Suggest treatment for Metastatic breast cancer
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i HAVE METASTATIC BREAST CANCER ER+ HER2-. I HAVE BEEN TAKING ANASTROZOLE AND NOW I AM TAKING EXEMESTANE. MY ONOCOLOGIST IS TELLING ME THAT HE DOESN'T THINK THE PILLS WILL WORK FOR ME SINCE MY METASTASIS HAS SPREAD MORE TO MY SPINAL CORD. I HAVE IT ALSO ON MY LEFT HIP. HE SAYS I SHOULD START CHEMO RIGHT AWAY. MY OTHER ONCOLOGIST TOLD ME TO TRY THE NEW PILL FOR 4 MONTHS AND THEN DO ANOTHER PET SCAN? WHAT DO YOU RECOMMEND?
Posted Fri, 7 Mar 2014 in Cancer
Answered by Dr. Indranil Ghosh 4 hours later
Brief Answer: Please refer below Detailed Answer: Hi, Thanks for your query. If the disease has spread further while on exemestane then it is not going to work any more. You have two options, to go for everolimus (a new drug) + tamoxifen (another hormonal drug) OR chemotherapy. Chemotherapy drugs may include anthracyclines, taxanes, capecitabine, vinorelbine and many others. Exact choice depends upon what you have received in the past, how much response and gap from last chemo, any residual side effects, etc. It will be difficult to say which of these will be better. But a trial of everolimus+tamoxifen may be justified before going for chemo. Also bisphosphonate group of drugs (zoledronate) OR denosumab will be required for bone metastases. Hope I have answered your query. I will be available to answer further followup queries, if any.
Follow-up: Suggest treatment for Metastatic breast cancer 5 hours later
HI, I WAS ON ANASTROZOLE BEFORE EXEMESTAN. I JUST STARTED EXEMESTANE AND MY ONCOLOGIST WANTS TO START CHEMO BECAUSE HE THINKS THE HORMONAL PILLS WILL NOT WORK. I AM VERY SCARED OF CHEMO PLEASE LET ME KNOW WHAT I SHOULD DO? I 'M TRYING TO CHANGE ONCOLOGIST AGAIN TO GET ANOTHER OPINION? I AM ER+ HER2- METASTATIC BREAST CANCER METS TO THE BONES.
Answered by Dr. Indranil Ghosh 1 hour later
Brief Answer: a trial of exemestane may be tried Detailed Answer: In metastatic breast cancer we always prefer sequential treatment, one therapy after another. However, regarding which one will be the best now, you have to trust the judgement of the treating oncologist. You can take another opinion also. But even if chemo is given now, exemestane, +/- everolimus may be tried later. Regards