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This question was answered on Wed 16, Sep 2009 07:55am by Dr. Monica, MD

Breast cancer with metastases to the lung


    
Asked by catialucero (Female; 79; Lupus thyroidectomy breast cancer in 2000. ) on Mon 14, Sep 2009 03:28pm

Hello, My mother in law's breast cancer has returned after 9 years in remission. She had a PT scan which revealed the cancer is now in her lung. After having surgery to remove it, they decided it is too late to touch it. Diagnosis is Stage IV. She is 79 years old. She is going thru chemo - 3 rounds out of 6 (adriamycin and cytoxan). She thought of quitting due to the heavy side effects. She is weak and frail more and more everyday. -what is her prognosis? (I never asked the doctor because I hate to ask such a question in front of her.) -is chemo going to benefit her life quality in the long run? -is there a build-up of toxicity as her treatments progress? thank you very much
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Answer by Dr. Monica, MD  on Wed 16, Sep 2009 07:55am:

Hi, How has she responded to the 3 cycles of chemotherapy? Chemotherapy is associated wth a lot of side effects which can adversely impact the quality of life. Adriamycin has a cumulative toxicity on the heart. It is worth continuing the chemotherapy only if she has shown a good response to the chemo given so far. Other options with lower toxicity would be hormonal therapy if the tumor is hormone responsive or targetted therapy. Please discuss your concerns with the doctor. Your mother-in-law will have many concerns of her own too and is probably shying away from discussing the same with her doctor for the same reasons that you are. Both the patient and his/her family is under a lot of emotional strain in such situations. Although it is difficult, you need to have an open discussion with the doctor and amongst yourselves. This will not only help all of you to plan the further course of action but also strengthen the bond between you and provide emotional support to each other. It may be a good idea to consult a psychologist too. All the best

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Comment by catialucero on Wed 16, Sep 2009 11:49am: Thanks. There is a lot of strain, absolutely. She doesn't discuss her disease often, mostly never. You're probably right, she is shying away. There is no mention from her oncologist in checking her progress to see if the chemo is working. We are aware that adriamycin can cause heart problems; echocardiograms were provided to the oncologist (it shows a healthy heart in february 09, with mild mitral valve prolapse.). She has developed horrible sores on her back now, which began sometime after the second treatment. Her primary care physician checked but is not sure what could be. She fears it could be mursa??? not sure if it is spelled like this. Her HER factor is negative. Hormonal treatment was not an option for her - not sure why. Her oncologist doesn't seem to be on top of her game - she is forgetful, distracted. Numerous times we had problems with her delayed response when my mother in law has side effects. She only decided to continue because her primary care physician, more or less talked her into continuing, because it is not good to be a quitter - his words. My mother-in-law respects his point of view and made the decision to continue. I believe it is best to push the doctor to check if some progress has been done so far. What kind of test would be performed to verify that??????????? thank you.
Comment by Dr. Monica, MD on Thu 17, Sep 2009 09:06am: Hi, An xray or CT scan of the chest may be helpful to assess the response of the metastatic lung disease. All the best
Comment by catialucero on Fri 18, Sep 2009 08:16pm: Hello Dr. Monica, Thanks for the reply once more. We should see the doctor on Monday again. Her blood count is extremely low right now. Her granules are non-existing as of today; she got a shot of neupogen due to her extremely low white blood count. Monday when we the doc I'll bring up the subject. Thanks once again.

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