My mom is staged-3 TNBC; invasive carcinoma of no special type (infiltrsting ductal carcinoma in-situ) . The lesion is reaching upto nipple with its heterogenous appearance. Periareolar skin thickening and edema is seen.
ER negative (0)
PR negative (0)
HER2 negative (1+)
Bone scan shows no evidence of osteoblastic metastasis.
We have gone thru all the tests and approached Tata Medical Center, Kolkata for treatment.
They have advised 6- rounds of neo-adjuvant chemotherapy followed by surgery (not sure whether Lumpectomy or mastectomy) and radiation therapy post-surgery. I was not present when my parents visited the doc; so not sure whether the doc said anything about adjuvant chemotherapy or not. For a second round of opinion, I personally visited Tata Memorial Hospital, Mumbai and tried to reach out to Dr Rajendra Bhadwe, though I could not get his reviews but only managed to get Dr. Shalaka Joshi. Dr. Joshi advised me 4 rounds of neo-adjuvant chemo-> surgery (most likely mastectomy coz tumor size is relatively higher- apprx 5.1cm X 3cm ; but will be accessed post 4th chemo)> radiation + 4 rounds of adjuvant chemo. She said, the chemo suggested by Dr. Roshina Ahmed from TMC, Kolkata is in line with TMH, Mumbai's standard procedure. Its just that the numbers will be different and they are sugesting adjuvant chemo also (TMC Kol may or may not have suggested adjuvant chemo; so I will get it clarified soon from the doc). I suggested that we don't have any base in Mumbai and it may take a toll on my mom to visit Mumbai for chemos (each at a gap of 21 days; both in Mumbai and Kolkata). She adviced that they will prepare a schedule for all the 4 chemos and we can get it done from Kolkata. The same will be done for adjuvant chemos and radiation. So, my mom has to travel only once, during surgery. The below chemo round has been done this Monday.
Chemo Cycle 1st:
Tab Aprepitant 125 mg for 1st 3 days
Inj Painox 0.25mg
Inj Dexa 12mg
Inj 5FU 750 mg IV push
Inj Epirubucin 150mg in 100 ml NS over 10 min
Inj Cyclophosphamide 750mg in 200 ml NS over 30 mins
Tab Dexa 8mg for day 2,3,4
Tab Perinorm 10 mg TDS X 3 days
Tab Pan 40 mg OD X 5 days
Now here are few questions for which I am confused and would seek opinion of Sumeet sir and others:
1. Will it be advisible for us to get the chemo schedule from TMH, Mumbai since the 1st chemo has just been given (based on the advice from TMC Kol)?
We are planning to get the surgery done from Mumbai. So, will it be advisable to take chemos from kolkata (using the prescribed schedule of tata memorial Mumbai), since we have already got the first chemo based on kolkata's advice.
If we follow the chemotherary schedule from TMC Kolkata (all 6), will TMH Mumbai accept my mom for ONLY surgery ? Even if they do, is it advisable to do so, to take chemo prescribed from one place and surgery from another place.
2. I read on a lot of research articles that turmeric helps in BC, specially in TNBC, though it has to be completely proved. If yes, how much quantity of daily consumption is advicable?
3. Does the first 7-10 days, specially for 1st chemo have much more side-effects and if u pass those days, ur chances of side effects go down? By side effects, I mean nausea, fever, diarrhea etc.
4. If it is only a big tumor size with no metastasis, do it mean a better condition than the one with metastasis? I am lil worried coz its stage-3.
5. Mumbai doc told me that it would most likely be a mastectomy looking at the current size of the tumor( though they may change the decision based on the response of chemotherapy. Will choosing the mode of surgery impact the chances of recurrence?
6. Does TNBC cases really respond well to chemotherapy compared to others and no hormone therapy is suggested to these cases?
7. A family doctor (non-oncologist) suggested not to take mom out of house at all, except for treatment, since she would be highly prone to infection and her immunity will go down drastically in coming days. Is it really true? As far as I remember, doc Sumeet suggested a lot of ppl to do exercise/yoga. Is there a cooling period post chemos, when mom shud not go out of house?
8. Any specific fruit/diet plan? Does red beet fruit help to keep the blood counts in check?
9. If anyone has personal exp in Tata Memorial Hospital, does dr Rajendra Badwe still do surgeries? This is one of our main reasons for us for choosing TMH, Mumbai. Any exp with other doctors there like Shalaka Joshi or Nita Nair?