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Which Chemo Should Be Given First For Stage IV Metastatic Breast Cancer?

Posted on Thu, 20 Mar 2014

Question: I have stage IV METASTATIC BREAST CANCER WITH METS TO THE BONES. WAS TAKING ARIMIDEX ONLY FOR ONE YEAR AND STOP WORKING AND MY METS HAVE SPREAD TO OTHER PARTS OF MY SPINE. MY NEW ONCOLOGIST HAS GIVEN ME EXEMESTANE WITH AFINITOR AND XGEVA TO TRY IT OUT. MY ONCOLOGIST WANTS ME TO DO A BRAIN SCAN ALSO. MY QUESTION IS IF I NEED TO DO CHEMO FOR THE FIRST TIME WHAT WOULD BE THE ONE TO TAKE THAT WOULD NOT BE HARD ON ME?

Answered by Dr. Meher Lakshmi Konatam (26 hours later)

Brief Answer: therapy is tailored to each patient Detailed Answer: Hi, Sorry that your disease has spread fast. You have not mentioned about your Her 2 neu status. Usually Her positivity has this type of rapid spread. The combination of therapy you are prescribed is fine. The choice of medicines depends on many factors like your previous therapy, duration between therapy and recurrence, harmonal receptor status, age, performance status, etc. Many issues are considered before prescribing therapy. hard to say which chemo should be given first without every detail and clinical examination. But i can say that you were given appropriate medication only. Remember that all cancer medicines have some side effect on the body. But it is not more harmful than the disease process. Disease is more XXXXXXX than medicines. So better to go ahead with therapy without fear. all the best

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Meher Lakshmi Konatam (18 hours later)

I AM HER2- ER+ AND MY METASTATIC BREAST CANCER HAS SPREAD MORE TO THE BONES. I AM TAKING EXEMESTANE AND AFINITOR TO SEE IF THIS WORKS OTHERWISE I WILL HAVE TO DO CHEMO? I DON'T UNDERSTAND IF I AM HER2- WHY THIS HAS SPREAD MORE IN A ONLY A YEAR WHILE I WAS TAKING ANASTROZOLE. IF I NEED CHEMO WHAT DO YOU RECOMMEND? I HAVE SO FAR GOOD HEALTH AND DON'T HAVE ANY OTHER COMPLICATIONS. I AM 57 YEARS OLD.

Answered by Dr. Meher Lakshmi Konatam (3 days later)

Brief Answer: you are already on therapy Detailed Answer: i dont understand why you got this doubt when you are already started on therapy. You said you were put on exemestane and afinitor. Exemestane is hormonal tablet and afinitor is a targeted molecule similar to chemotherapeutic agent. These are oral form but they still have side effects. Not that oral forms do not have side effects. Side effects occur whether treatment is given orally or intravenously. You are already put on therapy and i already told that it is fine

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Above answer was peer-reviewed by : Dr. Prasad