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Treating A Recurrence

11 years 5 months ago #15647 by danpeters
Wendy - Thanks - I'm literally on the way out the door for a consult. I'll add your info to my questions.

Dan

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11 years 5 months ago #15646 by wendy
Dear Dan,

You know...my heart skipped when i saw your message, because, yes, you'd just told me you were doing so well. So, what happened was that my eyes totally missed the part where you wrote docetaxel. All I saw was the letters and name of something I have never heard of -and I thought I'd heard everything - and then I was thinking, "isn't it unethical to ramdomize a recur to a placebo?" Thanks for clearing up the confusion. Maybe I need stronger reading glasses, too.

Yes, docetaxel is pretty common second line, but mostly in combos.

There are more and more studies looking into predictive biomarkers that hopefully can point to more useful drugs and avoid those that aren't useful. A piece of fresh tumor tissue is needed so it may not be possible for you even if you felt like running after that.
http://blcwebcafe.org/content/view/152/163/lang,english/

Know thine options, a cancer survivor's #1 mantra.

Dana Farber is great. But before you commit, please read Steve Dunn's info about clinical trials? His [url=http://http:www.cancerguide.org]http:www.cancerguide.org[/url] site has the best info on the subject. A trial saved his life, cured him of stage IV kidney cancer. His info is very well balanced from the patient's point of view.

I'm sensitive on the subject of clinical trials and chemosensitivity assays, it's personal. I had an assay done when I got dxed with breast ca in '99.

I know needle biopsies are all the rage but isn't a PET less invasive? for the patient and also covered in this setting? I suppose it depends on insurance, and their willingness to do a more expensive test when a cheaper one would do. I am not a medical professional, but if someone is gonna poke my tumor they may as well take it out if possible!

There is some interesting info about surgical removal of lymph node mets, and its contribution to disease free, long term survival. I have an article I will forward, "Impact of multimodal treatments on survival on patients with metastatic urothelial cancer", 3/'07, , where patients who qualified for surgical removal of limited cancerous lymph nodes benefited much more than those who did not have the mets removed, survival was highly increased.

There are other references to similar studies on webcafe's metastatic page.

If you qualify it could be an important avenue to consider, but is not standard. Perhaps this is in trial somewhere, as well....if you had an 'en bloc' removal of this suspicious lymph node you could use conceivably use a piece of it for a sensitivity assay. I hope I haven't overloaded you.

Keep us posted.
Wendy

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11 years 5 months ago #15643 by danpeters
Wendy - Thanks for the info. Once again I have home work to do. Certainly step one is to confirm the nature of the node. The doctors are consulting about its accessibility for biopsy. Regarding a Phase II trial, my initial impression was that docetaxel was commonly used as a second line treatment in BC. The trial is out of Dana-Faber and Columbia (NCT00378794). Everyone gets the standard dose of docetaxel. The study is looking to see what if any effects adding ZD6474 brings to the treatment. If that's so I'm left with understanding the additional side effects of zactima (ZD6474).

Ironic that the day before I got these results I sent you that note about how bad 2007 was and how good 2008 has been. Time to put up or shut up about fighting on. With my new granddaughter's pictures as my screen saver and desktop doing what ever I can to prolong life is an easy decision. The joy (her name is Erin Joy) she brings me far outweighs any pain, frustration or inconvenience that comes with treatment.

Dan

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11 years 5 months ago #15639 by wendy
Dear Dan,

First of all...find out if this is truly a met. Ask for a PET scan before you go further.

As for this clinical trial...if you were my sister (she had bladder cancer, is doing well) I would not let you join a randomized trial for your second line chemo.

There are many combos that have some data behind them that you can choose from, but I would see about another opinion before running through them with this current doctor...maybe.

There are some articles in the new UroToday online magazine, with full articles on the subject of chemo, second line chemo and novel agents, stats and trial researchers names as well. Of course the NCI has all the clincal trials listed as well. Check out webcafe's info and resources for trials, please, to learn as much as you can.

Try not to focus on the stats-I know of more than one person who has had total response to 2nd line chemo post op, one is is 8 yrs out, cancer free, she failed C/G and followed it with Adriamycin/Taxol.

Article: http://www.urotoday.com/browse_categories/bladder_cancer/bjui_mini_reviews__systemic_therapy_for_metastatic_urothelial_carcinoma.html
PS> I thought I should move this to the metastatic section where others in this situation can find it better, hope you don't mind.

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11 years 6 months ago #15623 by julieann
My mother has advanced bladder cancer. I however, won't be much help to you because she opted not to have chemo at all. She now has 3 nodes involved and goes back for tests this week. I'm sorry that you are having this recurrance and I'm sure others will chime in soon that can help you.

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11 years 6 months ago #15609 by danpeters
I've just returned from getting the results of my nine month check up and the CT of my abdomen shows "New enlarged left external iliac lymph node, which may represent metastasis". I can cling to the word "may" in that sentence, but my doctor's initial impression is that it is a recurrence of BC. I'm a soon to be 60 year old male who had a neobladder created in January 2007 and went through Gemcidibine/Cystplatain chemo which ended in June 2007. Things have been really good (clean CT scans and urine)until this news. My doctor is recommending that I join a Phase II trial that will pair docetaxel with ZD6474 (Zactima)or a placebo. His assertion is that there is no "gold standard" for second line treatment in BC but docetaxel is widely used with an anticipation of about a 50% chance of driving the BC into remission. I have an appointment tomorrow for a second opinion, but would like the benefit of the forum's collective experience. So, what's the word on second line treatments. Thanks for sharing.

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