TORADOL (ketorolac) linked to Recurrence Prevention
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Hi Jojo, The recommendation is for ketorolac for any subsequent surgery. Since generally there are not the subsequent surgeries for non reconstructors, it would seem it would be easy to sort them out.
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Sas...love this thread. Thanks for posting the video...going to watch it soon.
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Hi peace, I enjoyed it too. I learned so much and met some great folks. It was so intense, I think I still haven't recovered. Haven't studied that hard in a while.
Did you have your surgery? The video is good. Dr. V takes the difficult material and makes it easy to understand. I apparently misheard that Jennifer was Dr V wife. She was a friend of his wife's.
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Sas, watched video and helpful how he narrows it down in "practical" language. No decision on reconstruction yet...thanks for asking.
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Hi Sassy, I just posted a link to the video on my Twitter and Facebook accounts to help spread the word.
Dr. V thinks that this could help patients with all types of cancers. Amazing. He considers this similar to hand washing in the 1880s to prevent fever in women delivering babies, a change which eventually led to handwashing and sterilization in all areas of medicine. Truly paradigm shifting!
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Mominator Go to the topic box and look for Dr Patrice Forget's study. Then Dr Michael Retsky. Dr, V was a co-author with Dr. Retsky on Retsky's study.
The brilliant young doctoral student doing his thesis that Dr. V referred to was Dr. Forget.
Both Dr. Forget (forshey) and Dr. Retsky have been here in our little pond
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Keep Dr. Forget in your prayers. Remember he's in Brussels. We pm'd the day after the attack. It was brief. I worry b/c of the way he worded his response. It was brief. But I would only chose that phrasing if I were very worried.
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Hi folks did a thread that incorporates all the threads. It's self explanatory I hope. Please, give it a read and let me know what I can fix
Hootie hoo, Hope everyone's doing well. YAY, been meaning to do this for awhile.
https://community.breastcancer.org/forum/73/topics/843381?page=1#post_4691605
Oh yeah, I was tapped out on a name. Any ideas. Mods will change it if I ask sweetly.
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Trying to post the link from the previous post to each surgery group, and now sticking around for questions. Posted this today on the June surgery thread. Sent it to the Docs for review.
Falls and 123, consider make a plug for your threads. I know pushy, pushy.
Hope all are doing well solfeo, Stephy, rainnyc, geewhiz, Loverly, and anyone I missed hugs sassy
////////////////////////////////////////////////////////////////////////////////////////////////////////////////////Thought I'd drop this post here. It was written to the June 2016 surgery group:
To all. Check back to the post on Toradol and NSAIDS. Please, view Dr. V's video. He explains about the use of Ketorolac/toradol pre-incision. That's just the intro. If you follow all the links you will find the definitive studies and the work we all did last summer......................On the lumpectomy & rads versus mx and adjuvant. Is the most controversial of any subject. I think it's the SEER study that says the lumpectomy & Rads group do well, BUT it's how the MBC group fits into the story gets murky. Please, view Dr. V's study and then read my Toradol thread from last summer.
They're many elements that are the bases for consideration at the time of surgery time. It is known that the act of surgery causes the body's response of inflammation. That cascade of chemicals that are produced in the inflammatory response can cause 1. circulating tumor cells that are released from the tumor site to lodge at a distant point an stimulated to grow, and 2. cells that were released earlier that were dormant at a distant site are stimulated to grow.
This is the idea behind the interruption of the inflammatory cascade by the use of ketorolac/ Toradol. Not sure when inflammation was seen to be such a problem i.e what year, but Dr. Patrice Forget's first retrospective study done in 2010, looked at the drugs that were used at the time of surgery to see if the any connection could be found.
This was a highly unique situation of 325 patients at one hospital that had the same group of anesthesia docs and same surgeon(s). The finding was that ketorolac was the common drug in the group that had the longest time to reoccurrence or no recurrence. Dr. Forget then did a second retrospective study on a cohort of 725. The same finding. This was remarkable. It's earthmoving. Then Dr. Retsky did a study that looked at what was being done worldwide. There was more data worldwide supporting Forget's study in recognizing interference with the inflammatory cascade was a key connection. Though the connection to ketorolac was made by Dr.Forget, Dr. Retsky saw the immense meaning. Dr. Retsky 's study is a wild ride in the science behind Forget's discovery.
Dr. V from the video, was a co-author with Dr. Retsky. All the data that Dr. V uses in his video is from their study and Dr. Forget's study.
Dr. Forget has a prospective(double blinded) study going on in Brussels now. Dr Retsky is trying to get one going in Africa now.
The reason Dr. Retsky is in Africa is that blacks have a higher incidence(nearly exclusive) rate of triple negative patients. If ketorolac does in fact reduce reoccurrence it will be known pretty quickly b/c TNBC has the highest early reoccurrence rate. For Africa this would be revolutionary( the world too) b/c they don't have the medical resources that the developed world has. Ketorolac cost less than 10$.
I could go on for a very long time. I'm hoping this is enough to convince you of the importance of studying yourself, and then talking with your docs about ketorolac pre-incision. In the link to the topic box i have described how to use the info there. There are two posts that pull all the need to consider info & links to take to your docs. Our team from last summer did some very very intense work to put it all together to make it simpler for anyone reading this.
It has become my mission to try and make people aware of this research. If you and your physician choose not to do it b/c this is retrospective research, I get that. But the research is so compelling, don't discard it without a serious look.
Plus, there is compelling research about blocks and opiods. All the links are there.
I'm going to send this off to Dr. Retsky and Dr. Forget and see if they agree as to how I've stated this. Always like to check the facts
I'll post back if they have any comments.Okay, off the soap box
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I'm new here. I'm not lurking, just catching up on all this important reading and trying to prepare for my own surgery on the 5th. Thank you all for providing such vital information as well as your experiences. So valuable.
Rainy, thank you for the draft of your letter to your docs. It's very helpful!
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I'm hoping the hospital has the name of my anastesiologist when I call tomorrow. If not I'll call my BS and request a note he added that I want Toradol be give before surgery starts on 7/6. I may even call my PS and request the same thing. At least it will be on my surgery records and not be over looked.
Thank you Sassy for all you do for all of us here on BCO! Love you to pieces
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Asher, Sorry you are here, but happy you found us. We are actually the lurkers here now. We took the subject as far as we could take it. Please read all the connecting threads The Blocks and opiods are important for before surgery. NSAIDS asa continuing thing for after surgery.
Beta blockers is a new topic. It is in the same "realm" as all these discussions. Not absolutely proven, but the research is from compelling to useless HAHAhahahah. Sorry, only a person whose read way to many studies in her lifetime, would think that funny.
If you have questions post, we all lurk
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Hi Wenchi, thanks, but so many others do too. It's one of the beautiful things about BCO. Remember it's pre-incision Toradol. The connecting thread has all the research info for the docs. Hugs
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Asher, I haven't logged on in a while and just saw your note about my letter. I hope it got good results if you used something like that. More important, I hope your surgery went well!
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ump
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I am scheduled for port surgery on Wednesday the 9th of August. I just left the consult and I am happy to report I copied all the info and the Dr letter I found here as well as each of the professional info and clinical trial and gave it to my surgeon. It was a very hard sell, but he agreed to do the ketorolac preincision. I can't believe this iam so happy. Thank you everyone for sharing this info and giving us the tools to be active participants in our cancer journey.
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carmstra, Hi glad you found this. this link is the final composite of several threads. Toradol, blocks, and opioids. it's shorter than this and the other threads. It was specifically put together for the docs. You may want to send the link to your doc.
It starts with Dr. V's video.
https://community.breastcancer.org/forum/73/topics/843381?page=1#idx_18
Good Luck, sassy
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Thanks Sassy. Just had the ketorolac waiting to go in for the port placement probably 30 minutes. The are going to use propophol. They are afraid they won't be able to numb it completely with just local. But nothing else no versed or narcotics it is a difficultl port they will use the jugular vein on the left side. I hope I wake up with a port placed :
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All went well. Zero pain. I am very happy the port was placed exactly where I wanted it, I got ketorolac preincision and no amnesiac medication or narcotics. They left the 2 needles in so I can have my infusion tomorrow without any pain from the stick on my new double bard power port. Thank you everyone who helped with this information and to Dr. Forget. I believe this has just saved my life.
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carmstr, YAY plesee,keep us up todate. Please, review the linked thread. Let me know if it would have been easier to use.Which letter did you use with your doc. There are several. I think Rainnyc wrote one too. There is a letter from Falleaves, and me. Memory issues . I should add Rainnc's letter too.
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Carmstr--on the link look at Techtonicshifts post at the end. She actually had circulating tumor cells measured before and after surgery. CTC's.. No one here has had that done before. So.her situation is very unique. I may send her post on to Retsky and Forget. I'll send your Thanks to Forget if I do
Your situation sounds a bit different. I read that you had the torodal in pre- op versus preincision?
I think it's important that you send the links to your docs for review. Link the composite thread first.
Are you on any anti-hypertensive medications?
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I printed this post from Sas-
Apr 12, 2016 09:53AM - edited Apr 12, 2016 11:02AM by sas-schatzi
https://community.breastcancer.org/forum/73/topics...
Then I printed each article in full. I also copied TectonicShi's post about her port experience and raised cancer markers in her blood.
It was about 34 pages, in a bounded booklet, in protective inserts,(that way I used both sides of the inserts easier to turn pages and read), a table of contents with tabs acrossed the top for each article and tabs down the side with chapters.
Title page:
Pre-incision Ketorolac and Surgery
Introduction- letter to the Dr.
Cancer recurrance studies
Personal story
Risk of Bleeding
The meeting was about 45 minutes, it didn't start out well, he was very much against this, but did listen. I told him this book was his to keep, if it doesn't help me, maybe it will help someone else after he read it more in detail. I would rather bleed to death, than die of breast cancer, he knew I was very sure this was what I wanted. I doubt I would have gone through with this without the ketorolac. I did have my own on hand incase I decided to take it without the surgeon's knowledge. I did not know if 3- 10 mg tablets would be as effective as IV 30 mg. Hense my insistance on no sedation. But that became a moot point when he agreed, and I sure was happy. I doubt I would have just taken it, I probably would have just canceled the surgery and did without a port and risk serious lymphodema from the piclines and blood draws, I seem to have more issues than most with these things. I am happy to have my port.
He first said, that he could not in good conscience go into surgery without a plan B and with the subclavian port there was no option if I started to bleed. I asked about a different vein. He could use the right jugglar vein. He could use pressure if needed. I got him thinking. Then I informed him he could not place my port on the right. It needed to be radiated. He said left juggler is not a straight path, would require 3 turns and each turn could cause a kink and could force a failure of the port. I just said to him, but you can do it, can't you? It was a challenge then, and he was up to it. I was so happy. My port is just fine and works great, so far. The surgery took about 1 hour 15 min. The ketorolac was administered IV at about 1 +/_ 15 minutes hours before the surgery began. I believe the anti-inflamatory properties were well instilled by then. I had very little pain after and never did need any pain meds even after the lidocaine wore off.
Sas, I am not on any medications except pre and post chemo steroids. No BP meds. I did have the ketorolac pre op, but probably no more than an hour or so before the incision.
You guys are awesome for keeping up with all this!
Cindy
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Cindy, that was a lot of paper and ink.
Good Luck! 0 -
Hi,
I had a bilateral mastectomy on 8/7. I just came across this thread. In recovery they came at me with this big liquid bottle. I asked the nurse what it was, she told me it was ketorolac, a heavy duty anti-inflammatory. I even came home with a few pills of it but never used, maybe I should have. My PS is an oncologist reconstructive PS and does not like to use any other drugs. I remember him telling me prior to surgery that he would give me a block so that I'd be good for a few days. Honestly I can say, I really had no pain from when I woke up until now. Just some tightness from the implants, and some zings from where the sentinel nodes were taken out.
Wonder why they all don't use it especially since the concern these days are with addiction to Opioids.
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Hi beach2 The final story i.e clinical studies aren't done. The studies to date on Toradal are retrospective studies. Patrice Forget has a prospective study going now.
The three Torodol, blocks, no opioids are the best combo. In sharing the info with your docs use the info from the link i will place at the bottom. I'm also going to place a copy of Techtonicshift's post from that page for rview here.
https://community.breastcancer.org/forum/73/topics...0 -
repost
Jun 29, 2017 11:25PM - edited Jul 1, 2017 07:51PM by TectonicShift
I think this topic is very important.
I had to have my port replaced recently. I had gotten my measurable CTCs down to zero before the surgery (down from a pretty high number). I had the surgery and I had gas anesthesia and I did not ask for Torodol beforehand.
Immediately after the surgery, my CTCs shot back up to a positive double digit number - forget what exactly but enough to make me very nervous after six months of zero CTCs. My doctor said he wasn't surprised - that surgery and infection and wounds cause the release of nasty hormones that send cells into hyperdrive and the proliferation of new CTCs didn't surprise him. We worked hard to get the CTCs back down to zero after that surgery and did so successfully.
About four months later I had to have the new port removed. For this second surgery I asked for a shot of Torodol before the surgeon did anything at all. Also there was no anesthesia, just topical Lidocaine. I was awake during the procedure. But I was "cut" to get the hardware out of me. It was definitely a surgery, albeit small. This time, after the surgery, my CTCs did not go up. The first test after the port removal the CTCs were still zero.
I believe that possibly the lack of opioid anesthesia and the Torodol shot may have made a difference. Maybe not, maybe a coincidence. But I'm glad I had the Torodol shot before the second surgery. I will try to never have surgery of any kind again without it.
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What is interesting about TectonicShift's post is they had measured her circulating tumor cells - CTC's. Generally, CTC's are measured after a tumor has been diagnosed. That is not common practice before the initial surgery. I wonder in the future it will be used from initial surgery and for all subsequent surgeries. I certainly would add valuable insight as TechtonicShift post demonstrates.
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Sas, very interesting. Really. It's great to see many women researching and finding studies etc. It's so hard, we have to advocate for ourselves or at the very least, gather any information we can and place it out there to our Dr's. With a dx of cancer, anything we can arm ourselves with to help during, before or after and in the long run is a plus in my book. I'm still learning. Been looking at diet changes, melatonin, turmeric, D3...etc.. going all over to read and see what's new and old etc.
I had looked up comparisons of Ketorolac to any other type of anti-inflammatory. Was wondering if there was something in same class we could take that perhaps would help further to reduce reccurrance. I know some look-see's have been done with Aspirin use.
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Beach look in the topic box for the link to NSAIDS by 123 Just Me. The problem with NSAIDS is they can cause cardiovascular problems i.e. heart attack and stroke. The should always have the permission of your doc for use, preferably, cardiologist.
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Thanks!
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