Stage 2 Sisters Club
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Hi everyone, I sort of had a revelation after seeing the surgeon for my 3 month follow up. As I was reading my visit summary paperwork my diagnosis says DCIS left, LCIS right, and that I had a malignant neoplasm left. So, although when I joined here and went by my pathology report of T2N1mi it occurred to me that is now long gone!!! It's part of my history so I am thinking about changing my profile back to stage 0!!! LOL
Somedays it's the little things that make you smile! Well wishes to all!
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Hey ladies, My Dr just put me on tamoxifen. Just curious if anyone knows of this is better to take in morning or bedtime. Thanks, Mary
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It's whatever works better for you. Some people feel it makes them tired, so they take it at night. Some people feel it makes them restless, then it is best to take it in the morning. My Arimidex didn't make me feel any certain way at all so in the morning because I always got up at the same time and wouldn't forget about taking it later. (I did get a separate daily pill case, so if I couldn't remember whether I had taken it or not, I could look; if the 'Friday' pill was missing, then I must have taken it!
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My Mo recomend taking it at night..
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Thanks ladies, I started last night.
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Congratulations on your new report. Stage 0 always looks better.
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Hello Sisters,
Can you please explain what the difference is for grade 1,2, 3. I was stage 1 at biopsy, but became stage 2 after the surgery and I am assuming that is because the tumor was bigger than they thought before they took it out. My Oncotype score was 17 and it says my recurrence in 10 years is 11% after 5 years of Tam. However, I may be post menopausal and may take AI. (going thru blood analysis for hormones now) Is the recurrence % same for AI and Tam?
Mimi
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Hi ladies, been focused on my chemotherapy group, but glad to also find a Stage 2 thread! Finished chemo on May 3rd and now heading toward radiation in 2 weeks. After that it sounds like long-term hormone therapy, appreciate all the insights into the types and various SEs. Wishing everyone a great start to the summer.
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I was grade 3 at biopsy. My surgeon would not identify a stage until post-op. He said there were too many factors to consider; such as the size of the tumor, location and lymph node involvement. Post op. I was staged at. 2B. My grade level diminished from grade 3 to grade 2. Initially they thought my tumor was 1.2 centimeter but during the surgery they discovered it was much deeper and it became 2.5 cm.
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Mimi- it’s my understanding that AIs are actually slightly better at preventing recurrence.
My original biopsy was grade 2, later changed to grade 1. Turns out, not everyone uses the same grading system. Who knew?
Grade is different from stage though. Stage refers to how much cancer and grade refers to how aggressive. So I had grade 1 stage IIB.
Hope this helps!
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My Oncotype DX is 17 and it saidsRecurrence in 10 years is 11% after 5 years of Tamo. I am assuming this is without radiation bc it seems so high. I am doing rads right now so can I assume recurrence will become lower?. I know I should talk to Dr so i willl next time I see her. What is your recurrence %?
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So... my RO told me that without rads, my chance of recurrence was around 30%. With rads, plus Tamoxifen it drops to around 10%. Something like that. Not sure how true that is.
My Oncotype report has 10% at 5 Years that drops one whole percentage point at 10 Years. (Sarcasm) Forgive me if I don’t celebrate.
My score was 14.
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If, along with the recommended medical treatments, you make needed lifestyle adjustments.....exercise (the biggest recurrence reducer), maintain a healthy weight, limit alcohol consumption, clean up the diet (my big downfall), and take a low dose aspirin (not for everyone, clear this with your doctor first), you can shave some more points off your recurrence risk. Another thing to remember that these statistics are old (as they have to take them from a certain amount of time ago in the past) and our chances of being okay are better than the statistics because treatments are better and more tailored.
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I have been on plant based diet for 3 weeks and feeling good, no dairy, no meat, no fish, all vegetables , fruits and legumes...
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ruthbru- unfortunately for me, there’s little shaving to be done. I had less than 5% chance of having breast cancer. Already healthy weight, if anything slightly under, healthy diet, lots of physical activity, don’t drink really, don’t smoke, 2 kids before 30, nursed all three kids, etc,etc.
I do plan on asking about the baby aspirin, especially being on Tamoxifen. I just take it for what it is. Most people in my family die from cancer of one form or another, although no mutations found.
Nas- wow, that’s great that it’s working for you! Do you find it difficult to stick with? I like my veggies, but not sure if I could go all veg. I have a hard enough time maintaining weight with a diet of regular food! I do stick to what I call “real food.” Food that looks like food, stuff my great grandparents would recognize as food.
I’m curious how that’s working within your household? Is everyone going veg?
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I got the same stats as Cpeachymom - 30% chance of recurrence, down to 10% if I have rads, which I am due to start on the 18th. I also will be doing Tamox, then an AI. I had no family history of any kind of cancer, never smoked, and while my weight was up a bit the last few years (BMI of 24), until I hit my 50's it was much lower and I am pretty active. Sometimes you can't tell.
Very curious about the low-dose aspirin impact? Any more information on that? Would love to hear.
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Aspirin indirectly inhibits oncoprotein responsible for malignant cells
The research was conducted by scientists from Oregon Health and Science University (OHSU) in collaboration with Oregon State University (OSU), and the results were published in the journalAJP-Cell Physiology.
"The benefit of aspirin may be due to its effect on blood cells called platelets, rather than acting directly on tumor cells," says senior author Owen McCarty, a professor in the Department of Biomedical Engineering at OHSU.
Platelets are tiny blood cells that help a healthy body to form clots, in order to stop the bleeding when necessary.
It seems that our blood platelets also increase the levels of a certain protein that may support cancer cells and help them to spread. This "oncoprotein" is called c-MYC.
The biological function of c-MYC is to regulate the expression of over 15 percent of all the genes of the human body. The c-MYC regulator controls the life-and-death cycle of cells, the synthesis of proteins, and the cells' metabolism.
However, research has shown that in human cancers, this oncogene is overexpressed.
The researchers from this latest study explain that aspirin reduces the ability of blood platelets to raise levels of the c-MYC oncoprotein."Our work suggests that the anti-cancer action of aspirin might be in part as follows: during their transit in the blood, circulating tumor cells interact with platelets, which spur tumor cell survival by activating oncoproteins such as c-MYC. The inhibition of platelets with aspirin therapy reduces this signaling between platelets and tumor cells, thus indirectly reducing tumor cell growth."
Owen McCartyCraig Williams, a professor in the OSU/OHSU College of Pharmacy and co-author of the study, further explains the process.
"Early cancer cells live in what is actually a pretty hostile environment, where the immune system regularly attacks and attempts to eliminate them," he says. "Blood platelets can play a protective role for those early cancer cells and aid metastasis. Inhibition with aspirin appears to interfere with that process and c-MYC may explain part of that mechanism."
Low-dose aspirin may be 'safe and efficacious' in preventing cancer
This is the first time that a study has shown the ability of platelets to regulate the expression of c-MYC in cancer cells.
The researchers note that almost a third of colon cancer patients and 42 percent of patients with pancreatic cancer had overexpression of the c-MYC oncoprotein.
They also point out that the impact aspirin has on blood platelets is just as effective in high doses as it is at low ones. As a result, clinicians can weigh up the risks and benefits of aspirin intake, as well as reduce the risk of bleeding - which is a common side effect of ingesting too much aspirin.
The authors emphasize the crucial role of physicians and healthcare professionals when considering even a low-dose aspirin intake.
"Because the interaction between platelets and cancer cells is believed to occur early [...] the use of anti-platelet doses of aspirin might serve as a safe and efficacious preventive measure for patients at risk for cancer," the authors conclude.
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Aspirin May Prevent Cancer from Spreading, New Research Shows
In addition to relieving headaches and preventing heart attacks, the drug seems to keep malignant cells from spreading
- By Viviane Callier on May 1, 2017
If ever there was a wonder drug, aspirin might be it. Originally derived from the leaves of the willow tree, this mainstay of the family medicine cabinet has been used successfully for generations to treat conditions ranging from arthritis to fever, as well as to prevent strokes, heart attacks and even some types of cancer, among other ills. Indeed, the drug is so popular that annual consumption worldwide totals about 120 billion tablets.
In recent years scientists have discovered another possible use for aspirin: stopping the spread of cancer cells in the body after an initial tumor has already formed. The research is still developing, but the findings hint that the drug could one day form the basis for a powerful addition to current cancer therapies.
Not everyone responds equally well to the drug, however, and for some people it can be downright dangerous. Investigators are thus trying to develop genetic tests to determine who is most likely to benefit from long-term use of aspirin. The latest research into the drug's cancer-inhibiting activity is generating findings that could possibly guide those efforts.
MYRIAD MECHANISMS
During the past century researchers demonstrated that aspirin inhibits the production of certain hormonelike substances called prostaglandins. Depending on where in the body these prostaglandins are produced, they may trigger pain, inflammation, fever or blood clotting.
Obviously no one wants to block these natural responses all the time—particularly as they help the body to heal from cuts, bruises, infections and other injuries. But sometimes they linger for too long, causing more harm than good. Long-lasting, or chronic, inflammation, for example, increases the risk of developing heart disease and cancer by causing repeated damage to otherwise normal tissue. Eventually the damaged tissue, depending on where it is located and a host of other factors, may become a vessel-clogging plaque in a coronary artery or a tiny tumor hidden deep within the body. By turning down the prostaglandin spigot, aspirin prevents thousands of heart attacks every year and probably stops a significant number of tumors from forming in the first place.
In 2000 scientists discovered a second major mechanism of action for aspirin in the body. The drug boosts the production of molecules called resolvins, which also helps to quench the fires of inflammation.
More recently, investigators have started to elucidate a third way that aspirin works—one that interferes with the ability of cancer cells to spread, or metastasize, through the body. Intriguingly, in this case, the drug's anti-inflammatory properties do not appear to play the starring role.
Metastasis is a complex process that, somewhat counterintuitively, requires a certain amount of cooperation between tumor cells and their host. Some number of malignant cells must break away from the original tumor, cross the walls of a nearby blood vessel to enter the bloodstream and avoid getting detected by immune system defenders as they travel about the body. Those that survive this gauntlet must then cross the walls of another blood vessel at a different location in the body, nestle into surrounding tissue that is completely different from their original birthplace and start to grow.
Elisabeth Battinelli, a hematologist at Brigham and Women's Hospital in Boston, has shown that cells called platelets, which are better known for their ability to trigger blood clots, also have an important part in allowing tumor cells to spread. First malignant cells coopt certain chemical signals from the platelets that collect along the blood vessel wall. Instead of directing the repair of a potential breach in the wall, however, these repurposed signals help the cancer cells break through the barrier and sneak into the bloodstream. Then the cancer cells cloak themselves in a protective layer of platelets to hide from the patrolling sentries of the immune system. Once the tumor cells leave the bloodstream at some distant location, they instruct the platelets that have come along with them to produce so-called growth factors that trigger the development of new blood vessels, essential avenues that carry nutrients and oxygen to the now thriving secondary tumor.
Researchers often inject tumor cells into the bloodstream of mice to approximate what happens during metastasis when cancer cells must navigate the bloodstream to find a new home in the body. When Battinelli and her team fed aspirin to certain strains of mice and then injected them with malignant cells, the investigators discovered that the platelets did not shield breakaway cancer cells from the immune system or produce the necessary growth factors that allow cancer cells to grow and divide in a new location. Thus, aspirin appears to fight cancer in two ways: its anti-inflammatory action prevents some tumors from forming, and its antiplatelet properties interfere with some cancer cells' ability to spread.
REWIRING PLATELETS
How does aspirin stop tumor cells from hijacking platelets to do their bidding? Instead of blocking a single compound (a prostaglandin, for example), in this case the drug seems to turn entire groups of genes on or off in the nuclei of certain blood cells.
To try to better understand this previously unknown effect of aspirin, cardiologist Deepak Voora of Duke University and his colleagues looked at cells called megakaryocytes, which give rise to platelets. Using complex mathematical and pharmacological tools, they identified about 60 genes that are either turned on or off in the megakaryocytes in response to aspirin. The end result of all this genetic manipulation: the platelets produced by the megakaryocytes did not clump together, which presumably prevented them from camouflaging cancer cells. Thus, in addition to blocking prostaglandins, aspirin basically "rewires the platelets" so that they do not serve as inadvertent accomplices to metastasis.
There is still a lot of basic research that must be conducted, Voora says, before the feasibility of an aspirin-based therapy to prevent metastasis can be determined. The next steps are to confirm these experiments in larger, more diverse groups of people and to better understand the normal functions of these aspirin-sensitive genes. In the meantime, investigators hope to learn enough to create a genetic test that will make it possible to tell whether a patient might benefit from taking aspirin. Ideally, such a test would determine not only the most effective dose of the drug but also whether or not the person's body is reacting to the medication as predicted.ADVERTISEMENT
Much of aspirin's cardiovascular benefit, for example, stems from its ability—at a dose as low as 81 milligrams—to prevent clots from forming in the bloodstream. And yet one study of 325 people found that aspirin has no effect on the clotting processes of 5 percent of patients who consume the drug, with another 24 percent having a reduced effect. Furthermore, some people may experience severe side effects—such as bleeding. Thus, no responsible clinician would advise everyone to take the drug on a daily basis.
To date, the only way to know for sure that a patient is resistant to aspirin's anticlotting effects is to test the person's blood after several weeks of therapy to see if it takes longer to form clots than it once did—an expensive proposition that is not very practical. Genetic tests would presumably be less expensive, but they are a long way off. "It's challenging to develop a single molecular test that will tell you if someone will respond [to aspirin] or not because it's become clear that there is no single pathway by which aspirin works," says Andrew Chan, an epidemiologist at Harvard Medical School. In other words, researchers and physicians will have to look at many different genes—and their complex interactions—to determine how likely a patient is to benefit from aspirin treatment, whether for cardiovascular disease or cancer.
Until then, the U.S. Preventive Services Task Force, a national panel of independent health experts, recommends low-dose aspirin to prevent cardiovascular disease and colorectal cancer in only a very select group of people. Those who may benefit the most, according to the available evidence, are adults aged 50 to 59 years who are likely to live at least another decade, have a 10 percent or greater risk of having a heart attack or stroke in that time, are not at increased risk for bleeding (because of other medications, for example) and are willing to take low-dose aspirin daily for at least 10 years. For adults aged 60 to 69 years, the task force recommends selectively offering aspirin treatment depending on individual circumstances. It has determined that there is not enough evidence to weigh the potential benefits against possible harms for daily aspirin use in adults younger than 50 years or older than 70.
Most patients who have already suffered a heart attack or stroke, however, seem to benefit from regular aspirin therapy regardless of age, says Paul Gurbel, director of the Inova Center for Thrombosis Research and Translational Medicine in Falls Church, Va. And if you think you are currently suffering a heart attack, many doctors recommend chewing a 325-milligram tablet of aspirin immediately after you have called 911 to minimize the damage from any potential clot.
Nevertheless, aspirin cannot make up for a lifetime of bad habits. Quitting smoking—or better yet, never starting—eating moderately, keeping your body lean and remaining physically active may be as effective as—or even more effective than—taking aspirin on a daily basis for keeping lots of health problems, including heart disease and cancer, at bay. Aspirin may well be an amazing drug, but it is still not a cure for everything that ails you.
This article was originally published with the title "Aspirin vs. Cancer"
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ruthbur,
Thank you for all the great info. I will ask my MO about the aspirin.
I have been on a plant based diet for couple of months but did not lose weight. I cheated yesterday b/c I was so frustrated! I am 54 and I know losing weight is the best medicine prevent recurrence, in addition to all the treatments. Before Dx, I was not unhealthy, but not healthy b/c I didn't exercise. I still hate exercising, but I am pushing myself now. I know there are many variables to getting BC but I think mine is having 2 kids after 35, gaining about 20 pounds since childbirth, not exercising, and eating white rice, a lot of white rice. Per Dr. Kristi Funk and her book BREAST, red and black rice is anti-cancer foods so I am able to eat some rice...:)
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Ruthbur - thank you for the info on baby aspirin. I read about it in a book on top 20 things you can do to prevent cancer, but the explanation was not as detailed as this.
Nonomimi5- I hear you about the diet/weight thing. The weight comes off if I cut out ALL grains and dairy and only eat meat, veg and fruit (and eat veg with every meal), but I found it difficult to sustain. I was hungry all the time, and spent all my spare time going to the grocery store and cooking. It just never seemed there were any leftovers to eat another dinner without having to cook a whole new thing. So I need to work on my diet. I am going to prepare black rice tonight for the very first time! I hope we love it.
Nas - please tell us more about your eating plan. I also have to change my diet long term so that I can keep the lymphedema under control. I am curious to know examples of what you eat for breakfast, lunch or dinner. Does eating only fruit, veg and legumes give you enough energy to exercise and do everything you want to?
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Hi Cpeachymom and wildcolonialgirl - just got back from my MO appt where I got the results from my OncotypeDX score. It came back with 16 so similar to yours cpeachymom, and I see that you, like I, have had lymph node involvement
Am curious...your MO didn’t suggest chemo?
Mine suggested TC x4 and AI thereafter and this was after I had to strongly ask him to order the Oncotype test. I guess because I had the one positive lymph node and because I’m relatively young (44 yo)? Before he ordered the test, he mentioned two options - AC+T or TC. With the results of onco test, he then suggested TC but also left the door open if I was strongly against chemo.
Did either one of your MO’s initially suggest chemo to you?
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Dtr- Oh, she suggested it! She wouldn’t even send mine for Oncotype because I was young with node involvement. Even when I finally got that done through second opinion at Dana Farber and it came back low, she still wanted to do TC, like yours. I opted not to because that would delay rads and Tamoxifen for little to no gain. Those two things gave me the biggest reduction and I wanted to get them started. Why make myself sick for nothing? My Oncotype report actually showed a greater risk of death at 5 Years with chemo!
Should I have a recurrence, then I’ll probably do chemo
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cpeachy - thx so much for the feedback. Curious to know what your 2nd opinion dr. Recommended? Did they too suggest chemo?
My report is OncoDX report likely shows same as yours. Mine showed 10% 5yr recurrence risk of 10% with tamoxifen and 11% 5 yr recurrence risk with chemo+tamoxifen.
Now I'm all confused! I am going to seek a second opinion very soon so hoping this gives me some moreclarity.
Also, how did you determine that getting Rads and getting on tamoxifen would give you the best reduction of recurrence? Is that what your 2nd opinion dr. Told you
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Dtr- I went to a doc who specializes in breast cancer in young women at DF. They did not recommend chemo, which is why I felt comfortable with that decision. I was 100% er +, so Tamoxifen is like my best friend. I’m also doing ovarian suppression at the recommendation of my MO. I could switch to AI, but I’m doing well on Tamoxifen, so no reason to change it
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cpeachy - that is so great! How nice to hear that you were able to forego chemo and thank goodness for second opinions! Thx for sharing your story with me. All the best
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Ruthbru, thanks so much for the excellent information regarding the benefits of aspirin! Very helpful and I plan to discuss with my MO next visit.
DTR808, I was recommended chemo and did 4 rounds of Taxotere/Cytoxan. It was strongly recommended by both my breast surgeon and my MO. I was given the option of TC or ACT, and given a family history of cardiac issues plus my own hypertension and a heart murmur, I elected to go with the TC. I made it through and now will be starting radiation on the 18th. I'll be doing the hormone therapy after that - still trying to get a better handle on Tamox versus AI. Seems less clear given recent studies, particularly for postmenopausal women.
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wildcolonial- Your cancer was grade 3, which responds well to chemo. I may have opted to if I had a higher grade, but my understanding is that grade 1 doesn’t respond as well, if at all depending who you ask. I certainly understand your decision. I hope things go well for you and rads treat you kindly!
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Ladies, regarding my plant based diet, I don’t find it difficult, I am a teacher and have to walk and move all the time at work and so far have never felt out of energy, for example for breakfast I eat 2 slices sourdough bread with topped mashed avocado or homemade peanut butter or vegan chocolate with cup of coffee, overnight oats with chia seeds are great breakfast as well, for lunch And dinner I get many ideas in youtube.. I recomend everyone to watch the documentary “what the health” and “crazysexycancer” these two videos made my husband and I go plant based diet
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I have been a vegetarian most of my life. Prior to BMX, my labs were alway excellent. My energy level has never been a factor. I have always worked, run and exercise regularly; plus I have an active social life. 90% of my diet are legumes, veggies and fruits. 10% cheese and yogurt. With chemo I cannot tolerate yogurt , cheese and legumes. My last chemo treatment is tomorrow and I'm looking forward to my taste returning for cheese. I want a really good piece of gouda or Brie. Balance is everything. Good luck to all of you who are starting to exercise and making changes to your diet.
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I have also heard Chemo works best against aggressive cancer and ER and PR negative, and has little effect on low grade cancer. Radiation works best against ER and PR Positive. Perhaps because I am 54, with Oncotype 17, I was told I do not need chemo
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