Ibrance (Palbociclib)
Comments
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Thank you Jobur, JazzyJuneBug and Artistatheart for responding. JuneBug have you tried Zofran for the nausea? I take it with a laxative pill- It's highly effective for me for chemo nausea but you need a doctor's prescription. I've checked into omeprezole for my indigestion and I was told that drug interactions are classified A to D. Omeprezole is a Class B, interaction with Ibrance, which means there may be an interaction but it is minor. Pepcid is a Class A (not seen clinically) so I am starting with Pepcid. I have to do all this and take Thyroid pills too (not to take with antacids, yes on an empty stomach). Gets complicated scheduling pills if you want the maximum effectiveness. I am seriously thinking about reducing Ibrance pill strength to 100 mg. If my math is correct, if I take 100 mg with only one week off, it will more than equal 125mg with 2 weeks off after 3 months. Glad to hear the reduction was helpful against side effects for some of you. Nina
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And "Mama2twin..." I've been watching my one liver met. Another possible step for me is RFA (Radio Frequency Ablation) for the tumor. I think I'll try pills first. Femara worked for 14 years for me until now and Faslodex seems to be working on the tumor's reappearance. Nina
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Thanks Patty! Still not sure what is up with the enzymes. He thinks it could be a spontaneous immune system disorder from the meds. He says it is easily treatable (with more meds of course) and I may get to resume the first combo, although I really think the ibrance was affecting me too much with the heart rate breathing problems. I hope to find out something good in the next two days. Hope they sprung you from the hospital!
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Great news Patty (except about the infection) and Mama 2-happy dance time!
Babs
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I certainly didn't mean to cause any confusion in regards to what type of therapy Ibrance is. I only posted what the paper work from Pfizer says with each bottle I get, but I also stated that my Oncologist does call it a "Targeted Therapy." So that's what I will lean towards.
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Congratulations Mama!! I do hope I will see results like yours in a few months. Thank you for sharing your encouraging story! I'm with Hummingbird, hanging on to your words for the hope they provide.
Hi Patty.No birds? Well, you have a couple of boys/young men. It probably would not work out well. And your children interact with you more, especially give hugs.
3rd day on cycle 2: my excessive sweating on the left side of my body, especially my head, seems to have resumed. I was taking the letrazole the whole time I was off the Ibrance. I didn't think Ibrance did much about the estrogen; but I will choose to take it as a sign that something is going on with my hormones. Otherwise, it is just an aggravation. LOL
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Well Oh Happy day! Bone Scan results came back as reduced intensity of the nuclear tracer at my T11 tumor, plus no new lesions anywhere else. Also a slight shrinkage of the tumor. I guess the Faslodex & Ibrance are working for now.
Makes the fact that my next Injections, which will be on my birthday, not so annoying. I'm thinking I'll take balloons & cupcakes to the doctors appt. just for fun.
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Great news Jazzy June. May the Ibrance work for a LONG time!
Babs
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Jazzy - so glad to hear you got a good report. And happy birthday!
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Jazzy, wonderful news! Yes - bring those balloons and cupcakes! Happy Birthday!
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Hey Yall....would like to get your opinions: My dx in July was mets to bones. Currently on Faslodex/Ibrance 125 with minimal side effects and stable labs. TM's thus far have fallen three months in a row. I asked my onc yesterday when we would do another scan and he basically told me that he relies heavily on the TM's and really doesn't consider it necessary to do another scan for at least a year as long as the TM's do not rise. His response was that the mets will continue to "glow" on the PET for up to a year even if the disease is halted or slowed down. Does this sound logical? How can I be sure that I'm not having mets spread to other organs, etc.? The only marker that I get is the CA 27-29....
Can any of you ladies reassure me that this is a normal sequence of action? Thanks so much!!
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Masonsmawmaw--I'm sure some one or two ladies will assure you that that is ok and give you some reasons why. However, it is different than what my MO has me doing. I was dx with spine mets in June (CT Scan, MRIs spine, abdomen, biopsy of spine lesions) and my first bloodwork had the CA 27-29 done. But after that, my MO doesn't care about TMs because he thinks they aren't "helpful". He has me do MRIs not CT/Pet scans every 3-4 months to watch for progression. What he would have me do if there was progression, I'm not sure because that hasn't happened (yet). He likes MRIs because you don't get radiated like CT/Pets but maybe he uses them for patients with more progression or mutiple locations of mets. I'm sure someone here can clarify that for us newbies here.
Ellen
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Masonsmawmaw, I believe the standard of care for stage 4 is some kind of scan every three or four months. I do a PET and possibly an MRI depending on what the PET shows. I would NEVER wait a whole year, regardless of TMS. AT one point my ONC had said maybe we could go to 6 months, but then I had a progression and that went out the window. Good thing we were looking. So, ya never know.
Congrats on dropping TMS.....that can only be good, right?
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Yes...I am happy with the continuing drop in TM's....however, I continue to be concerned about the lack of scans. I am unable to have MRI's due to a pacemaker implant, but I thought for sure he would do a CT or PET at least every 4 months. Seems that there is so much disagreement among onc's about the reliability of tumor markers. I think at this point I'm going to be my best advocate and demand that we do a scan more frequently than every 12 months....if only for my peace of mind. By the way, you know I'm a newbie....but what does MO stand for? Thanks!!
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MO-Medical Oncologist. Or at least that's what I thought!
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Masonsmawmaw I believe as Stefajoy says it is standard to get scans every 3 or 4 months. In my case I have been stage 1V for14 years. When I was first diagnosed Stage 1V we scanned every quarter. Over the years my tumor markers have always been extremely reliable. When I've had progression the markers have gone up before we could find any progression. My onc had explained that for some women they are very reliable and for others not so much. So I asked to scan less frequently and he agreed totally. But that was after about 5 years of scans four times a year with very reliable Tumor Markers. In your situation having only recently been diagnosed with mets, I would insist on being scanned more frequently. My onc also does a test that not many other Drs. use called Circulating Tumor Cells (CTC) It is a blood test which tests for tumor activity. I have that much more frequently than scans and if that number goes up I get a scan immediately. But again in your situation, I would probably insist on being scanned more frequently.
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Masonsmaw, My onc is very conscious of the radiation from scans and doesn't like to do them more than necessary. MRIs are his main choice for bone, because of the lack of radiation, but I get some kind of scan- bone, CT or MIR at least every six months when I'm in a stable place, such as when I was on Faslodex, even though my tumor markers were dropping. Now that it's in the liver and I am on a new med, it's every 3-4 months. My progression to the liver came after my tumor markers starting going up again.
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Masonsmawmaw - I was diagnosed with mets at about the same time as you. My TM's have dropped each month, but I still had a second PET scan after the 3rd Ibrance cycle. There was definitely a difference between the two PETs--no uptake activity was seen on the second, which represented reduction in cancer activity. So I would probably want to question waiting so long for a second scan. As Pearlady said, I think until we each have experience to determine if TM's are reliable for us or not, scans are the only real way to see what's going on.
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I just had my second scan a few weeks ago, after the first 4 months, to see if the meds are working which they were. My insurance is refusing to pay......I'm floored! I too thought that was the standard at least in the beginning.
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artist, your onc should have gotten the scan pre-approved. Perhaps there was an error with coding or some such thing that can be easily corrected. If not, the error is with your doc's office or the RT dept. -- whichever one should have gotten the pre-approval prior to letting you go forward.
masonsmawmaw, I'm one who does not like frequent scans, but my TMs and pain level have always been excellent indicators of what's going on, so I've felt comfortable stretching them out a bit. My ULCA onc has always been fine with that, but at one point she did say that no matter how good I was feeling, I should have one at least once a year. But then, shortly after that conversation, my TMs started going up and the bone pain kicked in again, so I didn't wait that long. The point is, we're all different, as are our oncs, and the important thing is to find what's comfortable for you both, but maybe also be flexible. If all signs point to things going well, maybe you don't need one just because it's 3 or 4 mos. out. OTOH, if you're concerned for any reason -- including peace of mind -- discuss it with your onc so that you can reach a mutual understanding of each other's feeling about timing.
And I have a question... I saw my local onc today and also had labs. I won't get my CA27-29 results for a couple of days, but the basic counts are instantly done right there. So as we're talking, he said that my red count was good, but the RBCs were big or large (forget the exact word he used). Does anyone know what that means, or which number he was looking at to come up with that comment, so that I can look it up? Oh and my grans were 900, which is typical for my off week from Ibrance.
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If your RBCs are large, that means that they are being pushed out of the bone marrow too quickly. They are large and immature. It is the body's response to lowered RBCs, so the body hurries up production.
It's the MCV count, I think??? I learned all this when spouse was going through his blood values scare, but - clearly - haven't retained all the good details. But, it makes sense if you are doing Ibrance.
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jazzy. Yea !!!
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My MO also doesn't have much faith in TM's. But for me, my TM's have been right on. When they've gone up, even though I'm asymptomatic, my scans showed progression. On my blood tests of 11/23, my TM's doubled-a first ever for me. My MO wasn't too concerned-she has me doing my scans on 12/28 as per our predetermined schedule-she didn't move them up. I am concerned but we'll see. Trying to stay positive!
Babs
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Thank you for the info, Blaine. I looked it up, and yes, that's exactly what's going on. In the past my MCV has been around 94-95. Now it's over 105. Not sure how Ibrance is causing that, but I'll continue to read to figure it out.
Babs, in what time frame did your TMs double? And remind us... Did you go off Ibrance or are you still on it? If off, what are you on now?
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Here is a scan question. I used to get PET/CT scans for my liver met in 2001, now my new ONC gives CT scans only and he wants less scans due to radiation concerns but only considers CT scans. I realize docs like different scans for different mets (bone, etc) and have read that some of you even get MRI's. Is there any reliable info as to what scan is best for looking at the liver? CT or combo CE/PET or PET alone? It took months before the CT found the met that was showing up in the liver which was first discovered by my increased tumor markers (which for me have been very reliable, the way I found out I was metastatic, both times). Thanks
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Babs - I'll keep you in prayer as you wait for your scan & results.
Thanks for the birthday wishes. I am grateful to be having another one.
Patty - how are you doing? Will you be able to go home soon?
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Yes Deana, I will be questioning my Onc about that scan bill for sure. Feeling pretty nervous about having NO Tx for now. Hope I don't lose the ground I just gained.....Still waiting on a few blood tests for auto immune results. Not sure I want to start the Ibrance again though as my heart rate and respiration seem back to normal.
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NinaCA--Around the time of my dx, I had a Ct scan that showed "maybe something" on my liver. So I was sent for an MRI of my abdomen. For the scan, there was a about 16" flat plate that was pressed firmly on my abdomen and strapped down. During the scan, the plate would periodically vibrate. The results showed nothing on my liver, but it picked up stuff in my spine and later with a spine MRI and then biopsy I got my spine mets dx. Now I just get spine MRIs. Ask for a abdomen MRI.
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getting discharged. Heading home. Thank God. Thank y'all for your support
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YaY, Patty!!!!!! I hope and pray you will stay problem-free throughout the holidays!!!
Nina, I think things have changed a lot since 2001 with insurance coverage for PET Scans. It's become very difficult to get them approved due to cost. Most insurance companies seem to feel a CT will yield sufficient information, so they're quick to deny them unless your onc can successfully appeal, which is tough.
Happy Birthday, Jazzy, although I'm not sure from your post when it is, now or next month?
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