The cancer in the liver has gotten worse after three rounds of Doxil and Carboplatin, combined with Xgeva and Neulasta. Now, nearly 80% of her liver is cancerous. Basically, the doctor said that that combination was a failure, in my mom's case (stage IV, grade 3, tnbc, metastasized to the liver, bones and lungs).
Question 1: What to do in the above situation?
In the last two days, she is now going to the toilet every 2 to 3 hours, although stool is regular/normal. Her pain level is going up so she's now on Dilaudid every 3 to 4 hours.
Question 2: Is it possible that the level of pain is the same but that the Dilaudid's effectiveness is decreasing?
Question 3: Is the combination of decreasing pain management with increased trips to the bathroom a cause for concern?
According to a family-friend oncologist, doing a biopsy when you've got tnbc (and if it's a grade 3, like my mom's, i.e. aggressive) is like heading out to a huge lawn and randomly picking a one square foot area to find out if it has weeds. Fail.
Relying on a liver enzyme test is like heading out to that same lawn and taking a look at the lawn from one end and then saying that you cannot see any weeds. Fail.
If things get bad or really bad: Stay off of anything that has sugar, salt, and anything spicy. Make sure to avoid loose motion like the plague. Ban visitors to your home. If they do come, take em straight to the bathroom and have em wash hands with soap. Hand sanitizer is useless against C-Diff, a common bacterial infection whose side-effects (primarily loose motion) negate the effect of the chemo. Increase intake of Calcium, B12, Vitamin C, Protein. If your stomach does not agree to regular Ensure, go with Ensure Clear, available at Walmart and other fine establishments. Make sure to ask for Ensure Clear coupons from your Oncologist Dietitian.View Thread
My mother has tnbc, with nearly full metastasis to the liver. Stage IV. Please, please, right away, do a PET scan of the liver and lungs, including all lymph nodes, and all other major organs if possible, as well as a brain MRI (although, for some reason, it's not easy for cancer to metastasize to the brain).
Do NOT trust liver enzyme levels. My mom's liver enzymes went back to normal 3rd week of June. The doctors did nothing till mid-October. Not a single scan, nothing. Next thing we know, it fully metastasized to the point of being ineligible for even a liver transplant.
Also, do not trust a "bone scan" either. In my mom's case, it came out completely clear, no cancerous anything, and on the other hand, we've got CT and PET scan results that rubbish the bone scan.
Currently, mom's mid-way through her 3rd chemo (Doxil and Carboplatin, combined with Xgeva and Neulasta), we did a CAT scan last Thursday, and the oncologist basically said that this current chemo regimen is useless. We should have known something was off when mom did not lose any hair the last 7 weeks.View Thread
She takes the following meds at various times throughout the day: Haloperidol (Haldol), Dexamethsone, Omeprazole, Vancomycin (for the C-Diff, stops on Dec 12), Calcium w/ Vit. D, Vit. B-complex, Lorazepam (Ativan, as needed), Hydromorphone (Dilaudid, for pain, as needed), Senna Lax Docusate (for constipation as needed, stopped now coz of C-Diff & coz her stool is regular/normal). She was on Zofran (anti-nausea, primary) and Compazine (break-through nausea) for the longest time but the doctors stopped both of them a week into her recent two week stay at the hospital).
She's cheerful at times, while at other times, she's less than hopeful about her case and constantly reminisces about "what if they had done a PET scan much earlier, what if the doctors hadn't screwed up,..." etc. She's still physically weak, cannot stay standing for more than 5 minutes, is usually laying down most of the day, sits up occasionally, walks 5 to 10 minutes daily in the home coz she's scared the blood clot might come back. View Thread
Hi. My mom has tnbc. I have no medical background, so i may make mistakes in my choice of words. I'm also very long-winded so please bear with me:
A year ago, my mom (age 56 then) was diagnosed with tnbc, 9mm lump in left breast duct, stage 1, grade 3. Also, left breast lymph nodes checked at that time, came back negative for cancerous cells. The doctors did a 15mm (1.5cm) lumpectomy October 5, 2011. They did a biopsy on the outer edges of that too and did not find any cancerous cells. No idea if they did any more mammograms/chest x-ray/ultrasound/sonogram. We know for sure that no MRI/PET scan/CT was ever done.
They started her chemo a month later, on November 7, 2011. Six rounds of Taxotere + Cytoxan which lasted till February 20, 2012. In the meantime, shortness of breath was a problem since end of December, became acute by March. Doctors basically said they could not do anything to fix the "acute dyspnea". This became less severe over time, but remained for a few more months.
Radiation, scheduled to start after the chemo was done, was delayed due to this dyspnea. On April 20, 2012, started 30 rounds/doses of radiation targeted to the area around where the lump was.
Around middle of May, before the radiation was nearly completed, she had severe chest pains, went to ER, pleural fluid found, tapped 450ml fluid from around left lung, sent it for tests, did not find any cancer. At same time, ultrasound of leg showed blood clot, then heparin injections for 3 months. Liver enzymes were also found to be abnormal at that time but by 3rd week of June, enzyme levels came back to normal, liver function test came back normal, and soon, mom started looking and behaving and eating and living normally. We were all fully convinced that she was cancer free forever (LOL, on hindsight).
So, from mid-May after the radiation was done, for the next 5 months, mom had no further treatment or medicines of any kind besides the heparin. Mom had gone back to work (a part-time clerk in a hospital), looked and felt totally normal besides the occasional pain in the abdomen. Then, mom had a fall two days before a routine mammogram scheduled for Oct 13, 2012, and we requested an MRI rather than a mammogram. After pressuring the primary care doctor, an MRI was done, and lo and behold, "invasive ductal carcinoma of left breast with liver metastasis", confirmed as Stage IV, grade 3, two days later by what my mom calls a "PET scan CT".
More than 80% of the liver was now cancerous (so the oncologist said it was too late for a liver transplant or radiation), it had metastasized to most of her bones on the right side of her body including occipital bone in the back of the head (brain MRI showed no cancer in brain, only on bone), and a few spots in the lungs. Funny thing: a "bone scan" came back completely clear - i.e. no cancer in bones, but the PET scan said otherwise. Anywayz, we started chemo right away coz the oncologist said that her liver was very close to being jaundiced and she would not be alive for her daughter's (my sister's) wedding on Nov. 17, 2012 if we didn't start chemo.
The 1st round of this second chemo regimen (Doxil + Paraplatin) was given on Oct 25. 2nd round on Nov. 20 (delayed by a week coz of my sister's wedding). 3rd round is scheduled for Tuesday, Dec. 11, 2012, three weeks after which they might do a PET scan.
She was hospitalized for 2 weeks from Nov. 17 because of non-stop vomiting coffee ground - endoscopy showed an ulcer at the start of her stomach that was "apparently" causing her vomiting. The 2nd week of her hospital stay she was just throwing up white mucus, no more coffee ground after they started her on a new regimen of gastro-intestinal drugs. Been a week since she's back from the hospital. She's back to eating solid foods, vomiting has stopped.
This is all I know so far about my mom's condition. Suggestions? Advice?View Thread
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