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Bren

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Reply with quote  #1 

Below is a link to an article that just came out regarding the link to heart damage from anthracyclines taken by HR2+ breast cancer patients.

http://ap.google.com/article/ALeqM5jeK5N5795nWN92W-TkysAbDpo4aAD8S568RO1

I didn't have chemo, so I don't really understand a lot of it, but most of you who did may find the article interesting.

nosurrender

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Reply with quote  #2 
Thanks for this Bren.
When this was first being talked about I mentioned it to my doctor. This was when they were saying that Adriamycin doesn't work on but a very small percentage of bc and it greatly increases heart damage.
What they were testing was Her2 positive patients, apparently it only works on a small percentage of HER2 positive patients, but can cause heart damage that is then made worse by Herceptin which also can cause heart damage too.

There was a study out a couple of years ago that said women who had left breast radiation are also at in increased risk of heart damage.

So my first cancer was on the left and I had left breast rads, I just had Adriamycin for the second cancer and after all is said and done, I will never forget what my "first opinion" onc told me... "you will die of your cancer before you die of heart disease" when she was trying to convince me to use the Adriamycin. I wound up not going with her and switched to my current onc. We did  a Muga and an echo and I am sure i will get another Muga after I am done with chemo... but I think the Adria was the best thing for the way we are hitting my cancer- hitting it hard the first time is the best chance for a cure.

I am glad you posted this. It brings up an excellent discussion!


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Cherlilly

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Reply with quote  #3 
Hi Gina!

Just found out yesterday I will be starting chemo Oct. 26th.  She is saying I will be doing the standard of care, AC.  I have read that doesn't work very well on triple negs and also the heart risk factor.  I have extrememly uncontrolled cholesterol which has always concerned me regarding heart disease, etc.  Any input from you, I value!!!!!!!!

Cheryl

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nosurrender

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Reply with quote  #4 
Cheryl I hope you saw the post I made for you on Anthracyclines!!! It can be found HERE

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onecent

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Reply with quote  #5 
Can you please tell me what AC is? I do not want to take it if it does not work as a chemotherapy.
Thank you,
Penny


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chemoabi

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Reply with quote  #6 
Cheryl:  I have high blood pressure and coronary artery spasm.  Still got the A/C - I feel it was an important part of my chemo combination.  Im er/pr negative and cant take AI's.  Good luck with your chemo.
 
Nicki

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Reply with quote  #7 
Penny, A/C is short for Adriamycin and Cytoxan. Two chemotherapy drugs and the most commonly used. You can go to our website HERE and read about them.

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SoCalLisa

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Reply with quote  #8 


This is actually a very good article

http://www.medscape.com/viewarticle/563432_print

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azDarleen

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Reply with quote  #9 
Hi everyone,
Well I'm one who did get heart problems from A/C. About a year and a half out from chemo I was in the hospital with congestive heart failure, I also have Cardiomyopathy (with an eject fraction of 33%) and in Feb I had to have a Defibrillator put in. I'm only 54 . all my heart problems is from chemo.But at least I'm still here, and if I had to do it all over I would still have the chemo.
As of Aug after my Pet scan they found out I have a recurrence and I'm now doing radiation for 7 weeks.
my history:
right mastectomy, 02/2005, stage 3 estrogen neg ,13 lymph removed 1 with trace of cancer, reconstructive surgery, Lymphedema in right arm, breast and back Jan 2006.

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Darleen
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Reply with quote  #10 
Darlene:  Thanks for sharing you experience.  Ya know I didnt find out about heart damage with Adriamycin until after my chemo was over.  I made it through the A/C ok - but the herceptin got me.  Fortunately mine was reversible.
 
Sending you a great big hug.
 
Nicki

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Indigoblue

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Reply with quote  #11 

There are many side effects which can, might, or will affect the heart; even Tylenol can cause life threatening situations; per say, one has Hepatitis, unknown liver problems, aneurysms somewhere in the circulatory system.  It's crazy when you read the warning labels and possible side effects.

All too often, we are told to ignore the possible SE, and take medications as prescribed by your physician.  The Oncology Clinic where I was treated took very little responsibility regarding Pre-existing medical conditions.  All the standard procedures required (legally) like "Mugga", Chest Ex-ray, and blood work.  There was nothing beyond the primitive and sketchy "blood tests".

I read an article written by a "Cancer" surgeon, who said he would never endure any type of chemotherapy without first obtaining an MRI of the brain and body.  In his opinion, chemo is useless if the cancer is somewhere else, and treatment would then be designed to treat the situation specifically.  He also expressed  how valuable base tests are for future diagnosis and testing. 

My family doctor thinks the "specialists" expect the PCP to cover their rear-ends,   presuming one has a thorough and caring physician. 
If you're a "healthy" individual, how often does that person visit a doctor?
 

Finding "specialists" is not an easy task.  You never know what you'll end up with, especially the one in with a "group" practice and living off the reputation of retired physicians.  I always get the "new" ones, wondering to myself, why did I not INSIST on the physician I'd planned to see in the first place.

Meanwhile, I'm thinking to myself, "These pipsqueaks are trained to "go fetch".  "Good Dawg, come and get it! ~ See Spot Run.  Heal, Sit, and Roll Over, awwww, come, stay, don't beg...good puppy!". 

If you're a good patient (Doctor Trainer), you will research, and give the good doctors "commands" which, if they are "good doctors" will follow.  I was always led to believe the doctors are doing the research, planning, and guiding so patients can recover and get well, knowingly trusting their medical professionals.

So glad you made it through all those heart issues; I have a heart murmer, high blood pressure, absurdly hereditary high cholesterol, and other health problems.  I had to ask for ALL the Heart, Bone Scan, PET Scan, and CAT scan, so many tests...didn't understand them at the time.  Wanted to play it safe, and did a heck of a lot of research and reading.  I just don't understand why these tests are not required, and why must we be the advocates in what I believe is a life and death disease? 

Something is wrong with the medical "system", and when I hear stories like yours it's so upsetting.  Had a SIL who went through the entire breast cancer procedure, was a 6 year survivor, and healthy.  She decided to have reconstruction.  The physicians didn't check to see if she was allergic to the anesthetic, and the next day she went in and out of coma; didn't make it.
All they had to do were some simple blood tests, lung tests, etc.

Sorry for the long string...this stuff infuriates this otherwise passive woman.  Sometimes it all just makes me scream!

Thanks for the post.  Sorry to rant, but so much information was
"NOT" relayed to myself or my husband.  He's a smart man, and they made him look like an imbecile.  Now, he's sick of the words "breast" and "cancer".

Indi

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Reply with quote  #12 
Darleen, I am sorry you had this happen. Nicki and Indi, the paths we have had to hike uphill with 100 pound packs  no one ever tells us about....

I remember meeting an oncologist for my new cancer and voicing to her my very real concern about heart damage from adriamycin- I had previous left breast rads.
Her words: "You will die of your cancer before you die of a heart attack"

Needless to say I did not use her.

I chose the risk vs benefit route- and the benefit of adriamycin far outweighed the 1 percent risk I was told it presented. I got  a Muga half way through and it was a good score. Can't remember what it was, but I remember posting it and you all told me it was good.

Reminds me of the Evelyn Waugh quote from Brideshead Revisited:
"Oh where are we to turn to, we orphans of the storm"
Where do we turn? Where in the storm of a new diagnosis are we supposed to find the ability to make such life altering decisions when in reality no one knows the truth.



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jeffntate

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Reply with quote  #13 
Hi,

My wife is getting Adriamycin with Cytoxan.  I found out that in a small trial of 18 with 9 getting an ACE inhibitor (blood pressure med) there was no decline in LVEF (left ventricular ejection fraction) while in the control group w/o ACE there was a decline of 10% on average.  LVEF has been correlated well with coronary heart failure.

I also found an article by a cardiologist recently that indicated BNPs (simple blood test) is more prognostic and accurate than MUGAs.  BNP - Brain Nitriuretic Peptide (guessing at spelling of the "N" word).  If your BNP goes over 100 you have 8 times the risk of heard damage, if over 150 16 times, and if over 200 like 88 times.  My wife had hers tested after first AC cycle and she was 38.  It may not change your treatment, but it gives you peace of mind.

Jeff
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Reply with quote  #14 
Thank you Jeff, that was very interesting and something to definitely bring up to our oncs!

Welcome!


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Indigoblue

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Reply with quote  #15 
Thanks Jeff and G;
I will ask Oncoboy Blue-eyes about this BNP Blood test, as well. I vaguely recall reading the same article.  My pretty boy Floyd Oncologist doesn't even think Tumor Markers are accurate or realistic, and does not use those tests, as far as I know.  Might have to beg, or plead...or ask PCP.  She is always willing to run the tests, however, has little or zilch communication with the Onc, Surg, or Rads guys.  She's affiliated with a small town hospital, and they have almost no contact with her regarding my medical procedures.  I've had to supply her with almost all the information from Medical Records, and they only have the basic records and comments.

Want to transfer to another hospital, but the grapevine and blasted blacklisting of patients is far more common than we know.  Tip toe, keep you mouth shut, don't complain, and articulate all research; they hate us to "know" more than they are willing to give regarding medical procedures and prognosis.  Sometimes I think they're all  in a clandestine club of sneaky, snotty, snobby "Doctor Country Club for Nerdious Dorks". 

Then again, they save lives, and I couldn't, wouldn't, ever have the brains, stomach or emotional strength to do the remarkable, abeit sometimes unremarkable, business of disease, blood, guts, and bourgeois overseer Wardens who control our entire Medical protocol.  Hospitals...Churches...
Elementary Schools...they all make me a little nauseous and dizzy, for some strange reason...needles...sick people, sanity, sadness.  I try to avoid those things which break my heart.

Thanks, be well, prayers and love to your wife, yourself, family, and loved ones.  Hope is always on the horizon.

(((hugs)))

Indi
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