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Will Fluorouracil, Methotrexate And Cytoxan Cause Any Damage To The Heart?
Question: I have had CAD for at least 10 years. I also have pacemaker and 3 stents. Comple AV block. Multiple blockages in other arteries including "widow maker". All 50-60 % blockage. Now have triple neg breast cancer, stage 1, have had lumpectomy and directed radiation. No occurrence in lymph nodes. Oncologist prescribing chemo cocktail of Fluorourcil, Methotrexate, and Cytoxan. I'm scared it will do more damage to my heart. I am 71 years old and and don't know which is worse. Cancer recurring, or more damage to my heart. What is your advice?
Brief Answer:
Get Oncotype DX done if ER and PR positive.
Detailed Answer:
Hi. I understand your problem.
I have been practicing Oncology for several years now and specialize in breast cancer among st other fields.
It would help to know the exact size of your tumor in the pathology report and the estrogen receptor (ER) and progesterone receptor(PR) status and Her2 neu status of your tumor. These should be available in the pathology report. If these tests have not been done, then please ask your oncologist to get them done on the specimen. If the tumor was less than 0.5 cm then you don't need any chemotherapy. If the ER and/or PR is positive then there is an option to give hormone therapy which is easily tolerated and has minimal effect on the heart. To decide whether or not to give chemotherapy in stage 1 node negative ER PR positive breast cancer, there is a test available called Oncotype DX.
If cost is not an issue, then get that test done as it will tell you if you can avoid chemotherapy.
If the ER and PR is negative or if the Oncotype DX says that you cannot avoid chemotherapy, then I will suggest that you go ahead with the chemotherapy. The drugs chosen are not directly toxic to the heart and you should be able to tolerate them.
Another option is to just give chemotherapy with Paclitaxel which is also safe for the heart. I hope that answers your question. If you have any more queries, feel free to ask them.
Get Oncotype DX done if ER and PR positive.
Detailed Answer:
Hi. I understand your problem.
I have been practicing Oncology for several years now and specialize in breast cancer among st other fields.
It would help to know the exact size of your tumor in the pathology report and the estrogen receptor (ER) and progesterone receptor(PR) status and Her2 neu status of your tumor. These should be available in the pathology report. If these tests have not been done, then please ask your oncologist to get them done on the specimen. If the tumor was less than 0.5 cm then you don't need any chemotherapy. If the ER and/or PR is positive then there is an option to give hormone therapy which is easily tolerated and has minimal effect on the heart. To decide whether or not to give chemotherapy in stage 1 node negative ER PR positive breast cancer, there is a test available called Oncotype DX.
If cost is not an issue, then get that test done as it will tell you if you can avoid chemotherapy.
If the ER and PR is negative or if the Oncotype DX says that you cannot avoid chemotherapy, then I will suggest that you go ahead with the chemotherapy. The drugs chosen are not directly toxic to the heart and you should be able to tolerate them.
Another option is to just give chemotherapy with Paclitaxel which is also safe for the heart. I hope that answers your question. If you have any more queries, feel free to ask them.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
I am NOT ER PR positive. My Cancer is triple negative and has a 50% chance of not responding to chemo. My question is, do I take a chance of damaging my heart further, or do I just leave well enough alone since there is a good chance chemo won't work anyway?
Brief Answer:
Take single agent taxane based chemotherapy
Detailed Answer:
Hi.
Actually, triple negative breast cancer has a better response rate with taxane based chemotherapy. Normally, one would like to give other drugs also, but that would not be possible with your cardiac condition. Also, there is no scope of hormone therapy as your ER and PR is negative. Taxane based chemotherapy does not affect the heart although it has other side effects. The chemotherapy that has been planned for you will have little effect in triple negative breast cancer.
So, my opinion would be single agent taxane based chemotherapy which you should be able to tolerate. Discuss it with your treating oncologist.
Hope that answers your query. If you have no further, kindly rate the question and close the thread.
Thank you.
Take single agent taxane based chemotherapy
Detailed Answer:
Hi.
Actually, triple negative breast cancer has a better response rate with taxane based chemotherapy. Normally, one would like to give other drugs also, but that would not be possible with your cardiac condition. Also, there is no scope of hormone therapy as your ER and PR is negative. Taxane based chemotherapy does not affect the heart although it has other side effects. The chemotherapy that has been planned for you will have little effect in triple negative breast cancer.
So, my opinion would be single agent taxane based chemotherapy which you should be able to tolerate. Discuss it with your treating oncologist.
Hope that answers your query. If you have no further, kindly rate the question and close the thread.
Thank you.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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