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Join Us Today at 3:00 pm ET for Ask Me Anything with Metastatic Breast Cancer Expert Dr. Eleonora Teplinsky.

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Ask a metastatic breast cancer expert anything. Join the conversation by replying to this post.

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19 Replies
Maem profile image
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@estherdauther What are your thoughts on Functional Medicine?

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DrTeplinsky in reply to Maem

Hello! I think functional medicine definitely has a role to play in treatment of cancer. Functional medicine is a very broad field-- any specific questions?

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@Suzesunshine I have Metastatic Breast Cancer to the bones. I'm currently on Xeloda pills, but there has been progression to the legs, hip and ribs. Doc wants me to stay on X, but add Gemzar IV Chemo. Is this standard protocol?

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DrTeplinsky in reply to Maem

I can't answer specific treatment questions without having all the information about your medical history. I would recommend asking your doctor the rationale for that choice of regimen.

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@MacroMom Have you heard about a new CDK 4/6 inhibitor called Aplelisib for PIK3CA mutation?

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DrTeplinsky in reply to Maem

Alpelisib is actually not a CDK 4/6 inhibitor - it is a PI3K inhibitor. It is targeted therapy and data from the major study showing its benefit was just published last week in the New England Journal of Medicine -- nejm.org/doi/full/10.1056/N.... We expect that it will be FDA approved soon. There is clear benefit for use of this drug in patients with metastatic breast cancer who have a PIK3CA mutation (about 40% of patients with estrogen receptor positive HER2 negative breast cancer have this).

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@GreatMamy do you recommend CBD oil, which is legal in all 50 states, to reduce cancer treatment side effects.

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DrTeplinsky in reply to Maem

I think CBD oil has a lot of great benefits. It's an individual conversation with each patient but I think for women who are experiencing certain side effects such as joint aches and pains and problems with appetite and nausea, it can be a great tool to help with the side effects.

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@Villazon I have been using Ibrance and Fulvestrant injection since July aside facts have been tolerable but this last month I have been getting dehydrated I drink plenty of fluids but still dehydrated. Should I bother my oncologist?

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DrTeplinsky in reply to Maem

Absolutely call your oncologist!! Remember, you are not bothering us when you call. We WANT to hear from you! Definitely call and mention the side effects you are having.

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Besides BRACA! and BRACA2, are there other DNA combinations that are known to be dangerous?

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DrTeplinsky in reply to Maem

There are many other genetic mutations that increase your risk for breast cancer and/or other cancers-- such as PALB2, CHEK2 and much more. This is why we are no longer screening just for BRCA 1/2 mutations but doing expanded panels that look for all these different mutations.

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@nat1990 Does a normal tumour marker result mean there is no tumour? Thanks

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DrTeplinsky in reply to Maem

Not at all. Tumor markers are notoriously not reliable and they are the most useful in monitoring response to treatment (i.e. its 500 when you start treatment and it goes down to 350 with treatment-- that can guide you that perhaps treatment is working). I have seen many cases where the tumor marker is negative and there is in fact known cancer and vice versa.

Are there any new metastatic breast cancer treatments in the pipeline? I remember hearing about alpelisib, but is there anything else?

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DrTeplinsky in reply to

There are a ton-- depending on whether tumor is estrogen receptor positive, HER2 positive or triple negative breast cancer. Lots of amazing new drugs being studied- new compounds, new targets etc!! So much potential. I do think alpelisib will be FDA approved in the near future.

in reply to DrTeplinsky

Thank you, Dr. Teplinsky! That sounds great. I'm in the UK, so FDA approval won't affect me and my treatments.But hopefully that means we will soon get those treatments over here too.

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@ Rotagirl Halfway through 2nd cycle of Palbociclib ( 125 Ibrance) and letrozole. Comparatively new treatment in UK. Painful mouth ulcers getting me down, can cope with tiredness. Have tried gargles, rinses, gels, bonjela, anything else?

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DrTeplinsky in reply to Maem

You may need a dose reduction of the Ibrance. I would talk with your oncologist. It is still effective at a lower dose.

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