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Breast Cancer (Expert Forum)
novelbean
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
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novelbean
by LindaBug, Nov 02, 2001 12:00AM
My mother has had b.c. for 13 years. She has had several re-occurances in different areas. She has (again) been put on chemo and herceptin. Her oncologist has prescribed "novelbean" (spelling???). Please tell me how this works and what we can expect. I'm fairly sure of the herceptin. Also, she is extremely tired and exhausted all the time. Any suggestions?
Doctor's Answer
by CCF-RN,MSN-JS, Nov 05, 2001 12:00AM
Dear Lindabug, The goal of treatment of breast cancer that has metastasized is control of the disease. Navelbine or vinorelbine is a chemotherapy that has been found to have some activity in treating breast cancer. It has been studied on its own and in combination with other chemotherapy medications. It also has been studied in combination with herceptin for treatment of metastatic breast cancer. This combination shows activity, in terms of control of the disease.
The treatment is relatively well tolerated. The most serious side effect being neutropenia (decrease of white blood cells) that leave one more susceptible to infection. So blood counts will be watched closely, and treatments may be held at times to allow for recovery of the blood count. Other side effects of Navelbine are possible constipation, neuropathy which is reversible when the medication is discontinued, hair loss – more thinning rather than total hair loss, mild incidence of nausea and vomiting, diarrhea and mouth sores.
Regarding herceptin there may be a closer watch on her heart function, particularly if she’s had adriamycin, taxol or taxotere in the past. They may do baseline echocardiogram or MUGA scan, and check it again periodically during the course of treatment.
Fatigue is a common consequence of treatment for cancer as well as the cancer itself contributing to it. I have copied the following information from our Cleveland Clinic website, which I hope will give you some information and suggestions for dealing with the fatigue.
Cancer-Related Fatigue
What is the difference between fatigue and tiredness?
Fatigue is often confused with tiredness. Tiredness happens to everyone -- it is an expected feeling after certain activities or at the end of the day. Usually, you know why you are tired and a good night's sleep solves the problem.
Fatigue is a daily lack of energy; an unusual or excessive whole-body tiredness not relieved by sleep. It can be acute (lasting a month or less) or chronic (lasting from 1 month to 6 months or longer). Fatigue can prevent a person from functioning normally and impacts a person's quality of life.
What is cancer-related fatigue?
Cancer-related fatigue (CRF) is one of the most common side effects of cancer and its treatment. It is not predictable by tumor type, treatment or stage of illness. Usually, it comes on suddenly, does not result from activity or exertion, and is not relieved by rest or sleep. It is often described as "paralyzing." It may continue even after treatment is complete.
What causes CRF?
The exact reason for CRF is unknown. CRF may be related to the disease process or its treatments.
Cancer treatments commonly associated with fatigue
Chemotherapy -- Any chemotherapy drug may cause fatigue, but it may be a more common side effect of drugs such as vincristine, vinblastine and cisplatin. Patients frequently experience fatigue after several weeks of chemotherapy, but this varies among patients. In some patients, fatigue lasts a few days, while others report fatigue persisting throughout the course of treatment and continuing after the treatment is complete.
Radiation therapy -- Radiation therapy can cause cumulative fatigue (fatigue that increases over time). This can occur regardless of the treatment site. Fatigue usually lasts from 3 to 4 weeks after treatment stops but can continue for up to 2 to 3 months.
Bone marrow transplant -- This aggressive form of treatment can cause fatigue that lasts up to one year.
Biological therapy -- Interferons and interleukins are cytokines, natural cell proteins that are normally released by white blood cells in response to infection. These cytokines carry messages that regulate other elements of the immune and endocrine systems. In high amounts, these cytokines can be toxic and lead to persistent fatigue.
Combination therapy -- More than one cancer treatment at the same time or one after the other increases the chances of developing fatigue.
Other factors that may contribute to cancer-related fatigue
Tumor-induced "hypermetabolic" state -- Tumor cells compete for nutrients, often at the expense of the normal cells' growth. In addition to fatigue, weight loss and decreased appetite are common effects.
Decreased nutrition from the side effects of treatments (such as nausea, vomiting, mouth sores, taste changes, heartburn or diarrhea) can cause fatigue.
Cancer treatments can cause reduced blood counts which may lead to anemia, a blood disorder that occurs when there is not enough hemoglobin in the blood. Hemoglobin is a substance in the red blood cells that enables the blood to transport oxygen through the body. When the blood can not transport enough oxygen to the body, fatigue can result.
If the thyroid gland is under-active (hypothyroidism), metabolism may slow down so that the body does not burn food fast enough to provide adequate energy. This is a common condition in general, but may happen after radiation therapy to the lymph nodes in the neck.
Medications used to treat side effects such as nausea, pain, depression, anxiety and seizures can cause fatigue.
Research shows that chronic, severe pain
The treatment is relatively well tolerated. The most serious side effect being neutropenia (decrease of white blood cells) that leave one more susceptible to infection. So blood counts will be watched closely, and treatments may be held at times to allow for recovery of the blood count. Other side effects of Navelbine are possible constipation, neuropathy which is reversible when the medication is discontinued, hair loss – more thinning rather than total hair loss, mild incidence of nausea and vomiting, diarrhea and mouth sores.
Regarding herceptin there may be a closer watch on her heart function, particularly if she’s had adriamycin, taxol or taxotere in the past. They may do baseline echocardiogram or MUGA scan, and check it again periodically during the course of treatment.
Fatigue is a common consequence of treatment for cancer as well as the cancer itself contributing to it. I have copied the following information from our Cleveland Clinic website, which I hope will give you some information and suggestions for dealing with the fatigue.
Cancer-Related Fatigue
What is the difference between fatigue and tiredness?
Fatigue is often confused with tiredness. Tiredness happens to everyone -- it is an expected feeling after certain activities or at the end of the day. Usually, you know why you are tired and a good night's sleep solves the problem.
Fatigue is a daily lack of energy; an unusual or excessive whole-body tiredness not relieved by sleep. It can be acute (lasting a month or less) or chronic (lasting from 1 month to 6 months or longer). Fatigue can prevent a person from functioning normally and impacts a person's quality of life.
What is cancer-related fatigue?
Cancer-related fatigue (CRF) is one of the most common side effects of cancer and its treatment. It is not predictable by tumor type, treatment or stage of illness. Usually, it comes on suddenly, does not result from activity or exertion, and is not relieved by rest or sleep. It is often described as "paralyzing." It may continue even after treatment is complete.
What causes CRF?
The exact reason for CRF is unknown. CRF may be related to the disease process or its treatments.
Cancer treatments commonly associated with fatigue
Chemotherapy -- Any chemotherapy drug may cause fatigue, but it may be a more common side effect of drugs such as vincristine, vinblastine and cisplatin. Patients frequently experience fatigue after several weeks of chemotherapy, but this varies among patients. In some patients, fatigue lasts a few days, while others report fatigue persisting throughout the course of treatment and continuing after the treatment is complete.
Radiation therapy -- Radiation therapy can cause cumulative fatigue (fatigue that increases over time). This can occur regardless of the treatment site. Fatigue usually lasts from 3 to 4 weeks after treatment stops but can continue for up to 2 to 3 months.
Bone marrow transplant -- This aggressive form of treatment can cause fatigue that lasts up to one year.
Biological therapy -- Interferons and interleukins are cytokines, natural cell proteins that are normally released by white blood cells in response to infection. These cytokines carry messages that regulate other elements of the immune and endocrine systems. In high amounts, these cytokines can be toxic and lead to persistent fatigue.
Combination therapy -- More than one cancer treatment at the same time or one after the other increases the chances of developing fatigue.
Other factors that may contribute to cancer-related fatigue
Tumor-induced "hypermetabolic" state -- Tumor cells compete for nutrients, often at the expense of the normal cells' growth. In addition to fatigue, weight loss and decreased appetite are common effects.
Decreased nutrition from the side effects of treatments (such as nausea, vomiting, mouth sores, taste changes, heartburn or diarrhea) can cause fatigue.
Cancer treatments can cause reduced blood counts which may lead to anemia, a blood disorder that occurs when there is not enough hemoglobin in the blood. Hemoglobin is a substance in the red blood cells that enables the blood to transport oxygen through the body. When the blood can not transport enough oxygen to the body, fatigue can result.
If the thyroid gland is under-active (hypothyroidism), metabolism may slow down so that the body does not burn food fast enough to provide adequate energy. This is a common condition in general, but may happen after radiation therapy to the lymph nodes in the neck.
Medications used to treat side effects such as nausea, pain, depression, anxiety and seizures can cause fatigue.
Research shows that chronic, severe pain