Hi Brandi, I did not take this, but I took Arimidex and had such severe side effects that I had to stop. Reactions to these meds vary; some women do fine on one drug and have reactions to others. I told my doctor right away, she had me stop for a while, tried again, but was always immobilized with pain. It can be dangerous to stop a drug without supervision, as some meds can cause a rebound effect, so check with your doctor. You can look up side effects of fareston here, and search for any other med: www.rxlist.com/fareston-drug.htm Good luck!
Hi Brandi, I did not take this, but I took Arimidex and had such severe side effects that I had to stop. Reactions to these meds vary; some women do fine on one drug and have reactions to others. I told my doctor right away, she had me stop for a while, tried again, but was always immobilized with pain. It can be dangerous to stop a drug without supervision, as some meds can cause a rebound effect, so check with your doctor. You can look up side effects of fareston here, and search for any other med: www.rxlist.com/fareston-drug.htm Good luck!
Breast and ovarian cancer survivors, especially those with, hormone-sensitive cancers, may worry about using ovarian stimulating hormones either during fertility preservation prior to cancer treatment or during survivorship. For fertility preservation purposes, embryo or egg banking are options for many young women. In this process, hormones are used to induce the ovaries to produce multiple eggs in one month (normally an ovary produces a single egg per month). Clinical hormonal stimulation protocols have been modified to work for women with hormone-sensitive cancers. The one study that looked at cancer recurrence rates for breast cancer survivors who underwent this procedure, found that these women did not have an increased risk for cancer recurrence compared to those who did not have ovarian stimulation.
Survivors of hormone-sensitive cancers may also discuss using this protocol with their fertility specialist. However, they may first wish to examine their ovarian reserve, the number of immature eggs in their ovaries, as chemotherapy, radiation, and surgery for cancer treatment may have significantly reduced this number.
Breast and ovarian cancer survivors, especially those with, hormone-sensitive cancers, may worry about using ovarian stimulating hormones either during fertility preservation prior to cancer treatment or during survivorship. For fertility preservation purposes, embryo or egg banking are options for many young women. In this process, hormones are used to induce the ovaries to produce multiple eggs in one month (normally an ovary produces a single egg per month). Clinical hormonal stimulation protocols have been modified to work for women with hormone-sensitive cancers. The one study that looked at cancer recurrence rates for breast cancer survivors who underwent this procedure, found that these women did not have an increased risk for cancer recurrence compared to those who did not have ovarian stimulation.
Survivors of hormone-sensitive cancers may also discuss using this protocol with their fertility specialist. However, they may first wish to examine their ovarian reserve, the number of immature eggs in their ovaries, as chemotherapy, radiation, and surgery for cancer treatment may have significantly reduced this number.
Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):
1) Life/family responsibilities (i.e. your energy demands) 2) How regularly & intensely you trained before chemo 3) Resources ($, access to exercise equipment, facilities, etc) 4) Current energy levels and your energy cycles (i.e. good day vs bad day)
Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.
Exercise ---------- * Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.
* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.
* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.
* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.
* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:
Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.
Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.
* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.
Nutritionally ---------------- * Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.
* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.
* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!
* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.
* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)
I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!!
Kathleen,
Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):
1) Life/family responsibilities (i.e. your energy demands) 2) How regularly & intensely you trained before chemo 3) Resources ($, access to exercise equipment, facilities, etc) 4) Current energy levels and your energy cycles (i.e. good day vs bad day)
Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.
Exercise ---------- * Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.
* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.
* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.
* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.
* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:
Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.
Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.
* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.
Nutritionally ---------------- * Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.
* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.
* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!
* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.
* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)
I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!!
Similar to a previous answer (http://talkabouthealth.com/for-what-types-of-non-hodgkin-lymphoma-is-rituxan-a-typical-treatment-option), the B cell non-Hodgkin’s lymphomas are usually treated with Rituxan. This is because all but a few of these lymphomas express CD20, the target antigen that Rituxan binds to. Rituxan has been shown the be beneficial a single agent therapy in indolent lymphomas, when combined with chemotherapy (R-CHOP or R-CVP are two examples) and for maintenance after initial treatment in the case of indolent lymphomas.
Similar to a previous answer (http://talkabouthealth.com/for-what-types-of-non-hodgkin-lymphoma-is-rituxan-a-typical-treatment-option), the B cell non-Hodgkin’s lymphomas are usually treated with Rituxan. This is because all but a few of these lymphomas express CD20, the target antigen that Rituxan binds to. Rituxan has been shown the be beneficial a single agent therapy in indolent lymphomas, when combined with chemotherapy (R-CHOP or R-CVP are two examples) and for maintenance after initial treatment in the case of indolent lymphomas.
R-CHOP (cycophosphamide, adriamycin, vincristine and prednisone, with rituximab) is the standard front-line therapy for diffuse large cell lymphoma and older patients with mantle cell lymphoma. Hyper-CVAD ( a more intensive regimen of cyclophophamide, vincristine, and doxorubicin, alternating with cytosine arabinoside and methotrexate) is often used for younger patients who have mantle cell lymphoma or Burkitts lymphomas. Patients with follicular lyphomas may receive CVP (a gentler form of cyclophosphamide, vincristine and prednisone) with rituximab or receive single agent rituximab.
R-CHOP (cycophosphamide, adriamycin, vincristine and prednisone, with rituximab) is the standard front-line therapy for diffuse large cell lymphoma and older patients with mantle cell lymphoma. Hyper-CVAD ( a more intensive regimen of cyclophophamide, vincristine, and doxorubicin, alternating with cytosine arabinoside and methotrexate) is often used for younger patients who have mantle cell lymphoma or Burkitts lymphomas. Patients with follicular lyphomas may receive CVP (a gentler form of cyclophosphamide, vincristine and prednisone) with rituximab or receive single agent rituximab.
Rituxan is a useful drug for B-cell lymphomas. Most B-cell lymphomas express the B-cell marker protein CD20. Rituxan is a monoclonal antibody with specificity for B cell lymphomas expressing CD20. These include follicular, diffuse large cell, mantle cell and several other types.
Rituxan is a useful drug for B-cell lymphomas. Most B-cell lymphomas express the B-cell marker protein CD20. Rituxan is a monoclonal antibody with specificity for B cell lymphomas expressing CD20. These include follicular, diffuse large cell, mantle cell and several other types.
There are a variety of physician preferences for following tumors during therapy, but the approach used in most clinical trials is a standard CT scan every other cycle of chemotherapy. There is increasing use of PET scanning, but this is experimental, expensive, and there is a high risk of getting misleading information from a PET that could result in inappropriate changes in therapy.
There are a variety of physician preferences for following tumors during therapy, but the approach used in most clinical trials is a standard CT scan every other cycle of chemotherapy. There is increasing use of PET scanning, but this is experimental, expensive, and there is a high risk of getting misleading information from a PET that could result in inappropriate changes in therapy.
murray (Friend) voted for answer by DavidCarboneMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
These drugs are being tested in clinical trials after surgery or chemoradiation in stage I to 3 lung cancer, but the evidence available so far do not demonstrate that they work in this setting. I do not recommend using these drugs in the curative-intent setting unless as part of a clinical trial.
These drugs are being tested in clinical trials after surgery or chemoradiation in stage I to 3 lung cancer, but the evidence available so far do not demonstrate that they work in this setting. I do not recommend using these drugs in the curative-intent setting unless as part of a clinical trial.
Xalkori is very successful in causing tumor shrinkage in most patients whose tumors have an ALK fusion. Efficacy is usually measured by tumor shrinkage, time to progression or survival.
Xalkori is very successful in causing tumor shrinkage in most patients whose tumors have an ALK fusion. Efficacy is usually measured by tumor shrinkage, time to progression or survival.
The standard recommendation is for five years of aromatase therapy based on our present knowledge and the results of numerous large clinical trials that compared aromatase inhibitors to tamoxifen. It is also an acceptable strategy to initiate therapy with tamoxifen and switch to an aromatase inhibitor after 2 to 3 years to complete a total of five years of therapy. Based on evidence from a large clinical trial, it is also acceptable to switch to tamoxifen from an aromatase inhibitor; this is an option for individuals who are experiencing difficult side effects with aromatase inhibitors.
The standard recommendation is for five years of aromatase therapy based on our present knowledge and the results of numerous large clinical trials that compared aromatase inhibitors to tamoxifen. It is also an acceptable strategy to initiate therapy with tamoxifen and switch to an aromatase inhibitor after 2 to 3 years to complete a total of five years of therapy. Based on evidence from a large clinical trial, it is also acceptable to switch to tamoxifen from an aromatase inhibitor; this is an option for individuals who are experiencing difficult side effects with aromatase inhibitors.
This may vary depending on the individual and their risk for bone density loss or fracture. It is important when starting an aromatase inhibitor that you have a baseline bone mineral density study (referred to as a DEXA scan) and a clinical assessment for other potential risk factors for osteoporosis (defined as a T score < 2.5 on a DEXA scan by the World Health Organization). These risks include older age, previous fracture, low body weight, current tobacco use, and excessive alcohol consumption, among others. I encourage all women starting an aromatase inhibitor to adopt lifestyle changes that promote not only bone health but overall health as well. These include increasing physical activity (including weight bearing exercise), stopping smoking, and taking calcium and vitamin D supplements. Some individuals starting an aromatase inhibitor may be advised to take drug therapy with bisphosphonates if they have osteoporosis or a history of a fracture or osteopenia (http://www.medterms.com/script/main/art.asp?articlekey=8048)(T-score between -1 and -2.5 on a DEXA scan) with other risk factors. There is no consensus on the optimal strategy for monitoring but every two years is a common strategy.
This may vary depending on the individual and their risk for bone density loss or fracture. It is important when starting an aromatase inhibitor that you have a baseline bone mineral density study (referred to as a DEXA scan) and a clinical assessment for other potential risk factors for osteoporosis (defined as a T score < 2.5 on a DEXA scan by the World Health Organization). These risks include older age, previous fracture, low body weight, current tobacco use, and excessive alcohol consumption, among others. I encourage all women starting an aromatase inhibitor to adopt lifestyle changes that promote not only bone health but overall health as well. These include increasing physical activity (including weight bearing exercise), stopping smoking, and taking calcium and vitamin D supplements. Some individuals starting an aromatase inhibitor may be advised to take drug therapy with bisphosphonates if they have osteoporosis or a history of a fracture or osteopenia (http://www.medterms.com/script/main/art.asp?articlekey=8048)(T-score between -1 and -2.5 on a DEXA scan) with other risk factors. There is no consensus on the optimal strategy for monitoring but every two years is a common strategy.
Aromatase inhibitors lower estrogen levels in your body and this estrogen deficiency leads to increased bone turnover and bone loss. This side effect, however, does not reflect whether the medication is working for your breast cancer. Estrogen is known to stimulate hormone receptor positive breast tumor cells and aromatase inhibitors are very effective at lowering estrogen levels and thereby removing this growth signal and resulting in tumor cell death. Thus, the lowering of estrogen is a critical reason why these drugs work so well to treat hormone receptor positive breast cancer but may have, at the same time, a negative impact on bone health.
Aromatase inhibitors lower estrogen levels in your body and this estrogen deficiency leads to increased bone turnover and bone loss. This side effect, however, does not reflect whether the medication is working for your breast cancer. Estrogen is known to stimulate hormone receptor positive breast tumor cells and aromatase inhibitors are very effective at lowering estrogen levels and thereby removing this growth signal and resulting in tumor cell death. Thus, the lowering of estrogen is a critical reason why these drugs work so well to treat hormone receptor positive breast cancer but may have, at the same time, a negative impact on bone health.
The role of hormonal therapy for risk reduction should be carefully considered and discussed with experts in breast cancer risk assessment and management in a shared decision-making environment. Guidelines from expert groups recommend that the risks and benefits of breast cancer prevention be discussed with premenopausal and postmenopausal women who are at high risk for the disease.
Women at high risk may include some women over the age of 60; women with certain high-risk conditions found on breast biopsy, such as lobular carcinoma in situ (LCIS) or atypical ductal or lobular hyperplasia; women between the ages of 35 and 59 years who have a calculated five-year risk of developing breast cancer of 1.7 percent or higher, according to a system called the Gail model. The Gail model uses a woman's current age, age at first menstrual period, age at first live birth, the number of first-degree relatives with breast cancer, and the number and pathologic findings of any breast biopsies to estimate the probability of breast cancer over time. This model, and others, is used by health professionals to calculate an individual’s risk and the results should be interpreted with an expert in breast cancer risk assessment. It is also important to remember that the presence of breast cancer risk factors does not mean that cancer is inevitable as many women with risk factors never develop breast cancer.
Another very important issue is that the Gail model does not consider the risk of cancer associated with inherited breast cancer-predisposing genes such as BRCA1 and BRCA2. If an individual has a strong family history that suggests the possibility of an inherited predisposition to breast cancer, then that individual should be referred for genetic counseling. Other components of a risk/benefit assessment and counseling include a careful discussion of the side effects of hormonal therapy, options for participation in clinical research and healthy lifestyle changes.
The role of hormonal therapy for risk reduction should be carefully considered and discussed with experts in breast cancer risk assessment and management in a shared decision-making environment. Guidelines from expert groups recommend that the risks and benefits of breast cancer prevention be discussed with premenopausal and postmenopausal women who are at high risk for the disease.
Women at high risk may include some women over the age of 60; women with certain high-risk conditions found on breast biopsy, such as lobular carcinoma in situ (LCIS) or atypical ductal or lobular hyperplasia; women between the ages of 35 and 59 years who have a calculated five-year risk of developing breast cancer of 1.7 percent or higher, according to a system called the Gail model. The Gail model uses a woman's current age, age at first menstrual period, age at first live birth, the number of first-degree relatives with breast cancer, and the number and pathologic findings of any breast biopsies to estimate the probability of breast cancer over time. This model, and others, is used by health professionals to calculate an individual’s risk and the results should be interpreted with an expert in breast cancer risk assessment. It is also important to remember that the presence of breast cancer risk factors does not mean that cancer is inevitable as many women with risk factors never develop breast cancer.
Another very important issue is that the Gail model does not consider the risk of cancer associated with inherited breast cancer-predisposing genes such as BRCA1 and BRCA2. If an individual has a strong family history that suggests the possibility of an inherited predisposition to breast cancer, then that individual should be referred for genetic counseling. Other components of a risk/benefit assessment and counseling include a careful discussion of the side effects of hormonal therapy, options for participation in clinical research and healthy lifestyle changes.
Initiation of hormonal therapy is commonly begun after the completion of chemotherapy (and after completion of radiation therapy if you receive both). In terms of actual timing, hormonal therapy will typically begin approximately four to six weeks following completion of chemotherapy. A preference for sequential timing of chemotherapy and hormonal therapy, i.e., adjuvant chemotherapy followed by hormonal therapy, was suggested by a clinical trial, in which sequential versus concurrent chemo/hormonal therapy were directly compared and sequential treatment had superior outcomes for disease free and overall survival.
I would add that there are limited clinical data and no consensus on the use of concurrent hormonal therapy and radiation therapy, thus some medical oncologists advise overlap of hormonal therapy with radiation and others advise waiting until radiation is complete. I generally advise waiting until radiation is complete.
Initiation of hormonal therapy is commonly begun after the completion of chemotherapy (and after completion of radiation therapy if you receive both). In terms of actual timing, hormonal therapy will typically begin approximately four to six weeks following completion of chemotherapy. A preference for sequential timing of chemotherapy and hormonal therapy, i.e., adjuvant chemotherapy followed by hormonal therapy, was suggested by a clinical trial, in which sequential versus concurrent chemo/hormonal therapy were directly compared and sequential treatment had superior outcomes for disease free and overall survival.
I would add that there are limited clinical data and no consensus on the use of concurrent hormonal therapy and radiation therapy, thus some medical oncologists advise overlap of hormonal therapy with radiation and others advise waiting until radiation is complete. I generally advise waiting until radiation is complete.
Assuming you are talking about adjuvant therapy here, the answer is split into pre and post menopausal women. Most premenopausal women are asked to start on Tamoxifen but some may get an AI plus a zoladex shot (to make them postmenopausal). In that case, the advice is 5 years. If you are premenopausal and start on Tamoxifen but then become postmenopausal, you may be switched to an AI for 5 years after 5 years of tamoxifen.
For postmenopausal women, it is typically 5 years of an AI only OR it could be 5 years of an AI AFTER 5 years of tamoxifen.
Assuming you are talking about adjuvant therapy here, the answer is split into pre and post menopausal women. Most premenopausal women are asked to start on Tamoxifen but some may get an AI plus a zoladex shot (to make them postmenopausal). In that case, the advice is 5 years. If you are premenopausal and start on Tamoxifen but then become postmenopausal, you may be switched to an AI for 5 years after 5 years of tamoxifen.
For postmenopausal women, it is typically 5 years of an AI only OR it could be 5 years of an AI AFTER 5 years of tamoxifen.
There were some early reports in the literature that soy foods may reduce the effectiveness of Tamoxifen in animal studies, but at least one study from the Univ of So Cal (wu, JCO, 2007) showed that soy food consumption had no effect on the active metabolites of Tamoxifen in Asian American breast cancer survivors.
There were some early reports in the literature that soy foods may reduce the effectiveness of Tamoxifen in animal studies, but at least one study from the Univ of So Cal (wu, JCO, 2007) showed that soy food consumption had no effect on the active metabolites of Tamoxifen in Asian American breast cancer survivors.
As with radiation, anti-oxidants in supplement form can interfere with many chemotherapy treatments but there is no evidence that the anti-oxidants found in whole foods are harmful (againnot dehydrated, concentrated versions of what was once a whole food). If your chemotherapy will decrease your infection fighting cells (as most do) then your doctor or nurse will likely tell you to avoid unpeeled fruits and vegetables and sushi. There are also some foods that should be avoided with specific chemotherapies and your oncologist or chemotherapy nurse can tell you what these are if any.
As with radiation, anti-oxidants in supplement form can interfere with many chemotherapy treatments but there is no evidence that the anti-oxidants found in whole foods are harmful (againnot dehydrated, concentrated versions of what was once a whole food). If your chemotherapy will decrease your infection fighting cells (as most do) then your doctor or nurse will likely tell you to avoid unpeeled fruits and vegetables and sushi. There are also some foods that should be avoided with specific chemotherapies and your oncologist or chemotherapy nurse can tell you what these are if any.
No, I did not begin taking Tamoxifen until after my son was born. Tamoxifen is harmful to fetuses and should not be taken while pregnant.
No, I did not begin taking Tamoxifen until after my son was born. Tamoxifen is harmful to fetuses and should not be taken while pregnant.
The FDA’s approval in 2011 of Zelboraf (vemurafenib) is another important step in what is a rapidly changing landscape for melanoma and cancer therapy in general. Some cancers are formed when, inside a cell, a signal is passed from one molecule to another, like a game of telephone. Zelboraf stops that signal from being sent and, in doing so, stops the growth of the cancer. Data published in February of 2012 in the New England Journal of Medicine showed that Zelboraf extended average survival to about 16 months for stage IV melanoma patients whose tumors had BRAF mutations. The drug was generally well tolerated with minimal side effects. These results, while promising on their own, are a stepping stone to another exciting prospect in cancer research: combining drugs like vemurafenib with other therapies, where two treatments used together might be more effective than each one by itself.
The FDA’s approval in 2011 of Zelboraf (vemurafenib) is another important step in what is a rapidly changing landscape for melanoma and cancer therapy in general. Some cancers are formed when, inside a cell, a signal is passed from one molecule to another, like a game of telephone. Zelboraf stops that signal from being sent and, in doing so, stops the growth of the cancer. Data published in February of 2012 in the New England Journal of Medicine showed that Zelboraf extended average survival to about 16 months for stage IV melanoma patients whose tumors had BRAF mutations. The drug was generally well tolerated with minimal side effects. These results, while promising on their own, are a stepping stone to another exciting prospect in cancer research: combining drugs like vemurafenib with other therapies, where two treatments used together might be more effective than each one by itself.
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Good luck! Hi Brandi, I did not take this, but I took Arimidex and had such severe side effects that I had to stop. Reactions to these meds vary; some women do fine on one drug and have reactions to others. I told my doctor right away, she had me stop for a while, tried again, but was always immobilized with pain. It can be dangerous to stop a drug without supervision, as some meds can cause a rebound effect, so check with your doctor. You can look up side effects of fareston here, and search for any other med: www.rxlist.com/fareston-drug.htm
Good luck!
Survivors of hormone-sensitive cancers may also discuss using this protocol with their fertility specialist. However, they may first wish to examine their ovarian reserve, the number of immature eggs in their ovaries, as chemotherapy, radiation, and surgery for cancer treatment may have significantly reduced this number.
Breast and ovarian cancer survivors, especially those with, hormone-sensitive cancers, may worry about using ovarian stimulating hormones either during fertility preservation prior to cancer treatment or during survivorship. For fertility preservation purposes, embryo or egg banking are options for many young women. In this process, hormones are used to induce the ovaries to produce multiple eggs in one month (normally an ovary produces a single egg per month). Clinical hormonal stimulation protocols have been modified to work for women with hormone-sensitive cancers. The one study that looked at cancer recurrence rates for breast cancer survivors who underwent this procedure, found that these women did not have an increased risk for cancer recurrence compared to those who did not have ovarian stimulation.
Survivors of hormone-sensitive cancers may also discuss using this protocol with their fertility specialist. However, they may first wish to examine their ovarian reserve, the number of immature eggs in their ovaries, as chemotherapy, radiation, and surgery for cancer treatment may have significantly reduced this number.
Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):
1) Life/family responsibilities (i.e. your energy demands)
2) How regularly & intensely you trained before chemo
3) Resources ($, access to exercise equipment, facilities, etc)
4) Current energy levels and your energy cycles (i.e. good day vs bad day)
Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.
Exercise
----------
* Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.
* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.
* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.
* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.
* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:
Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.
Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.
* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.
Nutritionally
----------------
* Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.
* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.
* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!
* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.
* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)
I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!! Kathleen,
Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):
1) Life/family responsibilities (i.e. your energy demands)
2) How regularly & intensely you trained before chemo
3) Resources ($, access to exercise equipment, facilities, etc)
4) Current energy levels and your energy cycles (i.e. good day vs bad day)
Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.
Exercise
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* Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.
* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.
* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.
* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.
* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:
Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.
Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.
* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.
Nutritionally
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* Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.
* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.
* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!
* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.
* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)
I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!!
Women at high risk may include some women over the age of 60; women with certain high-risk conditions found on breast biopsy, such as lobular carcinoma in situ (LCIS) or atypical ductal or lobular hyperplasia; women between the ages of 35 and 59 years who have a calculated five-year risk of developing breast cancer of 1.7 percent or higher, according to a system called the Gail model. The Gail model uses a woman's current age, age at first menstrual period, age at first live birth, the number of first-degree relatives with breast cancer, and the number and pathologic findings of any breast biopsies to estimate the probability of breast cancer over time. This model, and others, is used by health professionals to calculate an individual’s risk and the results should be interpreted with an expert in breast cancer risk assessment. It is also important to remember that the presence of breast cancer risk factors does not mean that cancer is inevitable as many women with risk factors never develop breast cancer.
Another very important issue is that the Gail model does not consider the risk of cancer associated with inherited breast cancer-predisposing genes such as BRCA1 and BRCA2. If an individual has a strong family history that suggests the possibility of an inherited predisposition to breast cancer, then that individual should be referred for genetic counseling. Other components of a risk/benefit assessment and counseling include a careful discussion of the side effects of hormonal therapy, options for participation in clinical research and healthy lifestyle changes. The role of hormonal therapy for risk reduction should be carefully considered and discussed with experts in breast cancer risk assessment and management in a shared decision-making environment. Guidelines from expert groups recommend that the risks and benefits of breast cancer prevention be discussed with premenopausal and postmenopausal women who are at high risk for the disease.
Women at high risk may include some women over the age of 60; women with certain high-risk conditions found on breast biopsy, such as lobular carcinoma in situ (LCIS) or atypical ductal or lobular hyperplasia; women between the ages of 35 and 59 years who have a calculated five-year risk of developing breast cancer of 1.7 percent or higher, according to a system called the Gail model. The Gail model uses a woman's current age, age at first menstrual period, age at first live birth, the number of first-degree relatives with breast cancer, and the number and pathologic findings of any breast biopsies to estimate the probability of breast cancer over time. This model, and others, is used by health professionals to calculate an individual’s risk and the results should be interpreted with an expert in breast cancer risk assessment. It is also important to remember that the presence of breast cancer risk factors does not mean that cancer is inevitable as many women with risk factors never develop breast cancer.
Another very important issue is that the Gail model does not consider the risk of cancer associated with inherited breast cancer-predisposing genes such as BRCA1 and BRCA2. If an individual has a strong family history that suggests the possibility of an inherited predisposition to breast cancer, then that individual should be referred for genetic counseling. Other components of a risk/benefit assessment and counseling include a careful discussion of the side effects of hormonal therapy, options for participation in clinical research and healthy lifestyle changes.
I would add that there are limited clinical data and no consensus on the use of concurrent hormonal therapy and radiation therapy, thus some medical oncologists advise overlap of hormonal therapy with radiation and others advise waiting until radiation is complete. I generally advise waiting until radiation is complete. Initiation of hormonal therapy is commonly begun after the completion of chemotherapy (and after completion of radiation therapy if you receive both). In terms of actual timing, hormonal therapy will typically begin approximately four to six weeks following completion of chemotherapy. A preference for sequential timing of chemotherapy and hormonal therapy, i.e., adjuvant chemotherapy followed by hormonal therapy, was suggested by a clinical trial, in which sequential versus concurrent chemo/hormonal therapy were directly compared and sequential treatment had superior outcomes for disease free and overall survival.
I would add that there are limited clinical data and no consensus on the use of concurrent hormonal therapy and radiation therapy, thus some medical oncologists advise overlap of hormonal therapy with radiation and others advise waiting until radiation is complete. I generally advise waiting until radiation is complete.
For postmenopausal women, it is typically 5 years of an AI only OR it could be 5 years of an AI AFTER 5 years of tamoxifen.
Assuming you are talking about adjuvant therapy here, the answer is split into pre and post menopausal women. Most premenopausal women are asked to start on Tamoxifen but some may get an AI plus a zoladex shot (to make them postmenopausal). In that case, the advice is 5 years. If you are premenopausal and start on Tamoxifen but then become postmenopausal, you may be switched to an AI for 5 years after 5 years of tamoxifen.
For postmenopausal women, it is typically 5 years of an AI only OR it could be 5 years of an AI AFTER 5 years of tamoxifen.
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