Friday, April 05, 2002 6:09 PM
Subject: Karla


> 4/4/02
>
> Results of Karla's first visit with the medical-oncologist, Dr. FaiChe
> Lee@ UNM Cancer Center
>
>
> Dr. Lee confirms diagnosis of inflammatory breast cancer and recommends
> aggressive chemotherapy with a total of 8 rounds consisting of 4 rounds
> of Adriamycin/Cytoxan combination followed immediately by 4 rounds of
> Taxol or Taxotier. This is neo-adjuvant therapy meaning chemo before
> surgery. Results of most recent studies show this combo most effective
> in reducing tumor size or eliminating tumor prior to surgical
> intervention in the form of lumpectomy or mastectomy. Dr. Lee says that
> 14-15% of women receiving this particular therapy have no evidence of
> tumor after the chemotherapy. He says further that 2/3 of the women who
> had planned mastectomy following chemo were able to have a lumpectomy
> instead. The chemo will be delivered every three weeks in the Infusion
> suites at the Cancer Center, intravenously through a Porta-Cath. This is
> a central line catheter which will be placed under the skin in her upper
> chest. It is an out-patient procedure done with local anesthesia. It
> will be nearly invisible, and allow the chemo needle to be placed each
> time with relative ease and minimal discomfort for Karla.
>
> So-the plan now is for 8 rounds of chemo (3 weeks apart), then surgery
> (either lumpectomy or mastectomy, to be determined by her response to
> the chemo) followed by radiation therapy. Dr. Lee said this will all be
> completed after close to a years time.
>
> The good news is her labs came back estrogen receptor positive and the
> bad news is the HRTII was positive. Not sure of the implications of
> either of these but for those of you who are oncologists, it may mean
> something. The surgeon said on Wednesday that the cancer is a Stage III.
>
> He will treat her concurrently with tamoxifen, an oral hormone therapy
> that he feels will add to the aggressiveness of the treatment.
>
> The chemo can cause fatigue due in part to anemia from bone marrow
> suppression. White blood cells can decrease, making her less able to
> fight off infection, and her platelet levels can decrease (platelets
> help the blood to clot) She will loose her hair after the second round
> of chemo. He says typically the week after, a person will feel tired;
> the second week the bone marrow is suppressed and the third week the
> bone marrow recovers. Nausea can also occur after chemo. He gave her
> medication for this. He said he would, if needed, use a medication
> called Procrit if she needed it to fight the anemia, which might also
> help with fatigue. The good news, he says,  is that Karla is in
> excellent physical shape, and the fact that she is a runner and a cycler
> will only add to the bodies ability to respond to the chemo and add to
> her bodies ability to fight infection, to offset the negative symptoms
> of chemo, and have a positive impact on survival. He recommends a good
> diet and continued exercise throughout, as she is able. He says some
> women aren't even bothered too much by the chemo! He agrees to her using
> herbal medicine and is  open minded about the use of complimentary
> therapy.
>
> Dr. Lee wasn't able to give us information on the possibility of cure.
> He says everyone responds differently and we just have to take it a step
> at a time. He has ordered a bone scan to determine if it has spread to
> the bone. If there is bone metastases, the goal will be palliative, and
> if not the goal will be curative. He says whether the goal is palliative
> or curative, we will do chemo either way. He did say there was lymph
> node involvement.
>
> There is lots of info on the internet on INFLAMMATORY BREAST CANCER. I
> did a "search" through MSN. It will be a difficult year, but CURE is
> possible! The positive mind-body connection that  is so strong in Karla,
> modern medicine, and the collective love, prayers , positive energy and
> support of so many that love her will only add to the CURE potential.
>
> SHE WILL BE AMONG THE PERCENTAGE OF WOMEN WHO ARE CURED!!!
>
>
> Her schedule thus far:
>
> Tues     4/9     2:00 :  Teaching session for Porta-Cath self care and
> chemo
>
> Fri         4/12   10:00:  Porta-Cath placement
>                         To follow: Ist Chemo
>
> Wed      4/17    8:00:    Bone Scan
>
> Mon      5/6      9:30:     2nd Chemo
>
>
> Karla will have subsequent chemo treatments on Mondays every 3 weeks
>
>
> -Kris Coughenour
>
>