Treatments

Constipation is an expected and predictable side effect of opioid medications. It is one of the few side effects to which a patient will never develop tolerance, in other words, this side effect will never go away. For these reasons it is most important that a patient is provided with a prescription for a bowel regimen to prevent constipation whenever they are started on an opioid medication. In general, patients are started on a laxative such as sennakot, and a stool softener, such as docusate. If patients become constipated despite the prophylaxis they may be started on additional laxatives such as lactulose, dulcolax or miralax. Patients who are taking opioids and do not have a bowel movement for >48 hours despite being on a bowel regimen should be in contact with their physician for further recommendations and treatment. Constipation is an expected and predictable side effect of opioid medications. It is one of the few side effects to which a patient will never develop tolerance, in other words, this side effect will never go away. For these reasons it is most important that a patient is provided with a prescription for a bowel regimen to prevent constipation whenever they are started on an opioid medication. In general, patients are started on a laxative such as sennakot, and a stool softener, such as docusate. If patients become constipated despite the prophylaxis they may be started on additional laxatives such as lactulose, dulcolax or miralax. Patients who are taking opioids and do not have a bowel movement for >48 hours despite being on a bowel regimen should be in contact with their physician for further recommendations and treatment.

I've had lymphatic massage and a compression garments for my left arm to help with my lymphedema. »Interestingly enough, it was my osteopath who started loosening some on my arm and pectoral muscles that did the best job of all. I was an inch bigger in the upper arm before I saw him a few times and after a few weeks both arms were back to the exact same size. Now I wear my compression garment only for airflight. What a relief and do I need to tell you it's not very sexy during summer time! LOL Typically using lymphatic massage or compresion garments. Garments are offered FREE through http://crickettsanswerforcancer.com
Yes. I said FREE! :) Good luck!

I guess there are three or more components of preparing for a new round of chemotherapy treatments.
The first would be psychological, getting your head around the fact you need to have more treatment, either because of recurrence or progression - unless you deal with the psychological aspects then dealing with anything else gets harder. For me in a way the psychological aspect gets easier as time goes on. I am now on my 5th chemo in less than 3 and a half years and there is some level of acceptance now that this is part of my life. You also need to check your family's and friends' reaction to the news as well sometimes they have a harder time than you do accepting that you need more treatment. I go to counselling offered by the Cancer Society and I find that good for just checking 'my head's in the right place' before starting chemo.
Secondly, I try to be as healthy as possible, apart from the cancer. As my fitness had suffered from luck of exercise while on Xeloda, this time I enrolled in a 'Cancer Wellfit' course offered free by one of the gym franchises that gives you a light exercise regime tailored to your abilitiies and I have been surprised how quickly my fitness levels have picked up. If such a programme is not available, any amount of light physical exercise, walking, aqua-aerobics and such like is beneficial if you can do it.
Thirdly, would be organisational - I try to get big jobs done and out of the way before chemo treatment starts as to ease the load when I am not feeling well. I try to find out what likely sideeffects will be and schedule activities for what are likely to be my 'good days'. I am lucky that my children are grown up and my husband is a good cook so that I do not have to worry about organisisng meals and other household things in advance. I think if you have smaller children accept all the help you can get with meals, childminding and the like. I guess there are three or more components of preparing for a new round of chemotherapy treatments.
The first would be psychological, getting your head around the fact you need to have more treatment, either because of recurrence or progression - unless you deal with the psychological aspects then dealing with anything else gets harder. For me in a way the psychological aspect gets easier as time goes on. I am now on my 5th chemo in less than 3 and a half years and there is some level of acceptance now that this is part of my life. You also need to check your family's and friends' reaction to the news as well sometimes they have a harder time than you do accepting that you need more treatment. I go to counselling offered by the Cancer Society and I find that good for just checking 'my head's in the right place' before starting chemo.
Secondly, I try to be as healthy as possible, apart from the cancer. As my fitness had suffered from luck of exercise while on Xeloda, this time I enrolled in a 'Cancer Wellfit' course offered free by one of the gym franchises that gives you a light exercise regime tailored to your abilitiies and I have been surprised how quickly my fitness levels have picked up. If such a programme is not available, any amount of light physical exercise, walking, aqua-aerobics and such like is beneficial if you can do it.
Thirdly, would be organisational - I try to get big jobs done and out of the way before chemo treatment starts as to ease the load when I am not feeling well. I try to find out what likely sideeffects will be and schedule activities for what are likely to be my 'good days'. I am lucky that my children are grown up and my husband is a good cook so that I do not have to worry about organisisng meals and other household things in advance. I think if you have smaller children accept all the help you can get with meals, childminding and the like.

First off, most importantly, I would recommend that you seek evaluation and management by a psychiatrist. To find one, you can start by discussing referral with your surgeon, medical oncologist, and/ or current prescribing physician. A psychiatrist with specialization in palliative care or, more typically, psychosomatic medicine can be beneficial, since such training and practice is geared toward helping people with psychiatric problems – be they emotional concerns, behavioral difficulties, or problems with cognition or thinking, concentration, and memory – related to medical conditions, or addressing these issues as they emerge in the context of a serious chronic or advanced illness. A psycho-oncologist is a psychiatrist who works with cancer patients and has a specialty in psychosomatic medicine, also called consultation-liaison or C/L psychiatry because much of the work involves consultation for physicians in other fields and acting to facilitate complicated dynamics between patient, family, and provider within the medical setting. A psychiatrist with a specialty in palliative care is less common but specializes in dealing with the various psychiatric issues – e.g. mood or anxiety symptoms or emotional concerns – and their interaction with physical symptoms, along with social issues, and spiritual concerns that emerge for people dealing with a chronic advanced disease. On a practical level, such training subsumes developing additional skills in management of physical as well as emotional symptoms, and, for psychiatrists, provides a better understanding of their interaction within the patient who ought to be treated as a whole person rather than a manifestation of the consequences of a disease and a variety of associated symptoms. Less commonly, psychiatrists may have training in pain medicine given the complex interface of this physical symptom, in particular, with other elements within the psychiatric realm that are processed in the brain – such as mood, anxiety, and perception.

Regardless, a psychiatrist with expertise or experience dealing with patients and issues related to your medical problem is always helpful. There may be a psychiatrist within or closely affiliated with the practice of the physician who initially screened for depression, and specifically addressed the issue and prescribed a medication. Whatever the case may be, psychiatric evaluation and management in addressing problems with mood is essential and ought not be substituted or overlooked.

For one thing, clarifying and refining a diagnostic impression over time requires careful and ongoing assessment by an expert, in part to rule out and further assess the multitude of other factors which may potentially be contributing to the decline in mood – including related psychiatric conditions, other medical issues, and a host of distressing issues that may be at play in one’s social circumstances, with a variety of possibilities in each domain for which one is at risk, given a close association, after undergoing surgery or during chemotherapy treatment for cancer.

Pursuing a psychiatric evaluation is important for evaluation of psychopharmacologic – or medication management – options, as well as non-pharmacologic interventions for depression in cancer, including psychotherapy. Additionally, seeking counseling and support from a social worker, if on staff where you are being treated, be it at a cancer center, or in the practice of the oncologist providing your care, can be invaluable. Social workers providing clinical care in the oncology setting can help to provide counseling and emotional support as needed, as well as referral to community resources and practical assistance with the various stresses that emerge in the life of a someone with cancer or other medical illness – in relationships with family and friends, financially, and at work or school, etc.

There are a variety of medications to treat depression, with reasonable evidence to support their efficacy in cancer patients, including those in several classes of antidepressants, as well as other classes of medication which may be used adjunctively or alternatively. Choosing a medication to alleviate depressive symptoms requires careful consideration of a variety of factors which should be carefully assessed by a psychiatrist.

Conducted by psychiatrists, psychologists, social workers, or other types of therapists, various forms of psychotherapy and emotional or behavioral counseling, conducted supportively, are an important aspect of optimizing adaptive functioning when facing the challenges associated with a medical condition and associated mood changes. There are a variety of approaches, such as psychodynamically-oriented supportive or supportive-expressive psychotherapy, cognitive behavioral therapy, various existential therapies, and client-centered or humanistic approaches that may be used and have been shown to be beneficial – be it observationally or experimentally – and seem generally to be related in part to the establishment of a rapport between a patient and clinician to develop a working alliance in the service of improving one’s psychological well-being. This is routinely conducted on an individual or one-on-one basis, but work with families, couples, or in a group setting amongst peers, may also be valuable as a means of addressing emotional difficulties encountered, particularly in the setting of relationships affected by one’s illness. In addition to providing a safe and open space to engage in the task of processing one’s thoughts and feelings, psychotherapy in an individual and group setting involves an educational and informational component. Alternative therapies which may be beneficial and available in the medical setting include the creative arts therapy – such as art therapy, music therapy, and drama therapy – as well as other mind-body techniques, such as hypnosis or hypnotherapy, guided imagery, relaxation techniques, and mindfulness-based approaches – and may be incorporated to the approach of a given therapist. There are additional integrative therapy approaches provided by practitioners who are not just mental health providers. In general, when dealing with issues related to medical conditions, a supportive approach is employed to help the individual foster the use of pre-existing internal resources which may be challenged when confronted with mortality and the threat to one’s livelihood but can be harnessed or aided in providing assistance for coping with an otherwise overwhelming experience. In this vain, the individual is the agent of change with the support of the provider, such that approaches to helping oneself may be found within one’s own self, environment, and lifestyle, and, as such, may even include improving healthy behaviors such as exercise and diet and reducing harmful behaviors such as substance abuse. First off, most importantly, I would recommend that you seek evaluation and management by a psychiatrist. To find one, you can start by discussing referral with your surgeon, medical oncologist, and/ or current prescribing physician. A psychiatrist with specialization in palliative care or, more typically, psychosomatic medicine can be beneficial, since such training and practice is geared toward helping people with psychiatric problems – be they emotional concerns, behavioral difficulties, or problems with cognition or thinking, concentration, and memory – related to medical conditions, or addressing these issues as they emerge in the context of a serious chronic or advanced illness. A psycho-oncologist is a psychiatrist who works with cancer patients and has a specialty in psychosomatic medicine, also called consultation-liaison or C/L psychiatry because much of the work involves consultation for physicians in other fields and acting to facilitate complicated dynamics between patient, family, and provider within the medical setting. A psychiatrist with a specialty in palliative care is less common but specializes in dealing with the various psychiatric issues – e.g. mood or anxiety symptoms or emotional concerns – and their interaction with physical symptoms, along with social issues, and spiritual concerns that emerge for people dealing with a chronic advanced disease. On a practical level, such training subsumes developing additional skills in management of physical as well as emotional symptoms, and, for psychiatrists, provides a better understanding of their interaction within the patient who ought to be treated as a whole person rather than a manifestation of the consequences of a disease and a variety of associated symptoms. Less commonly, psychiatrists may have training in pain medicine given the complex interface of this physical symptom, in particular, with other elements within the psychiatric realm that are processed in the brain – such as mood, anxiety, and perception.

Regardless, a psychiatrist with expertise or experience dealing with patients and issues related to your medical problem is always helpful. There may be a psychiatrist within or closely affiliated with the practice of the physician who initially screened for depression, and specifically addressed the issue and prescribed a medication. Whatever the case may be, psychiatric evaluation and management in addressing problems with mood is essential and ought not be substituted or overlooked.

For one thing, clarifying and refining a diagnostic impression over time requires careful and ongoing assessment by an expert, in part to rule out and further assess the multitude of other factors which may potentially be contributing to the decline in mood – including related psychiatric conditions, other medical issues, and a host of distressing issues that may be at play in one’s social circumstances, with a variety of possibilities in each domain for which one is at risk, given a close association, after undergoing surgery or during chemotherapy treatment for cancer.

Pursuing a psychiatric evaluation is important for evaluation of psychopharmacologic – or medication management – options, as well as non-pharmacologic interventions for depression in cancer, including psychotherapy. Additionally, seeking counseling and support from a social worker, if on staff where you are being treated, be it at a cancer center, or in the practice of the oncologist providing your care, can be invaluable. Social workers providing clinical care in the oncology setting can help to provide counseling and emotional support as needed, as well as referral to community resources and practical assistance with the various stresses that emerge in the life of a someone with cancer or other medical illness – in relationships with family and friends, financially, and at work or school, etc.

There are a variety of medications to treat depression, with reasonable evidence to support their efficacy in cancer patients, including those in several classes of antidepressants, as well as other classes of medication which may be used adjunctively or alternatively. Choosing a medication to alleviate depressive symptoms requires careful consideration of a variety of factors which should be carefully assessed by a psychiatrist.

Conducted by psychiatrists, psychologists, social workers, or other types of therapists, various forms of psychotherapy and emotional or behavioral counseling, conducted supportively, are an important aspect of optimizing adaptive functioning when facing the challenges associated with a medical condition and associated mood changes. There are a variety of approaches, such as psychodynamically-oriented supportive or supportive-expressive psychotherapy, cognitive behavioral therapy, various existential therapies, and client-centered or humanistic approaches that may be used and have been shown to be beneficial – be it observationally or experimentally – and seem generally to be related in part to the establishment of a rapport between a patient and clinician to develop a working alliance in the service of improving one’s psychological well-being. This is routinely conducted on an individual or one-on-one basis, but work with families, couples, or in a group setting amongst peers, may also be valuable as a means of addressing emotional difficulties encountered, particularly in the setting of relationships affected by one’s illness. In addition to providing a safe and open space to engage in the task of processing one’s thoughts and feelings, psychotherapy in an individual and group setting involves an educational and informational component. Alternative therapies which may be beneficial and available in the medical setting include the creative arts therapy – such as art therapy, music therapy, and drama therapy – as well as other mind-body techniques, such as hypnosis or hypnotherapy, guided imagery, relaxation techniques, and mindfulness-based approaches – and may be incorporated to the approach of a given therapist. There are additional integrative therapy approaches provided by practitioners who are not just mental health providers. In general, when dealing with issues related to medical conditions, a supportive approach is employed to help the individual foster the use of pre-existing internal resources which may be challenged when confronted with mortality and the threat to one’s livelihood but can be harnessed or aided in providing assistance for coping with an otherwise overwhelming experience. In this vain, the individual is the agent of change with the support of the provider, such that approaches to helping oneself may be found within one’s own self, environment, and lifestyle, and, as such, may even include improving healthy behaviors such as exercise and diet and reducing harmful behaviors such as substance abuse.

I was on the NASBP Protocol B-40. I was ramdomly put into the Groupe 3B where I first received Docetaxel combined with Gemcetabine for a period of 12 weeks witht he addition of Avastin. Then for another 12 weeks, I received AC with more Avastin. It was followed by a double mastectomy, including reconstruction with implants. Once done, I received 24 radio tx and 10 more injection of Avastin. What was so amazing, I had 4 tumors in my left breast who made a lump of about 2,5 inch diameter and several my lymph nodes were infected. Two tx into the b40 protocol, and my lump had diminished to the point where I didn't have any discernible lump during a manual eval. At mastectomy time, there was only an less than half-inch of cancer left in the breast.

It was incredible to see how fast I responded to chemo and how the combination with Avastin allowed to pratically melt my tumors away in so few tx. I was on the NASBP Protocol B-40. I was ramdomly put into the Groupe 3B where I first received Docetaxel combined with Gemcetabine for a period of 12 weeks witht he addition of Avastin. Then for another 12 weeks, I received AC with more Avastin. It was followed by a double mastectomy, including reconstruction with implants. Once done, I received 24 radio tx and 10 more injection of Avastin. What was so amazing, I had 4 tumors in my left breast who made a lump of about 2,5 inch diameter and several my lymph nodes were infected. Two tx into the b40 protocol, and my lump had diminished to the point where I didn't have any discernible lump during a manual eval. At mastectomy time, there was only an less than half-inch of cancer left in the breast.

It was incredible to see how fast I responded to chemo and how the combination with Avastin allowed to pratically melt my tumors away in so few tx.

Unfortunately, there is no IBC specific chemotherapy for now. But in general, it is anthracycline (adriamycin, epirubicin) based or taxane (paclitaxel or docetaxel) based. For newly diagnosed IBC, both are used in sequence. Weekly paclitaxel followed by FAC (FEC) is our standard at MD Anderson Cancer Center IBC program. Unfortunately, there is no IBC specific chemotherapy for now. But in general, it is anthracycline (adriamycin, epirubicin) based or taxane (paclitaxel or docetaxel) based. For newly diagnosed IBC, both are used in sequence. Weekly paclitaxel followed by FAC (FEC) is our standard at MD Anderson Cancer Center IBC program.

Currently, there are no exception for the sequence of how the inflammatory breast cancer should be treated. The newly diagnosed inflammatory breast cancer without metastasis needs to receive systemic therapy (chemotherapy and/or targeted therapy), followed by surgery, and radiation. The surgery must be modified radical mastectomy. It is very important to see the IBC specialists.
Currently, there are no exception for the sequence of how the inflammatory breast cancer should be treated. The newly diagnosed inflammatory breast cancer without metastasis needs to receive systemic therapy (chemotherapy and/or targeted therapy), followed by surgery, and radiation. The surgery must be modified radical mastectomy. It is very important to see the IBC specialists.

I posted an answer before, but I don't see it...silly iphone! So please bear with me if the other post shows up and I repeat myself...

It is critical to ask others for help. Give them specific food tasks to do for you - running to the store, chopping veggies, bringing over a pot of soup. You've got to delegate. I found during my own treatment that people really do want to help - they just don't know how, and they're honestly relieved when you give them a specific role.

The other key item for me was to have a protein smoothie every single morning for breakfast - whether I felt like eating or not! I looked at it as medicine - part of my treatment. Cancer treatment does so much to our red and white blood cells, so it is critical to keep up strength as much as we are able.

There are many varieties and flavors of protein powder available from healthy grocery stores. For those who avoid soy, try rice protein powder. Here's a smoothie I made every morning:

2 tbsp. protein powder, 2 tbsp. flax seeds or chia seeds, a handful of spinach if you can tolerate veggies, milk of your choice, and an apple. Blend it all in a blender. And remember - delegate someone to pick up these things for you. Then all you have to do is chop the apple and throw it all in the blender. NOTE: Coconut milk can be very soothing to the stomach.

If you happen to have access to a juicer, try to juice veggies every day. This gets a little more complicated because you have to wash the veggies and then wash out the juicer. But if you live with someone else, perhaps you could delegate juicing to them.


I posted an answer before, but I don't see it...silly iphone! So please bear with me if the other post shows up and I repeat myself...

It is critical to ask others for help. Give them specific food tasks to do for you - running to the store, chopping veggies, bringing over a pot of soup. You've got to delegate. I found during my own treatment that people really do want to help - they just don't know how, and they're honestly relieved when you give them a specific role.

The other key item for me was to have a protein smoothie every single morning for breakfast - whether I felt like eating or not! I looked at it as medicine - part of my treatment. Cancer treatment does so much to our red and white blood cells, so it is critical to keep up strength as much as we are able.

There are many varieties and flavors of protein powder available from healthy grocery stores. For those who avoid soy, try rice protein powder. Here's a smoothie I made every morning:

2 tbsp. protein powder, 2 tbsp. flax seeds or chia seeds, a handful of spinach if you can tolerate veggies, milk of your choice, and an apple. Blend it all in a blender. And remember - delegate someone to pick up these things for you. Then all you have to do is chop the apple and throw it all in the blender. NOTE: Coconut milk can be very soothing to the stomach.

If you happen to have access to a juicer, try to juice veggies every day. This gets a little more complicated because you have to wash the veggies and then wash out the juicer. But if you live with someone else, perhaps you could delegate juicing to them.

Inflammatory breast Cancer (IBC) is typically treated with chemotherapy prior to surgery (neoadjuvant chemotherapy). Since the disease is already in the lymphatic system, chemotherapy is the only systemic (whole body) treatment available. Once the disease is well controlled and the breast looks more "normal" a modified radical mastectomy with axillary node dissection (removal of breast and lymph nodes under the arm) is usually performed. (this may not be the case if the IBC has spread beyond the breast and axillary lymph nodes) Daily radiation therapy to the chest wall and axilla (underarm) usually follows surgery. Additional chemotherapy may be used and if the cancer is estrogen receptor positive an anti-estrogen therapy may be used to help prevent recurrence. Also, if the cancer over-expresses something called Her2/neu, a targeted therapy called trastuzumab (Herceptin) may be given IV as part of the treatment regimen. Note that this is a generalization of the treatment patients receive and should not be considered medical advice. There is an NCCN (National Comprehensive Cancer Network) treatment guideline for IBC which can be found on their website www.nccn.org This guideline can provide guidance in treating IBC. Patients should also talk to their physician about clinical trials for initial and later treatment. Inflammatory breast Cancer (IBC) is typically treated with chemotherapy prior to surgery (neoadjuvant chemotherapy). Since the disease is already in the lymphatic system, chemotherapy is the only systemic (whole body) treatment available. Once the disease is well controlled and the breast looks more "normal" a modified radical mastectomy with axillary node dissection (removal of breast and lymph nodes under the arm) is usually performed. (this may not be the case if the IBC has spread beyond the breast and axillary lymph nodes) Daily radiation therapy to the chest wall and axilla (underarm) usually follows surgery. Additional chemotherapy may be used and if the cancer is estrogen receptor positive an anti-estrogen therapy may be used to help prevent recurrence. Also, if the cancer over-expresses something called Her2/neu, a targeted therapy called trastuzumab (Herceptin) may be given IV as part of the treatment regimen. Note that this is a generalization of the treatment patients receive and should not be considered medical advice. There is an NCCN (National Comprehensive Cancer Network) treatment guideline for IBC which can be found on their website www.nccn.org This guideline can provide guidance in treating IBC. Patients should also talk to their physician about clinical trials for initial and later treatment.

The latest radiation techniques for the treatment of breast cancer include IMRT (Intensity-Modulated Radiation Therapy) for certain patients, Accelerated Partial Breast Irradiation (APBI), AccuBoost as an accurate non-invasive method for tumor cavity localization, and C-Rad sentinel to monitor patients real-time while on treatment (The Farber Center for Radiation Oncology is the only center offering these techniques in Manhattan). The latest radiation techniques for the treatment of breast cancer include IMRT (Intensity-Modulated Radiation Therapy) for certain patients, Accelerated Partial Breast Irradiation (APBI), AccuBoost as an accurate non-invasive method for tumor cavity localization, and C-Rad sentinel to monitor patients real-time while on treatment (The Farber Center for Radiation Oncology is the only center offering these techniques in Manhattan).

There is a wonderful product that is very helpful in burns such as radiation burns, cuts and abrasions in fact I use it quite a lot for scrapes and cuts, though it is VERY messy and stains everything it comes in contact with. It is called Gentian Violet, available in the pharmacy or some health food stores. This product was recommended to a friend who was having rads. and it quickly alleviated the burns. At the beginning of treatment, before you have any side effects, moisturize the skin after your daily treatment with an ointment such as A&D, Eucerin, Aquaphor, Biafene, Radiacare, aloe preparation, vitamin E cream, or emu oil. Some people get some relief by blowing air on the area with a hair dryer set to "cool" or "air" (no heat). Be careful wearing a bra if there are raw areas. Perhaps try soft bras.

If your skin becomes dry and flakey during the course of your treatment, moisturize frequently and cleanse skin gently.

For mild pinkness, itching, and burning, apply an aloe vera preparation or non-prescription 1% hydrocortisone cream thinly over the affected area. Your physician may prescribe lidocaine cream which helps the burning feeling.

If areas become red, itchy, sore, and starts to burn, and low-potency cream no longer relieves your symptoms, ask your doctor for a stronger steroid cream available by prescription. Examples include 2.5% hydrocortisone cream and bethamethasone.

If your skin forms a blister, leave the the blister alone. The blister keeps the area clean while the new skin grows back underneath. Try to keep the area relatively dry washing with warm water. Then apply a non–adherent dressing, such as Xeroform dressings (laden with soothing petroleum jelly) or "second skin" dressings made by several companies. For pain, take an over-the-counter pain reliever (acetominophin), or ask your doctor for a prescription if you need it.

For more severe burn reactions, a typical treatment includes pain pills and silvadene prescribed by the physician. Apply silvadene to the burned skin with pads to cover the area. The pads my be wrapped with gauze.

Letrozole is categorized pharmacologically as an Antineoplastic Agent and as an Aromatase Inhibitor. The action of Aromatase Inhibitors is to inhibit the production of estrogens by stopping the conversion of androgen into estrogen.

- Aromatase Inhibitors operate by blocking the aromatase enzyme from converting androgen to estrogen in women who have gone through menopause.
- Post-menopausal women get estrogen from the conversion of androgen into estrogen in the tissues of the body.
- In contrast women who have not gone through menopause receive their estrogen from the ovaries.
- By inhibiting the production of estrogen, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive tumor breast cancer cells cannot grow. Letrozole is categorized pharmacologically as an Antineoplastic Agent and as an Aromatase Inhibitor. The action of Aromatase Inhibitors is to inhibit the production of estrogens by stopping the conversion of androgen into estrogen.

- Aromatase Inhibitors operate by blocking the aromatase enzyme from converting androgen to estrogen in women who have gone through menopause.
- Post-menopausal women get estrogen from the conversion of androgen into estrogen in the tissues of the body.
- In contrast women who have not gone through menopause receive their estrogen from the ovaries.
- By inhibiting the production of estrogen, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive tumor breast cancer cells cannot grow.

Antidepressant medications and talk therapy are the two most common treatments for clinical depression. They are often used at the same time. Research indicates that the best kinds of talk therapy are cognitive-behavioral therapy (CBT) and interpersonal therapy. CBT focuses on changing the negative thought patterns that can drive depression. Interpersonal therapy focuses on improving and understanding relationships. Therapists often offer a combination of talk therapy approaches.

For more about depression and its treatment, see our article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue1.cfm
Antidepressant medications and talk therapy are the two most common treatments for clinical depression. They are often used at the same time. Research indicates that the best kinds of talk therapy are cognitive-behavioral therapy (CBT) and interpersonal therapy. CBT focuses on changing the negative thought patterns that can drive depression. Interpersonal therapy focuses on improving and understanding relationships. Therapists often offer a combination of talk therapy approaches.

For more about depression and its treatment, see our article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue1.cfm

Therapy and medication together are often more effective than either one alone, but antidepressant medication can have side effects. Treatment also can take a while to improve clinical depression. It is important to discuss changes or concerns about your treatment with a professional before discontinuing medication and/or therapy. Your family doctor or psychiatrist can help you make the best choice for you.

For more about depression and its treatment, see our article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue1.cfm
Therapy and medication together are often more effective than either one alone, but antidepressant medication can have side effects. Treatment also can take a while to improve clinical depression. It is important to discuss changes or concerns about your treatment with a professional before discontinuing medication and/or therapy. Your family doctor or psychiatrist can help you make the best choice for you.

For more about depression and its treatment, see our article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue1.cfm

It is important to note that phyllodes tumors are often categorized as benign and malignant. Benign phyllodes tumors are more common, and the treatment is surgical excision with a clear margin. They can become quite large, and rarely, mastectomy is needed; most can be removed with a lumpectomy. They do have the potential to recur in the breast, but do not have the potential to metastasize or spread to other areas of the body, and no other treatment besides removal is recommended.

Malignant phyllodes tumors are fortunately much less common. As mentioned by knutter1, chemotherapy has not been shown to be effective, and the data regarding radiation therapy is limited, but radiation therapy might be beneficial in some cases. Phyllodes tumors are a rare sarcoma type of cancer that occures within the connective tissues of the breast. It is technically a soft tissue sarcoma but originates within the breast so in some respects and fortunately we are now also catagorized as breast cancer as well. For US Phyllodes survivors this is fortunate as we can now have coverages previously not available from insurance and orgizations as well as making it easier to locate other Phyllode survivors. This is very helpful when dealing with a rare cancer as there is little or no information on treatment options and so forth. Phyllodes is reported to rarely metastisize though will often reoccur in or near the previous location. Surgery is the main treatment for Phyllodes or PT's until recently, but there was a study done in NH by Dr. Barth that has indicated that radiation has reduced the reoccurance rate. Thus far chemotherapy has proved to be useless in treatment of PT but when there is mets. often the treatment will include chemo but as far as I know there has been no success in it's use. It is unfortnate but if the mets are in a location where they cannot be surgically removed the prognosis is not good.

Although unintended effects are most often associated with medications and cancer treatments like chemotherapy and radiation, any treatment can have a side effect. We usually think of side effects as occurring when a treatment causes new symptoms or problems. Although unintended effects are most often associated with medications and cancer treatments like chemotherapy and radiation, any treatment can have a side effect. We usually think of side effects as occurring when a treatment causes new symptoms or problems.

I was also told about reconstructive surgery by my breast surgeon when I received the news that I needed a mastectomy. Being told you need major surgery (in addition to being diagnosed with cancer) is completely overwhelming. I went home and, in the few days between meeting with her and seeing the plastic surgeon, I did a lot of internet research at respectable sites (mayo clinic.com, health.harvard.edu, etc.) to familiarize myself with the options. When I met with the plastic surgeon, I understood the basics and was ready to have a real conversation about what I wanted done and what was possible for me. It wasn't an easy discussion, but I had some measure of control because I felt I was prepared for the conversation. I cried when my breast surgeon, Dr. Joseph said I needed a mastectomy but in the same sentence she said reconstructive surgery and that gave me hope. She recommended a plastic surgeon that did the one step procedure and I had a mastectomy and reconstructive surgery during the same surgery. I had my breast cancer surgery at Nyack Hospital. My plastic surgeon was Dr. Laura Sudarsky. Here is the website for Nyack hospital it is in Nyack New York near the Tappanzee bridge.
www.nyackhospital.org/services_breastcenter.asp Also if you are interested in finding out more about the one step procedure this is a good site. It is full of information about reconstructive procedures after a mastectomy. You don't have to buy the book http://www.breastrecon.com

I agree you should avoid Chlorine. Chlorine is toxic. Chlorine is linked to cancer of the esophagus, rectum, breast and larynx, of Hodgkin’s disease and to atherosclerosis and resulting heart attacks. A few dips in the pool won't hurt anyone, but Chlorine is absorbed into the skin and is inhaled. Also, while the Vasoline will help keep the water off your skin, Vaseline and Aquaphor are petroleum based and mineral oil (liquid petroleum) is a by-product of petroleum, which is known to increase the risk of cancer, so I do not advise the using these products in or out of the pool.
http://www.health-report.co.uk/petroleum_petrolatum_health_concerns.htm Yes, you should avoid chlorine. Chlorine is very drying and can make your skin reaction worse.

If you do swim in a pool, you might want to spread petroleum jelly (a product like Vaseline) on the treated area to keep chlorinated water away from your skin.

For hair loss prevention this site will help you. http://www.ecancerchemotherapy.com/chemotherapy-hair-loss-prevention.html
http://www.ecancerchemotherapy.com/chemotherapy-hair-loss There is no guaranteed way to prevent hair loss if you are receiving chemotherapy medications known to cause hair loss. There are treatments that have been used and investigated for their effectiveness in preventing hair loss under specific circumstances.

Scalp freezing (also referred to ask "scalp hypothermia") has been used and explored to a greater degree in Europe and is gaining some attention in the U.S. This method relies on wearing a "cold cap" to freeze the scalp and hair follicles and reduce blood flow to the scalp so that less of the chemotherapy drug is absorbed by the hair follicles. For this procedure to be effective, the scalp must be kept cold before, during and for hours after chemotherapy treatment. To maintain a cold enough temperature on the scalp, the caps must be changed every 30 minutes in order to maintain the optimal temperature of 22 degrees below zero Fahrenheit. It takes either a biomedical freezer or about 159 lbs of dry ice to maintain the caps at that temperature. Only a couple of hospitals in the U.S. currently have biomedical freezers.

There has been little-to-no research in the U.S. exploring the effectiveness or potential side effects of cold cap treatments. In Europe they are considered effective at preventing or reducing hair loss. Cold cap treatments are not deemed safe for cancers that are at high risk of having blood borne cancer cells.

Minoxidil (Rogaine) does not prevent chemotherapy-induced hair loss.