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Feb 17, 2018 08:20AM
Thank you very much for your kind reply. Apologies in advance for the following babbling. It's basically a brain dump.
First, here are some questions.
1) Did your medical oncologist say anything about taking Ibrance with a fungating tumor?
2) Is the purpose of radiotherapy to the fungating tumour only to reduce or eliminate the fungating?
3) And do you have any specific pointers to Breast Cancer forums on Facebook?
If you have been dealing with breast cancer for 20 years, that sounds horrifying beyond imagining. I've only been dealing with it for 6 months, and would quite like to stop. Strangely, I've found that watching episodes of the TV show "Shrubs", in its idiosyncratic reflections of life and death, has a calming effect.
To be clear, initially my mother was taking just letrazole by itself, not with Ibrance. Which didn't seem to be doing much to stop the spread. Now the plan per the medical oncologist Maniar is now to switch to fulvestrant + Ibrance. All the oncologists I've talked to have said that Chemo isn't an option for my mother, because of her
A major problem is that I haven't found an oncologist that I feel comfortable with. None of them give the impression they give a crap. And their competence seems questionable. For one thing, they often contradict each other, and none of them seem able or willing to provide references. Admittedly, I haven't cross-examined them on the point. Also, when I send them emails with questions, they routinely ignore them.
We met with a surgeon (Dalal) on Tuesday 13th February - he wasn't very pleasant. He thought it was ok to proceed with surgery. He was alarmingly casual about the surgery. And he thought that it was ok to go with just the fulvestrant for now, and delay the Ibrance for a month and a half. He was alarmingly casual about that too. From what I've heard, fulvestrant + Ibrance either works very well, or doesn't work at all. I guess it would be a good idea to find out which asap. I don't really want to delay this any more than necessary, certainly not 1 1/2 months.
As regards the major issue of having a masectomy before using Ibrance, I'm leaning heavily towards just going ahead with the fulvestrant + Ibrance. The medical oncologist (Basade) said that there could be problems with the Ibrance if the ulceration wasn't resolved, but I haven't found anything online to support this. And two people, yourself and Chicagoan (see her post on https://community.breastcancer.org/forum/8/topics/...) thought proceeding with Ibrance if one had a ulcerated wound was reasonable. Also, I found a somewhat relevant thread, https://community.breastcancer.org/forum/72/topics... about people with open wounds being treated with chemo.
And more generally, there does not seem to be a concensus about the advisability of having a masectomy if one has stage 4 breast cancer. Clinical trials don't seem to be conclusive. And I've heard that one the one hand it's good to get rid of a big tumor mass in the body. On the other hand, apparently the surgery can promote growth in
distant metastatic tumors. See for example https://www.guelphmercury.com/living-story/4267002... and https://academic.oup.com/annonc/article/19/11/1821...
Also, one of the surgeons (Sankit Mehta) I consulted with said that in my mother's case, she has "heavy infection" of the lymph nodes, and if the lymph nodes were removed, there would be heavy drainage, the surgical wound would take a long time to heal, and perhaps not heal at all. Of course I don't know if this is likely, but it certainly gives