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  • Drugs Before Surgery

    Posted 10/1/2013 by hhill
      Over the past years, there has been an increasing use of "neoadjuvant" treatment for women with newly diagnosed breast cancer. This means that some women have received chemotherapy before surgery (obviously, after a biopsy) in an attempt to shrink the tumor and eventually allow a lumpectomy rather than a mastectomy. In my clinical experience, this has often been successful, and I have known many women whose treatment was planned in this way. Read more... Comments (0)
  • Expert Advice re Triple Negative

    Posted 8/30/2013 by hhill

      First an explanation: I had planned to post this entry tomorrow, but our travel plans have changed, and it clearly is wiser to do so this evening. I realize, as I type this, that it is likely no one will even notice, but I do, and I want to explain on the off chance that anyone is curious. We had hoped to depart for Maine in early to mid afternoon, but things got busy at work, and, by the time we could depart, it clearly would have made no sense. It seems much wiser to get up very early tomorrow morning than to sit in horrible holiday weekend traffic and arrive very late at night.

      So, having said that, the topic of the moment is treatment of triple negative breast cancer. As most of you know, the term refers to breast cancers that are ER negative, PR negative, and her2 negative. This means that none of the known targeted therapies (including hormonal therapies) have any value, but these cancers are especially sensitive to chemotherapy, and many women do just fine.

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  • Scalp Cooling Safe

    Posted 8/28/2013 by hhill
      For many women, the hair loss associated with chemotherapy is almost the worst (or, sometimes, the very worst) part of the whole experience. This was a major topic of conversation in my group yesterday for women who are currently going through adjuvant chemotherapy. One woman has just lost her hair, and another is anticipating the "fall out" this week. It is awful, always, for everyone. No question about it. Although some women insist that they don't care "too much" and adjust fairly easily, I have never met anyone who wasn't traumatized to a greater or lesser degree by new baldness. Read more... Comments (0)
  • Cold Caps for Hair Loss

    Posted 7/24/2013 by hhill
      I have written about so-called Cold Caps before, but just came across a new series of articles about them, so am bringing the topic to you again. This is a good example of "whatever goes around, comes around" as I remember an earlier version of these caps more than twenty years ago. The theory then and now is that wearing an extremely cold cap during chemotherapy infusion causes the blood vessels in your scalp to constrict, reduce blood flow, and thereby reduce hair loss. The possible problems are immediately obvious. Read more... Comments (0)
  • When the First Treatment Does Not Work

    Posted 7/7/2013 by hhill

        Especially for adjuvant treatment, this is not something anyone wants to consider. If you read yesterday's entry about understanding statistics--and even more if you read the other mentioned resource from Cancer Net about understanding cancer research, you are aware that no treatments work equally well on all people. The first choice, the so-called first line or standard treatment, will be the one that has been proven to be the most effective for the most people, but there will be exceptions. This is harder to know in adjuvant therapy until/unless the cancer recurs--then it is sadly clear that the first treatment was not completely effective. Sometimes when a woman is receiving neoadjuvant chemotherapy (chemo given before breast surgery), it will be obvious if the tumor is not shrinking. More often, it comes up in the treatment of advanced or metastatic cancer when tumor markers begin to rise or  scans show progression. Even though women/patients are told that no treatment is going to work forever, that the cancer cells will figure out how to become resistant, it is always shocking and very upsetting when the evidence is clear that it is time for a treatment change.

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