Time to fight, no time to lose

First, an update on the surgery and how I am healing:  I am doing pretty well.  My incisions look good, the drains are slowing down and I am hoping they can be removed on Thursday, my right arm is almost back to normal and my left arm is getting better.  Some of the numbness is fading and I am starting to feel almost human.  I ventured out to the grocery store this morning, alone, much to the displeasure of Rick.  But this was not against doctor's orders...we needed a few things, I took a small cart so I wouldn't be tempted to get more than I could handle, and I am not taking any drug that would compromise my ability to drive safely. 

I received a call from the breast surgeon's nurse with the rest of the pathology information.  This cancer has a mission and it's going to take every ounce of fight in me to send it into remission.  All my hormone receptors came back negative and the Ki67 (rate of cell division) was 77.  I don't fit the profile for triple negative breast cancer and I don't fit the profile for a cancer growing at this speed - these are supposed to be "young" women's pathology.  Furthermore, metformin is thought to slow down the cell division rate.  And there is thought that it can prevent a recurrence.   My last hope for the metformin is that it partners with chemo to bring a complete pathological response...in other words, put me into complete remission.

When I first talked to my new oncologist, she said she would want me to do four cycles of  Adriamycin and Cytoxin (AC) followed by four cycles of one of the Taxanes.  I hear there is a shortage of Adriamycin, so there is another regimen currently in use... fluorouracil, epirubicin & cyclophosphamide (FEC) and I think this protocol is already used more commonly in Canada.

I've had my research hat on for the last couple of days and learned that there is another Taxane product  (made from the Pacific yew tree) called Abraxane.  Rather than being mixed with a solvent (castor oil) it is bound with nanoparticle albumin.  As a result, there is less likely to be an allergic reaction to the drug.  So there is no need to administer huge doses of steroids in advance of treatment.  And it has a better track record of keeping blood sugars in control than its cousins Taxol and Taxotere.  The results of the clinical study I found stated that the overall response rate was better for Abraxane than for either of the other Taxanes.  In the clinical trials, they administered higher doses of Abraxane than the alternative Taxane, in less time, with less side effects and better outcomes.   I wonder why it's not standard protocol. 

Here's a link for those of you who I know will want to read the information:

http://jco.ascopubs.org/content/23/31/7794.full

Regarding the FEC protocol, I need to do a little more homework. 

I have an appointment next Monday with both the breast surgeon and the oncologist.  While I really didn't want to start treatment until we get out east, I'm not sure waiting is wise.  It might be ill-advised, considering I have an active node still there, with cancer cells multiplying at light speed. 

Michelle