according my oncology MD I need to take Tamoxifen for 5 years, but according to Practice Guidelines in Oncology from NCCN I don’t need to take Tamoxifen. What will be your recommendation about my feature treatment? Thanks a lot.
Your doctor is not following standard of care. Get a second opinion. Per nccn guidelines you needed a repeat turbt to get muscle in specimen 4 to 6 weeks after first and maybe bcg if no muscle invasion. Sometimes a bad hgt1 can go straight to chemo then surgery to remove bladder but doesn't seem he is following standard protocol... there may be more to the story but look up the nccn guidelines for bladder cancer...
Dear markowd, NCCN guidelines for doing a bone scan with a diagnosis of breast cancer is only if bone pain or tests suggest cancer has spread to the bone. Your oncologist will be better able to discuss whether this test is necessary for you in context of your situation.
Your present tumor status is microinvasive disease (T1mic), and with reference to present guidelines, chemotherapy is indeed not indicated (per National Comprehensive Cancer Network or NCCN guidelines). I believe that additional chemotherapy will not give additional benefit since it is also unlikely that your present tumor status would lead to systemic spread.
however, I believe that additional treatment may still be warranted in the form of radiotherapy to the breast.
This has [url=http://www.dearcancer.org/]information about cancer [/url] and issues related to it.
Hi,
According to the latest National Comprehensive Cancer Network (NCCN) guidelines, the recommended treatment for ductal carcinoma in situ (DCIS) is either mastectomy alone or lumpectomy plus radiation. Radiotherapy is added to the lumpectomy because it decreases local recurrence rates by 50% compared to lumpectomy alone.
Lumpectomy alone, without subsequent radiotherapy, may be an appropriate treatment if the DCIS is considered to have a "low risk" of recurrence.
Hi. According to the latest National Comprehensive Cancer Network (NCCN) guidelines, the recommended treatment for ductal carcinoma in situ (DCIS) is either mastectomy alone or lumpectomy plus radiation. Radiotherapy is added to the lumpectomy because it decreases local recurrence rates by 50% compared to lumpectomy alone. Wide excision is NOT equivalent to lumpectomy (lumpectomy is a more extensive type of surgery), and is not the recommended procedure for treating DCIS.
Hi. According to the latest National Comprehensive Cancer Network (NCCN) guidelines, the recommended treatment for ductal carcinoma in situ (DCIS) is either mastectomy alone or lumpectomy plus radiation. Radiotherapy is added to the lumpectomy because it decreases local recurrence rates by 50% compared to lumpectomy alone.
Lumpectomy alone, without subsequent radiotherapy, may be an appropriate treatment if the DCIS is considered to have a "low risk" of recurrence.
Hi. The fact that you have been previously diagnosed with Stage IV colorectal cancer make persistent elevations in carcinoembryonic antigen (CEA) highly suggestive of recurrent disease. A CEA value persistently greater than 5.0 is already abnormal, and should already prompt a thorough work-up for recurrence. The higher the value of the CEA, the higher is the probability of the presence of metastases/ recurrent disease.
For Stage IIA patients who have undergone mastectomy and who have a metaplastic histology, the NCCN (National Comprehensive Cancer Network) guidelines suggest that radiation therapy be done if the tumor is 5cm or less and the margins of resection are close (less than 1 mm). Since the closest margin in your case is 0.5 cm or 5 mm, you have the option not to undergo radiotherapy.
The decision to receive chemotherapy or not depends on the stage (usually if positive lymph nodes or tumors greater than 1 cm in size [NCCN guidelines]). However, a grade 3 cancer can add a new dimension on the decision to undergo additional treatment. Though medullary cancer generally behaves less aggressively than the usual invasive ductal cancer, a grade 3 finding can influence you and your oncologist to give additional treatment (like chemotherapy).
total removal may be difficult. National Comprehensive Cancer Network (NCCN) practice guidelines for melanoma in 2006 are as follows (tumor thickness, recommended clinical margin):11
Tumor in situ, margin 0.5 cm
Tumor less than 1 mm, margin 1 cm
Tumor 1-2 mm, margin 1-2 cm
Tumor 2-4 mm, margin 2 cm
Tumor >4 mm, margin at least 2 cm
http://emedicine.medscape.
chemotherapy is recommended for breast cancers that are node positive, or those whose primary tumor has a size of more than 1cm according to the NCCN guidelines (national comprehensive cancer network). Chemotherapy aims to reduce the chance that the cancer will come back by an additional 10-15% by killing microscopic cancer cells called 'micrometastases' (there are actually no means to test for micrometastases; this is just intelligently assumed by cancer specialists).
Do you mean filgrastim? And are you saying Dengue fever? It would be a surprising though perhaps not impossible use of filgrastim. Dengue is usually treated by pain managers and sometimes hospitalization and a blood transfusion.
Anyway, if you have a legitimate prescription from a doctor, you should be able to fill it in the United States.
Certainly, intramuscular injection of Carboplatin is NOT standard procedure. The National Cancer Control Network (NCCN) treatment guidelines specify the use of Carboplatin in ovarian cancer for intravenous administration only. Giving chemotherapy prior to surgery in stage 2 ovarian cancer is a valid option. This procedure is called neoadjuvant chemotherapy. This is done to shrink the tumor or limit its spread before doing the surgery.
//www.nccn.org/patients/patient_gls.asp) also has information available for patients regarding treatment guidelines. These are guidelines and not treatment plans set in stone, but they do offer information about breast cancer and treatments used for various stages of the disease. The information may be helpful as a person is making treatment decisions, not in place of but in addition to the advice of their oncologist.
"....Chemotherapy and its related immunosuppression can cause a reactivation of HBV – "a potentially fatal and preventable disease," said Emmy Ludwig, MD, from Memorial Sloan-Kettering Cancer Center in New York City.
"Reactivation may complicate cancer therapy," said Dr. Ludwig, explaining that delays in treatment can result.
For this reason, patients are prescribed antibiotics and even receive injections to increase white blood counts (such as filgrastim or lenograstim).
If this 0.4 value really pertains to your white counts, then I believe this is really low and what you are experiencing is a condition called 'febrile neutropenia'. I would suggest you ask your doctor about filgrastim or lenograstim injections aside from the Levaquin.
Regards.
The National Comprehensive Cancer Network (NCCN), in their breast cancer guidelines, has issued the following criteria for determining if a woman is likely post-menopausal:
1. At least 60 years old.
2. If less than 60 years old, the woman has stopped menstruating for 12 months or more in the absence of chemotherapy, tamoxifen, toremifene or other hormonal treatment to suppress the ovaries, AND blood levels of FSH (follicle stimulating hormone) and estradiol are in the post-menopausal range.
Hi. The National Comprehensive Cancer Network (NCCN) guidelines state that removal of the uterus and ovaries is not routinely recommended even for those with full-blown Lynch syndrome (those who already have colon cancer). Hysterectomy/oophorectomy is, however, a reasonable option for those who have Lynch syndrome, as well as those who carry the gene.
Hi. The National Comprehensive Cancer Network (NCCN) guidelines for the treatment of breast cancer state that an absolute contraindication for lumpectomy is "widespread disease which cannot be incorporated by a single local excision which achieves negative margins". Since the lumpectomy was able to remove the two additional lesions with clean margins, the smaller lesions were in effect, "incorporated by a single local excision which achieves negative margins".
Thank you so much for your comments... My oncol. first recommend 6 rounds of chemo or abdominal radiation, but when I asked about the NCCN guidelines to just observe he said that "We could do that." He did ask about starting me on Tamoxifen. I said I might consider that but we did not agree as to when. Where we left it was he would see me in 3 months and I would get a ct scan and CA-125 blood work.
Filgrastim is also prescribed as pegfilgrastim (called Neulasta). My doctor used the 500 neutrophill count as a cut-off, so every time I got down around 500 I used Neulasta. The interferon drops neutrophils and platelets. Some people can do okay with low neutrophils but just as many end up with kidney and sinus infections, etc., that make you even more miserable.
Doctors unable to give any explanation for such wide variations on a dose to dose basis. Till date, I have also taken 5 doses of Filgrastim - the WBC Stimulator.
Can you pleae advice possible reasons for such wide fluctuations.
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