of recurrence, metastasis, and cancer-specific mortality.In an editorial comment (doi:10.1200/JCO.2011.35.8820) accompanying the articles, Dr. Patricia A. Ganz and Steven W. Cole, Ph.D., both of the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, wrote that the findings raised "the intriguing possibility" that these and other agents targeted to other diseases might provide "previously unappreciated opportunities for therapeutic control of disease progression, metastasis, and disease recurrence." Because of this, they argued, future clinical treatment trials should "endeavor to collect prospective data on relevant medication exposures, weight and weight gain, comorbid conditions, and behaviors that have the potential to influence the microenvironment of the tumor, as these may be potent mediators of prognosis and survival, and may or may not be effectively accounted for in randomization."In both studies, women with breast cancer prescribed beta-blockers for hypertension and other cardiovascular conditions were compared with women not taking the drugs. For the first study (doi:10.1200/JCO.2010.33.5422), Thomas I. Barron, Ph.D., of Trinity College Dublin and his colleagues used linked data from an Irish national tumor registry and a pharmacy database to set up a case-control comparison of women prescribed the beta-blockers propranolol (n = 70) or atenolol (n = 525) in the year before and after their breast cancer diagnoses. These women were matched 1:2 to 4,738 women not prescribed beta-blockers, with matching inclusive of age, socioeconomic status, tumor grade and stage, and comorbidities. After a median follow-up period of 3.5 years for the propranolol group and controls and slightly less than 3 years for the atenolol group and controls, the investigators found significant reductions in tumor size and nodal or metastatic distribution for the propranolol users, but not for the atenolol users. The cumulative probability of breast cancer-specific mortality was significantly lower among propranolol users (HR, 0.19). Propranolol users were also significantly less likely to present with a T4 (OR, 0.24) or N2/N3/M1 (OR, 0.20) tumor compared with matched controls. However, the atenolol group saw neither a significant reduction in breast-cancer specific mortality nor a difference in T4 or N2/N3/M1 tumor incidence from the matched controls.In the second study (doi:10.1200/JCO.2010.33.4441), Dr. Amal Melhem-Bertrandt of the M.D. Anderson Cancer Center at the University of Texas, Houston, and colleagues identified 1,413 patients treated for breast cancer in a 12-year period, comparing those with (n = 102) and without (n = 1,311) concurrent beta-blocker exposure for a pathologic complete response, relapse-free survival, and overall survival. Mean follow-up was 55 months in the beta-blocker group and 63 months in the nonuser group.The investigators saw no difference in pathologic response for those taking beta-blockers; however, after adjustment for variables including age, race, and tumor grade, women on beta-blockers showed significantly greater relapse-free survival (HR, 0.52; P = .015) and a trend toward greater overall survival that did not reach statistical significance (HR, 0.64; P = .09). In a triple-negative subgroup (n = 377), the investigators found significant effects for beta-blocker use on relapse-free (HR, 0.30; P = .03) but not overall survival (HR, 0.35; P = .05) after adjustment.In their editorial, Dr. Ganz and Dr. Cole noted that the findings from the second study, in which most of the beta-blockers were the beta-1-selective agents metoprolol (42% of patients) followed by atenolol (37%), would seem to contradict Dr. Barron and his colleagues' findings, in which only propranolol, which inhibits both beta 1 and beta 2, had a significant effect. However, they wrote, "Neither metoprolol or atenolol is totally beta-1 specific; both partially inhibit beta-2-adrenergic receptors as well." The editorialists noted that the new findings build on recent animal work indicating that beta-adrenergic receptors affect breast tumor growth and metastasis, and also on a 2010 U.K. retrospective study (n = 466) that was the first to look at a variety of antihypertensive agents in women with breast cancer. It found that women treated simultaneously with beta-blockers had a 57% reduced risk of metastasis compared with breast cancer patients receiving either other types of antihypertensive drugs or no antihypertensive drugs. Women on beta-blockers also saw 71% less cancer-specific mortality after 10 years (Oncotarget 2010; 1: 628-38). "Beta-adrenergic signaling appears to have little effect on the biologic processes involved in breast cancer initiation, but more strongly affects the biologic processes involved in the subsequent progression and metastasis of incipient tumors. Given these results from the laboratory, and the clinical results from three recent retrospective reports suggesting the potential to limit recurrence of incident tumors, perhaps it is time to consider proof-of-concept trials testing the value of [beta-blockers] in the setting of breast cancer," Dr. Ganz and Dr. Cole wrote.Dr. Barron and his colleagues declared that they had no financial disclosures relevant to their study, which was funded by the Irish government. Dr. Melhem-Bertrandt and colleagues said they had no financial disclosures relevant to their study, which was supported by a grant from the National Institutes of Health. Dr. Ganz and Dr. Cole, who were supported by the Breast Cancer Research Foundation, the Jonsson Comprehensive Cancer Center Foundation, Susan G. Komen for the Cure, and the National Cancer Institute, also declared that they had no relevant financial disclosures.0 -
Well crap!! Just went for a follow up with my surgeon today. He found a small lump on top of some scar tissue. She asked me to stay and have it removed. So I did and won't have the pathology back until next week on the 8th. Not jumping into panic mode but I HATE waiting for results!!! Grrrrr!
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Learned a valuable lesson, I am way out of shape playing two kickball games at the hotest time of the with a heat index of 102...atleast we won the tournament having to play the stacked team first and out scoring the other three teams 12-4... I don't think I will make it out of my lazy boy...at least it kept my mind of my upcoming scan on the 14th of all days on my birthday...better be a good present...lol
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Wow, that's exciting, Heidi! I wonder if I could get my doc to prescribe me some Inderal (propranolol) even though my blood pressure is fine.
That sucks, Tiffany. I had found a BB-sized bump on my incision line, too. My BS immediately did an US and said it was just a bubble of fluid trapped in the scar tissue, probably from my post-op seroma. Crossing my fingers for you!
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tiffany: I hate when they make you wait! I hope it isn't anything!!!
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OK Ladies... tomorrow is the day.... I am having TE surgery , ooph and port removal. I am very nervous and scared so please keep me in your prayers over the next few days. Hugs to everyone.
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Blondelawyer - yes, I live in NC. I am about 60 miles inland, but have a beach house in Rodanthe, on Hatteras Island. I was just there, and it was the perfect beach weekend. You should have seem me, white as milk, in a skirted swimsuit with a shirt over the top, gardening hat and my dad's old fit - over sunglasses. It's a wonder my boys would be seen with me!
What part of NC did you live in? Karen0 -
Tracie - I hope all goes well and that you have a speedy recovery.
Wishing you well, Karen0 -
Karen--I lived in Winston-Salem for a year and then spent 3 years in Raleigh (I went to UNC Chapel Hill for law school). We would go to the outer banks often for weekend trips. It is so beautiful there!
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You ladies living in the Carolinas! Lucky you! My family has vacationed at Hilton Head for many years..I love Hilton Head...we were there b-4 all the tourists (HA HA)..came..I can't think of anywhere else I would like to live..If and when we retire we would like to live in South Carolina....I feel so at home there...
Oh Tracie..good luck to you..will be thinking about you all day...love ya sweetie!
Hey Hydeskate..you WON...even though it was hot..you go girl!
You know what..every time I hear that word LUMP..I just totally freak..lump is a 4 letter word...it is such an ugly little word..
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hi girls, just wanted to give everyone a (((hug))) and tell you that you are all in my prayers.
TiffanyF4 thanks for the welcome, and I am glad your doctor is on top of things, that is a key in this tn business I think. And yes waiting is TERRIBLE!!!
HeidiToo very interesting article, I am a reader/researcher, so I take it all in, will ask my mo about some of the things I have read on this site. What a great place this is!!
Hydeskate way to go girl! I love it. I had a brief moment of fuel this afternoon and got about 1/2 of my small barn cleaned up and organized before I ran out of steam. Beautiful but windy day here.
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Hey Gang,
Not used to the board yet so I am just hitting reply as I don't know how to start a new subject, can't find a button. I wanted to say thanks for the warm welcomes the other day and I apologize for not answering before now. I forgot who said it but Shitty Titty was one of my sayings too. I did have several people in person (a couple here) tell me not to blame the boob. It was not really blaming the boob just dealing with the situation. I would have said stupid leg had it been my leg....:). Stupid Boob just stuck. Anyways, I should have been in the bed long ago but can't sleep right now as tomorrow is the big day and I am TERRIFIED!!! I start A/C and any tips to help ease some of my anxiety would sure be welcomed. I am scared I will be one of the horror stories I keep reading about, with having to be taken to the ER, dying right there on the chemo floor and etc. It is not bad enough to know the side-effects we are going to have from it in the days to come, but the horror stories sure make you want to not do it. Hubby says I will be hog tied and taken....;). Also, when did you all first get symptoms?0 -
Stupid boob- I had TC not AC but I will tell you this. They are very cautious giving your first chemo. The nurses put me right in front of the nurses station and asked my Husband to keep the curtain open. They were constantly checking on me for side effects. They also give it to you slow the first time. Explain to the nurse how nervous you are. They will give you something to relax. I slept through most of my treatments. I usually didn't start SE until a few days after. Make sure you take your pre chemo meds each time. Also being hydrated before and after chemo is very very important! My oncology nurse said that if I had side effects to make sure I communicate with the nursing staff in order to keep the SE under control. I did pretty well. Wishing you well, I will be thinking of you tomorrow sister!
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Stupid boob- I had AC with no problems, just make sure you stay hydrated. For me pre meds made me sick only took them before my first treatment which was suppose to Taxol and AC but I had the fastest allergic reaction to Taxol the nurses & doctors ever saw so I was switched to Abraxane, I choose then to trash the pre meds, I made sure to listen to my body if it said sleep I sleep, had a water bottle by the bed and a snack usually tuna fish in the packet. I would wake up hungry at 2am and no way was I going downstairs to the kitchen, I was very lucky and didn't have any side effects.
Rella40 and Titan...thanks the game was fun and made it on the local news apparently we are getting a trophy for winning the first ICA Kickball Tournament. And now I am really sore..
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Ladies,
I read often but don't post much here. I have my final chemo on Friday with lab work and exam this afternoon. Am wondering what questions I should ask for my final visit...anything specific to TN follow up? I guess I am nervous about this. Will start rads in a few weeks, but that isn't scheduled either. Will get appt while at chemo and they anticipated 6-7 weeks. Who decides how many? The onc? The RO?
Any suggestions for things to ask or consider would be welcome.
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Huskerkkc - congratulations on almost being done chemo...yay!!! Regarding rads, the radiation oncologist will decide how much and for how long. Mine was 21 sessions (16 whole breast and five boosts to tumour bed). In Canada, it's done a little differently than the US whereas we get fewer, larger doses. It wasn't too bad other than the fatigue at the end. You're nearly done!!!
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Huskerkkc: the blood draw for tumor markers (I don't have my follow-up paperwork w/ me so correct me ladies if I am wrong), but I THINK I can safely say this will be done. Just make sure you stay low fat as much as possible, feel for lymph nodes and do your monthly breast checks. We are all closet feelers here. I do my checks weekly and I am PROUD TO SAY SO! I I feel for lymph nodes everywhere.
Two week rule applies if something hurts longer than 2 weeks go to the DOCTOR.
Good Luck girlie and hand in there!!
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Hello ladies. I have not posted here in a bit but just catching up on the posts today and I cannot believe all of the newbies. Welcome to you all. It is sad though, knowing that so many more woman have to go through this crap. You are all in a great place with lots of support and information. Sorry to all of you that are having such a rough time with Chemo. I had AC x 4 then T x 12. The AC was the worst and I only finished 7 of the Taxol due to neuropathy then 28 rads. I did work through the whole treatment process and radiation, besides needing the money it kept my mind off of things. The hardest part I think was the day after the AC for being tired and the bone pain for 3 days with the neulasta. But it is all duable and you CAN ALL get through it. Big hugs to you all and best wishes.
Jen
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Hi Everyone,
This is my first post. I was diagnosed in April at age 51 with a 4-5 cm triple negative tumor. I am having neoadjuvant chemo for 4 months, to be followed by surgery and radiation. I already finished the AC treatments and they really weren't bad. Also, for you ladies who are just starting, the hair loss was much less of a big deal than I had anticipated. Before I got treatment my hairdresser cut my hair to chin length. Then, once it started to fall out, I cut it myself very short. I didn't want to shave my head, so I now have sparse very short hair, which I cover with soft hats and scarves when I am out.
I will be starting on Taxol in two weeks and I am a little worried about neuropathy. Any advice on how to prevent or deal with that?
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This thread moves so fast, please forgive me for not catching up completely!
Yay to those done with chemo!! It is such a relief, and a great milestone.
ellipses - my doctor recommended something for the neuropathy, and of course my chemo brain can't remember! I'm sure someone will come along with good suggestions. I actually didn't have any neuropathy (I did weekly Taxol), I'll keep my fingers crossed for you.
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A little good news tonight. My insurance company approved Avastin for 4 months, yay! I hope it can help me, I know it is hit or miss.
My liver function tests all came back normal, another yay! but we are still going ahead with the CT scan because it isn't definitive. My hemoglobin and WBCs are also still a bit low, but we think it is due to radiation. It won't stop me from starting chemo in a few weeks, but it is something we'll watch.
Have a good evening everyone!0 -
Suze35: Glad to hear your good news! My blood counts were a little low also after radiation, my onc said radiation affects the ribs where a lot of those cells are made.
ellipses: Congrats on finishing AC! I didn't have too much neuropathy when I had taxol, hopefully others can come along and give you some advice on that.
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Oh yes Suze...we will take the good news when we can get it!
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Ellipses-my onc told me to take Vitamin B Complex when I started weekly Taxol. I started to feel a little neuropathy on the 3rd week and they had me skip that week and the dose was lowered slightly for the next time. I didn't have the problem again. The main thing is to communicate any and all se's to the infusion nurse that is starting you out before each Tx. They really didn't brush anything off for me. I don't have any permanent neuropathy.
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Stupid boob (still like your name)...how did the AC go? I never had any issues..just kinda felt..I just can't describe it well...not really any pain..just felt weird....I did find that if I did a little too much I would feel a little dizzy and just kind of out there somewhere..
Ellipses...taxol..and neuropathy...hm..didn't have any real issues...my feet were a little numb now and then...kinda achy...if I sat for along time..I had issues getting up and moving again..I could usually walk it off...
Everyone experiences chemo differently..I tried to "pretend" that nothing had changed..that I was the same old person as b-4..but honestly I just couldn't pull it off..I had to actually sit in the recliner and rest and take a nap now and then...I did work but I know now that I wasn't 100%.
One night I had a "spell"...one day after AC..my son was in the regionals for track..we were rained on, then I had to make a million phone calls to change the date of his grad party, then got home, made dinner, laundry..all of a sudden the world was spinning around me..I was scared, very scared....but I sat down and I was OK after a minute or two..the next day my husband and daughter and some family got my son's grad party together...I just sat and watched..I knew that I had pushed myself too much...and had to chill a little.
This is serious crap we are dealing with..those chemo drugs are STRONG.
I chilled after that experience..and even though I was BORED out of my mind...it was probably the best thing to do.
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I had neurpathy. But it went away before the 2nd chemo and didn't return.
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I had neuropathy on Taxol too but only on my left side, fingers and toes, weird..... It got pretty numb for the last 3 Taxol. Now I'm almost 5 months past Taxol and sometimes I still have numbness that comes and goes on my left fingers and toes but nothing serious. Just a little numb and it goes away fast.
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Suze- Yay for normal liver function!!!! And Yay for finally being set on your next chemo!!!! Happy for you that everything is moving foward as far as treatments go. Love the way your doctor pushes for all that is possible for you. You are in good hands. Hugs to you.
Going for rads #19/25. The Bolus part is making my skin pretty much "well done"
but I have been putting lots of cream on it and it's holding on so far. Almost done.......Have a great week-end everyone. xx
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Ellipses: On 12 weekly taxol, I had a little tingling in my fingers around weeks 5-9, nothing major and it went away. Hopefully your SEs will be minimal too.
On a related (and trivial) note, I am going for a pedicure today after 1 1/2 years! My toenails have finally completely recovered from taxol. Looking forward to open-toed shoes this summer.
Suze35: Great news on the liver function!
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babs - you are almost done - yay! I know what you mean about looking fried - I have had a bolus every other day, and the skin is brown. Only two more of the axilla for me, then 8 on the scar line, and who knows how many left on the clavicle, lol.
Luah - Enjoy that pedicure!! My nails are still wrecked, but it was the AC that did it for me. Hopefully it won't take 1.5 years to get better
.I'm cautiously optimistic about the liver function test, but as my doctor said, it is a positive indicator but not a perfect one. So, until I hear the all clear, I'm keeping myself busy.
Today my mom and I are getting our tomato and pepper plants, and hopefully will put them in this weekend. It got a little colder here after all that wild weather and tornadoes, so I want it to be a smidge warmer. My broccoli and brussel sprouts are growing like crazy though - I'll have FRESH organic broccoli in just a few weeks, yay!
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Good morning ladies,I am just feeling tired today. Had a good sleep lst night but just feel like curling up on the couch and watching tv too bad Im sitting in my chair at work lol. I am trying to pretend I am not going for treatment next week dont even want to let my mind go there. Hope you all have a great friday
Hugs Kymn
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