Sentinel Node day 9/30/2009

If this post is not completely cogent, it's because I'm still a little woozy from the general anesthesia. Surgery was at 7:30, and thanks to good drugs, I was out before I got to the operating room. Upon waking, I met with my doctor who told me that they had taken 5 lymph nodes. Apparently, the cancer has spread beyond the breast, and into the lymph nodes in the body.

I will be taking "chemo teaching" on Friday, so I can learn the particulars of my treatment plan.
But I do know the drugs I will be taking:
Herceptin:
Cancer cells grow in an uncontrolled fashion. Herceptin works on the surface of the cancer cell by blocking the chemical signals that can stimulate this uncontrolled growth.
Genes are like instruction manuals that tell each cell of our body how to grow, what kind of cell to become, and how to behave. Genes do this by ordering the cell to make special proteins that cause a certain activity -- like cell growth, rest, or repair.
Some cancer cells have abnormalities in genes that tell the cell how much and how fast to grow. Sometimes the cancer cells have too many copies of these genes with abnormalities. When there are too many copies of these genes, doctors refer to it as "overexpression." With some forms of gene overexpression, cancer cells will make too many of the proteins that control cell growth and division, causing the cancer to grow and spread.
Some breast cancer cells make (overexpress) too many copies of a particular gene known as HER2. The HER2 gene makes a protein known as a HER2 receptor. HER2 receptors are like ears, or antennae, on the surface of all cells. These HER2 receptors receive signals that stimulate the cell to grow and multiply. But breast cancer cells with too many HER2 receptors can pick up too many growth signals and so start growing and multiplying too much and too fast. Breast cancer cells that overexpress the HER2 gene are said to be HER2-positive.
Herceptin works by attaching itself to the HER2 receptors on the surface of breast cancer cells and blocking them from receiving growth signals. By blocking the signals, Herceptin can slow or stop the growth of the breast cancer. Herceptin is an example of an immune targeted therapy. In addition to blocking HER2 receptors, Herceptin can also help fight breast cancer by alerting the immune system to destroy cancer cells onto which it is attached.
Herceptin causes flu-like symptoms in about 40% of the people who take it. These symptoms may include:

• fever
• chills
• muscle aches
• nausea

Side effects generally become less severe after the first treatment. Your treatment team will monitor you during your infusions, especially your first dose, and can adjust the infusion if you are very uncomfortable. If you are receiving Herceptin every 3 weeks, you may have stronger side effects. I am getting chemo every 3 weeks, and will take Herceptin every 3 weeks for a year.
Less commonly, Herceptin can damage the heart and its ability to pump blood effectively. This risk has ranged between 5% to 30%. The damage can be mild and result in either no symptoms or signs of mild heart failure, like shortness of breath. Less commonly, the heart damage is bad enough that people experience life-threatening congestive heart failure or a stroke. The risk of heart damage, especially severe damage, is greater when Herceptin is given along with other chemotherapy medicines known to cause heart damage. Adriamycin is an example of a chemotherapy that can cause heart damage.
Women who experience mild or more serious heart damage can stop taking Herceptin and start taking heart-strengthening medications. This often brings heart function back to normal.
Herceptin can rarely cause two possibly related serious reactions that interfere with breathing. One of these is a reaction during or shortly after Herceptin is being administered. This is like a bad allergic reaction, with symptoms that include hives, as well as wheezing and trouble breathing due to sudden swelling and narrowing of the airways. The other reaction, called pulmonarty toxicity, results in swelling of the lung tissue, low blood pressure, and possibly fluid buildup around the lungs (called pleural effusions).
The risk of these life-threatening reactions is rare -- much less than 1%. In most cases, these reactions happen during infusion or within the first 24 hours of the first dose of Herceptin. Less commonly they can happen within a week of the first dose. Only occasionally do these reactions occur with the second or later doses. The lung reaction can be more severe when lung disease, such as asthma or emphysema, already exists, or if the breast cancer has spread significantly into your lungs. If you are currently undergoing treatment with Herceptin and have been tolerating it well, you're unlikely to develop these serious reactions.
Taxotere
Taxotere info here.
Carboplatin
Carboplatin info is here. Sounds like fun, huh?

So that's all I have from here so far. Not to worry. As Alex used to say of me when he was little: I'm "one tough cream puff". And with all of your prayers and support, I'll come through this just fine.
When I know the chemo schedule, I'll post that.

Peace to all!

"So do not fear , for I am with you; be not dismayed, for I am your God.
I will strengthen you and help you; I will uphold you with my righteous hand." Isaiah 41:10