Taxol and Small Cell Carninoma of the Breast

[mathews52]

My sister has been diagnosed as having breast cancer identified as Small Cell Carcinoma of the left Breast.  It is the primary site.  It didn't originate in the lungs. It has spread to various lymph nodes throughout her body.  The doctor is treating her with Taxol.  I have read the literature for the drug and it specifically says it is ineffective for small cell to the lung.  It says nothing about the breast.  My sister has been told that she will be on it for the rest of her life.  She was told, in clear terms that she will be given the drug for as long as it works and it will eventually be ineffective.  I asked the doctor about the use of Taxol and he told me that he was treating the lymph nodes for which the drug was effective in an effort to contain the cancer, reduce the lymphadema and to bring the disease under control.  So my question is whether this seems to be an appropriate strategy?  Are there really no treatments available for small cell of the breast?  How do I help my sister deal with the feelings she has of hoplessness and dispair since she has been told she will die, but we don't know if it will be one month, one year or ten years?  We want to make this time as productive for her as possible and give her a quality of life to the extent possible.  Finally, how do I consel her with regard to treatment. The idea of perpetual treatment with doctors, needles and hospitals weekly forever is very difficult for anyone to bear.  I know I have asked a lot of questions.  We are having a tough time with this and any guidance would be wonderful.

[CCF-RN,MSN-rf]

Dear mathews52:  You are describing a neuroendocrine tumor that just happens to be located in the breast.  As you mention, it is spread throughout the body, making her disease stage 4.  Treatment for this can include a number of drugs, either alone or in combination.  Taxol, cisplatin and etoposide are drugs that show activity in this disease, so taxol is not an unreasonable choice.  As long as it appears to be working, it is reasonable to continue.  There are three reasons to stop therapy in this situation:  1.  The drug stops working (switch to a new drug); 2.  The toxicity is not tolerable (either switch drugs or stop treatment); 3.  There is no evidence of disease.  All scans are negative.  (this is unlikely, but not impossible.  even if this happens, the disease is likely to return).  No one really knows how long a person will live.  Part of this will depend on how well and how long the drug works.  To attempt to answer your question, your sister will likely live months to years (but likely not 10 years).

[surgeon]

"small cell" is not a term commonly used in reference to breast cancer. But the issue is certainty regarding the cell of origin; in other words, it's less important that the cells might be called small cells than it is to know from where they came. Breast cancer is breast cancer, wherever the cells show up; likewise, lung cancer is lung cancer, even if it's found in bones, etc. Taxol is effective against many cancers of breast origin, no matter some other characteristics. So it would be a reasonable choice if it's felt likely that the cancer arose in the breast.

[cow chaser]

Please look into IP6 with inositol on the net...  I had 5cm ductal cancer started the ip6.. my pet scan is negative... Praise God!

[mathews52]

Thank you so very much for your helpful information.  What you have told me is what i expected to hear, but I wanted to hear it from someone else rather than just speculating myself.  I asked about alternative treatmente becuase the oncologist originally told us that he felt that Taxol was the only viable agent in my sister's case.  Now, after two treatments, he says she is responding but not as well as he had expected.  He is going to do a third treatment and then rerun all the scans to see if there had been any further expansion of the disease.  From there he intends to change her treatment.  I love my sister very much and have a difficult time watching her go through this.  But I find honest answers combined with an understanding of what is happening easier to deal with than not knowing.  Thank you again for the help.

[UncleLou]

A related discussion, My niece has just been diagnosed with breast cancer small cell was started.