Monthly Archives: March 2017

Perhaps, perhaps, perhaps….

I had the treatment of group B of these women. Looks like I might be lucky….That said, trial was for regular breast cancer, early diagnosis and I was late and this was not trialled for my rarer form of inflammatory breast cancer

However….The Texas Programme for Inflammatory Breast Cancer issued this (rather lengthy) statement, which I have shortened.

Those of you who are active on social media may have noticed that this week, Genentech announced that their ongoing phase 3 trial of Pertuzumab (Perjeta) along with Trastuzumab (Herceptin) and chemotherapy has reached its primary endpoint (https://www.gene.com/…/phase-iii-aphinity-study-shows-genen…). The press release notes that the results would be shared at a major medical conference this year. We’d like to proactively answer some questions about the impact of these results on IBC care with this post.

Trial design:
Patient population: Early breast cancer patients (IBC excluded) with HER2+ tumors, removed by surgery and who are candidates for adjuvant chemotherapy with a Trastuzumab-containing regimen.

Study arms: Physicians choice of 3 acceptable standard types of chemotherapy along with Trastuzumab for everyone for 6-8 cycles, followed by Trastuzumab to complete 1 year. 50% of patients received Pertuzumab in addition to this for the whole year and the rest received a placebo.

Take-home for IBC patients: All we know from the press-release so far is that the result is positive, but we don’t know the details. These data have only a limited impact on how we approach IBC care due to the fact that the current standard of care for IBC is neoadjuvant (pre-surgical) chemotherapy. The FDA approval label for Pertuzumab specifically includes IBC and we routinely use Pertuzumab for our HER2+ IBC patients.

Inflammatory breast cancer is treated with neoadjuvant chemotherapy – chemo first, surgery/radiotherapy afterwards….

So…perhaps, perhaps, perhaps (do click to hear Doris!)

 

Advertisements

Stoned

4 therapists (so far). One opinion. One reaction – all reduced to laughter as none had encountered such a knotty specimen as I presented. The unknotting work has begun. Neck and back combo done outdoors in a warm breeze. Ayurveda next, a practice which combines preventive and palliative care. Warm oils were drizzled over me as I was kneaded by 4 hands in a 75 minute  Abhyanga massage. 

A glutton for punishment I progressed to a deep tissue massage, a very deep tissue workout. An experience so pain filled,  I yelped and whined but Natasha persuaded me to go with it, she thinks she can fix me. Even my feet caused hilarity  in the final session of the day because they were so rigid and tense,  my lovely practitioner couldnt take control. 

Hot stones….Hot stones may just be the answer. Some bit of the knot seems to have eased and the stoner therapist struggled to get me to leave.

Whilst my brain may finally be edging toward recovery mode, my stress has taken root, like burs in neck, shoulders, thighs, calves AND feet. I notice that after these treatments my back is bruised all over. Royally bruised I should say – in a very fetching shade of purple. Now looking forward to Chavutti and more deep tissue “work” …Chavutti, I gather, involves someone walking along my spine whilst hanging onto a rope. Apparently I will end up feeling taller as my spine is ironed out. I am suspending my cynical side and, for the time being, I believe!

As I enjoyed/endured I focused (in a mindful kinda way) on how wonderful it was to be touched again. Cancer is such a  journey of being handled. I hadn’t clocked how much this other handling was missing from my life. Maybe some of the tears were about loss and re – connecting with a world of loving people. As my head was massaged and my hair stroked I seemed to recall a softer version of myself bubbling up. Maybe I can start to bring this less brittle person back, I can hope…

 My other thought, as my feet were indulged, was the known reaction of my, now dead, friend. She was so averse to feet touching, that, even with 2 dislocated shoulders, nobody was allowed to cut her toenails or even approach them. She would have shut her ears and started a loud LA LA LA refrain when I tried to tell her about it. Not that it would have stopped me.