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Doctors' Answers to "Frequently Asked Questions" - Breast Cancer

Related Women's Issues

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Breast Cancer Treatment [posted 1/6/99]
Question:While I was receiving AC treatment for breast cancer my hemoglobin ranged from 10.1 to 8.4. My niece's hemoglobin went down to 7.5. She was hospitalized and given blood transfusions. She was on her college running team. Should I have been concerned when my hemoglobin went to 8.4.? Is there a difference in how to treat anemia by cause of the anemia? How low can one's hemoglobin be when receiving chemotherapy before a treatment is started and how do they treat it?

Answer: A lot depends on the rate of loss and the symptoms. For example, rapid blood loss will cause more problems than slow since your body can adjust to a slow loss better. Generally, we transfuse about 25 (Hg of about 8) and almost always by a Hct of 20 (6.5 or so). But, it depends a lot on how weak, short of breath etc., you are.

Breast Cancer
Question: What could I do to prevent myself from any chances of having breast cancer? Do you think that experts have done a satisfactory job to cure or find the causes of breast cancer? As a doctor, what is the major problems that faced you in your field and your life style?

Answer: To prevent breast cancer, keep a low fat diet, avoid radiation to your chest (even x-rays and strong sunlight), do regular breast exams, breast feed your children, and pick the right parents. After 40, get regular mammograms. The cause and hopefully the cure for breast cancer will come out of basic research in the human chromosome for aging and repair of DNA in the human body. Often times direct research will not provide the answer, but basic research will. Consequently, a wide avenue of research will give us the answers in all types of cancer-especially breast. I think that sufficient research is being done considering the funding priorities. However, my bias is to focus on human issues and not on many of the wasted federal dollars in defense, crop subsidies, etc.

Breast Cancer
Question: What does the presence of calcium deposits found in a mammogram indicate? Are they a precursor to breast cancer? There is a history of breast cancer in my family. Most recently, calcium deposits were found in my mammogram. I am age 60. Now I have a mammogram every 6 months.

Answer:The presence of calcium by itself means nothing. Calcium can occur from several sources including previous trauma. However, many cancers have calcium flecks or deposits which show on mammograms, probably due to the blood supply of the tumor. Consequently, new specs raise the possibility of cancer. Usually these are always biopsed. If they are negative no further evaluation is necessary.

Weight Gain
Question: I was diagnosed with breast cancer 2.5 years ago. I am 41 now and had 10 months of chemo and I am on Tamoxifen for 5 years. I gained 40 pounds during chemo and became very depressed. I went to a Psy. and he put me on Zoloft 1 year ago. Since then I have gained another 30 pounds even after exercising 10 hours per week, 3 with a personal trainer. My gyn. told me the Zoloft was making me gain not the Tamox as I had thought. I quit taking the Zoloft 1 week ago and have really gone downhill. Depression is back severely. Can you please give me an answer to this weight problem? Is it Zoloft or Tamox?

Answer: Could be either. Most of my patients on Tamoxifen will gain weight. Zoloft also. Try a different antidepressant like Wellburtin, Serzone etc.

Stage IV Metaststic BC
Question: My wife has stage IV metaststic Breast Cancer and has recently begun treatment with the drug Taxotere, with the hope that she will be able to have a bone marrow transplant. What are some of the possible side effects of this drug? How can they be combated? Is it safe (advisable) to use nutritional supplements, while undergoing this treatment?

Answer: Taxoter(docetaxel) works by disrupting the microtubular network in cells responsible for mitotic and interphase functions. Its side effects include neutropenia(low white count), low platelets, anemia, hypersensitivity, fluid retention, and liver toxicity. Most nutritional supplements would be ok; but, check specifically with your physician.

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