Aa
Hep C "cured" now breast cancer
Hi. It's been a year or so since my last post here. I did the horrible treatment in 2005 and cleared the virus. I was extremely ill and debilitated during the treatment and needed both Procrit and Neupogen.
It took me two years on many herbs and supplements (along wtih lifestyle changes) to feel close to how I felt before treatment and now I have been diagnosed with Stage I breast cancer. I had a lumpectomy and it was small but aggressive but not spread to the lymph nodes. The doctors are telling me I should do chemo.
Has anyone heard anything about chemotherapy reactivating the Hep C virus? I read that it's difficult doing chemo with HCV but can't find anything about after treatment. It's crazy but I'm faced with the same decision now that I had with Hep C. In my case they couldn't assure me the Hep C treatment would be successful and they can't say the chemo will prevent cancer from returning. It's a crapshoot. Since it's a very personal choice, I probably won't do the chemo after my experience doing this treatment.
-cbee
It took me two years on many herbs and supplements (along wtih lifestyle changes) to feel close to how I felt before treatment and now I have been diagnosed with Stage I breast cancer. I had a lumpectomy and it was small but aggressive but not spread to the lymph nodes. The doctors are telling me I should do chemo.
Has anyone heard anything about chemotherapy reactivating the Hep C virus? I read that it's difficult doing chemo with HCV but can't find anything about after treatment. It's crazy but I'm faced with the same decision now that I had with Hep C. In my case they couldn't assure me the Hep C treatment would be successful and they can't say the chemo will prevent cancer from returning. It's a crapshoot. Since it's a very personal choice, I probably won't do the chemo after my experience doing this treatment.
-cbee
I take your points and I agree with much in your post, although I think that probably "sleeping" goes some way into staving off cancer:) I made a point about agonizing over what caused cancer in another post relating to this topic...to me, it probably doesn't make much sense, in that once you have it, you have it. Like you said. This info is good for the cancer researchers though, obviously.
And, regrettably, this is the only treatment for hep c we have available, so many of us take what we need to take in order to eradicate this virus, and many of us remain grateful for it for obvious reasons. After all, hep c could be the greater thread to our livelihood in some cases. Beggars can't be choosers, unfortunately.
But, in my view, none of this takes away from Kittyface's original point, that cancer is indeed listed as a possible outcome, however rare. Ironically, most, if not all forms of chemo-therapy are. Hopefully, in the coming years, they will have much more benign therapies, but that's not happening anytime soon I'm afraid....which just adds to the giant "**** shoot" that this whole disease process (and it's treatments) pose for us. But yeah, just living is a **** shoot as well, in many ways. Just my take.
And, regrettably, this is the only treatment for hep c we have available, so many of us take what we need to take in order to eradicate this virus, and many of us remain grateful for it for obvious reasons. After all, hep c could be the greater thread to our livelihood in some cases. Beggars can't be choosers, unfortunately.
But, in my view, none of this takes away from Kittyface's original point, that cancer is indeed listed as a possible outcome, however rare. Ironically, most, if not all forms of chemo-therapy are. Hopefully, in the coming years, they will have much more benign therapies, but that's not happening anytime soon I'm afraid....which just adds to the giant "**** shoot" that this whole disease process (and it's treatments) pose for us. But yeah, just living is a **** shoot as well, in many ways. Just my take.
I just came across this and thought it might be of interest here.
Gene-Expression Signatures Predict Treatment Response in Breast Cancer Patients
Roxanne Nelson
November 23, 2007 — In breast cancer patients with estrogen-receptor-negative breast tumors, gene-expression signatures based on cell lines might be able to predict response to chemotherapy, researchers report in a study published in the November 14 online issue of the Lancet Oncology. Although long-term follow-up is needed to ascertain whether regimen-specific genomic signatures can also predict long-term survival, study results show that regimen-specific signatures significantly predicted a complete pathological response in patients treated with the appropriate regimen.
"This trial is a very good example of a modern concept — individualized medicine or treatment," senior author Hervé Bonnefoi, MD, from the department of medical oncology, Institut Bergonié, University of Bordeaux, France, told Medscape Oncology. "It [will be] a real improvement in the way we treat breast cancer if the positive predictive values and negative predictive values seen in this trial are confirmed in our ongoing validation study."
The results of the study were striking, he added. "That is why we need to confirm it — or not — urgently. I won't recommend use of these signatures before our confirmatory trial."..........
They found that the signatures significantly predicted response in patients who received the appropriate drugs. The FEC predictor showed a sensitivity of 96% (27 of 28 patients) and a specificity of 66% (25 of 38 patients). The positive predictive value (PPV) in this group was 68% (27 of 40 patients); the negative predictive value (NPV) was 96% (25 of 26 patients). The results were similar among patients in the second treatment group. The TET predictor had a sensitivity of 93% (25 of 27 patients) and specificity of 69% (22 of 32 patients). There was a PPV of 71% (25 of 35 patients) and a NPV of 92% (22 of 24 patients).
If genomic signatures had been used in all patients to determine the most appropriate therapy, the estimated hypothetical pathological complete response rate would have been 65% to 70%, which is well above the 42% and 46% pathological complete response rates that were observed in the FEC and TET groups in the clinical trial..........
See:
http://www.medscape.com/viewarticle/566436?sssdmh=dm1.320795&src=nldne
Mike
Gene-Expression Signatures Predict Treatment Response in Breast Cancer Patients
Roxanne Nelson
November 23, 2007 — In breast cancer patients with estrogen-receptor-negative breast tumors, gene-expression signatures based on cell lines might be able to predict response to chemotherapy, researchers report in a study published in the November 14 online issue of the Lancet Oncology. Although long-term follow-up is needed to ascertain whether regimen-specific genomic signatures can also predict long-term survival, study results show that regimen-specific signatures significantly predicted a complete pathological response in patients treated with the appropriate regimen.
"This trial is a very good example of a modern concept — individualized medicine or treatment," senior author Hervé Bonnefoi, MD, from the department of medical oncology, Institut Bergonié, University of Bordeaux, France, told Medscape Oncology. "It [will be] a real improvement in the way we treat breast cancer if the positive predictive values and negative predictive values seen in this trial are confirmed in our ongoing validation study."
The results of the study were striking, he added. "That is why we need to confirm it — or not — urgently. I won't recommend use of these signatures before our confirmatory trial."..........
They found that the signatures significantly predicted response in patients who received the appropriate drugs. The FEC predictor showed a sensitivity of 96% (27 of 28 patients) and a specificity of 66% (25 of 38 patients). The positive predictive value (PPV) in this group was 68% (27 of 40 patients); the negative predictive value (NPV) was 96% (25 of 26 patients). The results were similar among patients in the second treatment group. The TET predictor had a sensitivity of 93% (25 of 27 patients) and specificity of 69% (22 of 32 patients). There was a PPV of 71% (25 of 35 patients) and a NPV of 92% (22 of 24 patients).
If genomic signatures had been used in all patients to determine the most appropriate therapy, the estimated hypothetical pathological complete response rate would have been 65% to 70%, which is well above the 42% and 46% pathological complete response rates that were observed in the FEC and TET groups in the clinical trial..........
See:
http://www.medscape.com/viewarticle/566436?sssdmh=dm1.320795&src=nldne
Mike
But just about everything causes cancer, it is the second biggest killer for a reason. Sleeping causes cancer, just living causes cancer. You can lead a perfectly healthy life, yet still get cancer. It just happens, whether it be genetic, or brought on more rapidly through external factors. Once you have it, I doubt it really matters how you got it, anymore than it matters how one got Hep C.
You have gone through so much and now this. My heart goes out to you.
As far as HCV tx causing cancer, I believe cancer is listed as one of Ribavarin's risks.
As far as HCV tx causing cancer, I believe cancer is listed as one of Ribavarin's risks.
Thre is so much the medical community cannot tell us. Therefore, I don't put my full faith in what they tell me or don't tell me. I believe that I have made the right decision for me and it has been made lightly or withoiut careful consideration of all the known facts
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I am with you 100%. The medical community does not know it all and its best to get their advice, weigh it all - THEN deceide, which is exactly what you have done. Good for you! You have a good head on your shoulders thats for sure. Wish you the best cbee.
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I am with you 100%. The medical community does not know it all and its best to get their advice, weigh it all - THEN deceide, which is exactly what you have done. Good for you! You have a good head on your shoulders thats for sure. Wish you the best cbee.
Hi. I really didn't think my thread would have produced so many replies. I'm glad that everyone feels comfortable enough to express their opinions. That is what we are all here for.
Just to clear up the confusion. I was just asking if anyone had heard of a reactivation. There are numerous studies of Hep B reactivation but I only found a couple about Hep C. They do say it is possible. What I do know about the studies on SVR and reocurrence from chemo is that they are very new. The article above shows that it did happen to the 47 year old man who developed lymphoma after Hep C treatment. His virus was reactivated following chemo. And who can say positively whether or not his lymphoma was a result of the immune suppression during Hep C treatment? Remember there are a lot of unknowns just as there was when I did my treatment in 2005.
I live in Los Angeles and I've been to 2 very prominent oncologists. I like and respect them both very much. They both gave me statistics for not doing and doing chemo. They both suggest it based on "statistics". But in fact that oncologist I quoted above was the one who suggested the more aggressive treatment yet he said that he couldn't argue with my conclusions which were: "I have read about chemotherapy causing reoccurrence of hepatitis. I have read that so many people who do chemo it doesn’t work for. No one can tell me for sure if I am one of the people who will benefit from it. No one can tell me that if I do the chemo I won’t have a reoccurrence" I am meeting with the other oncologist tomorrow who is much more conservative in his treatment and I believe he will respond the same way.
I read an article recently that really resonated with me. I'lll quote a portion:
"It has been estimated that, by the laws of chance, all people actually produce about 10,000 potentially mutagenic cells every day. Those are normally identified as defective by the immune system and removed. In carcinogenesis, however, some of these "rogue" cells escape detection and go on to form tumors. A strong healthy body in a good nutritional state will be more abl to identify mutangenic cells when they arise and to deal with them than a body whose immune system is weakened by poor diet and other physiological stresses. In the developement of cancer it is usually not the availability of pathogens that is significant, but the condition of the body. If a body is sub-standard to its optimum level of functioning then nature tends to remove that body through disease and death.
This is my personal opinion but If you ask me whether I think the severely debilitated immune suppressed condition I was in for months on treatment in 2005 has something to do with my cancer. I do. Perhaps I was predisposed but I still believe this to be true in my case. I also know that my side effects were extreme even though I was healthy when I started treatment and had very little fibrosis. I am extremely sensitive to medicines. I struggled for 15 years over whether or not I would treat the Hep C and although I am thankful for the outcome I wouldn't have done it again has the outcome been different.
Thre is so much the medical community cannot tell us. Therefore, I don't put my full faith in what they tell me or don't tell me. I believe that I have made the right decision for me and it has been made lightly or withoiut careful consideration of all the known facts.
I thank you all for your time, thoughts and best wishes.
-cbee
Just to clear up the confusion. I was just asking if anyone had heard of a reactivation. There are numerous studies of Hep B reactivation but I only found a couple about Hep C. They do say it is possible. What I do know about the studies on SVR and reocurrence from chemo is that they are very new. The article above shows that it did happen to the 47 year old man who developed lymphoma after Hep C treatment. His virus was reactivated following chemo. And who can say positively whether or not his lymphoma was a result of the immune suppression during Hep C treatment? Remember there are a lot of unknowns just as there was when I did my treatment in 2005.
I live in Los Angeles and I've been to 2 very prominent oncologists. I like and respect them both very much. They both gave me statistics for not doing and doing chemo. They both suggest it based on "statistics". But in fact that oncologist I quoted above was the one who suggested the more aggressive treatment yet he said that he couldn't argue with my conclusions which were: "I have read about chemotherapy causing reoccurrence of hepatitis. I have read that so many people who do chemo it doesn’t work for. No one can tell me for sure if I am one of the people who will benefit from it. No one can tell me that if I do the chemo I won’t have a reoccurrence" I am meeting with the other oncologist tomorrow who is much more conservative in his treatment and I believe he will respond the same way.
I read an article recently that really resonated with me. I'lll quote a portion:
"It has been estimated that, by the laws of chance, all people actually produce about 10,000 potentially mutagenic cells every day. Those are normally identified as defective by the immune system and removed. In carcinogenesis, however, some of these "rogue" cells escape detection and go on to form tumors. A strong healthy body in a good nutritional state will be more abl to identify mutangenic cells when they arise and to deal with them than a body whose immune system is weakened by poor diet and other physiological stresses. In the developement of cancer it is usually not the availability of pathogens that is significant, but the condition of the body. If a body is sub-standard to its optimum level of functioning then nature tends to remove that body through disease and death.
This is my personal opinion but If you ask me whether I think the severely debilitated immune suppressed condition I was in for months on treatment in 2005 has something to do with my cancer. I do. Perhaps I was predisposed but I still believe this to be true in my case. I also know that my side effects were extreme even though I was healthy when I started treatment and had very little fibrosis. I am extremely sensitive to medicines. I struggled for 15 years over whether or not I would treat the Hep C and although I am thankful for the outcome I wouldn't have done it again has the outcome been different.
Thre is so much the medical community cannot tell us. Therefore, I don't put my full faith in what they tell me or don't tell me. I believe that I have made the right decision for me and it has been made lightly or withoiut careful consideration of all the known facts.
I thank you all for your time, thoughts and best wishes.
-cbee
OK. I think we're in agreement then that cbee should get all the medical input necessary before she passes on treatment for her breast cancer. Also, I didn't see any medical advice in this thread as well -- except if suggesting someone get medical advice is medical advice, hmm. In any event, hopefully everyone here -- or in any forum for that matter -- checks anything they read with independent sources, including their own doctor. I know I always did, but must say, the catalyst for a lot of that indendent research came from internet sources like here. The internet is great, just have to know its limitations and how to use it.
-- Jim
-- Jim
Nooo, the whole issue really has to do with whether after researching and weighing the pro's and con's, Cbee should treat her breast cancer now, or decline treatment because of some of the reservations expressed-
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Jim,
I understand what you are saying, but that was not her question. She asked if anyone has heard of "reactivation." She received a few studies and then "discussion" took place between you and I as far as reactivation. She had "already" told her Oncologist last night that she had made a decision NOT to get chemo....But I do agree with you as far as getting another opinion and weighing it all. Without a doubt you're right about that. Another doctor may tell her to get radiation and she may feel more comfortable with that. Its a tough decision for anyone, but yes I myself would speak to another Oncologist and also my Hepatologist.
And the heads-up? You don't need a heads up- you know me. Bill O'Reilly I think must be my cousin. Don't get me wrong. I like me. Very much too. I'm my best friend.
Susan I don't see where anyone gave medical advice. But I do agree with you - no one should give medical advice except a doctor.
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Jim,
I understand what you are saying, but that was not her question. She asked if anyone has heard of "reactivation." She received a few studies and then "discussion" took place between you and I as far as reactivation. She had "already" told her Oncologist last night that she had made a decision NOT to get chemo....But I do agree with you as far as getting another opinion and weighing it all. Without a doubt you're right about that. Another doctor may tell her to get radiation and she may feel more comfortable with that. Its a tough decision for anyone, but yes I myself would speak to another Oncologist and also my Hepatologist.
And the heads-up? You don't need a heads up- you know me. Bill O'Reilly I think must be my cousin. Don't get me wrong. I like me. Very much too. I'm my best friend.
Susan I don't see where anyone gave medical advice. But I do agree with you - no one should give medical advice except a doctor.
No one on hear-besides a physician, should be depensing medical advice--only opinions--when referring to what they would do for their own situation-if it happened to them. While there are certain people on here who may have done a lot of research on Hep C, there are not a lot of doctors on here. Please keep this in mind when you are reading posts on message boards....IMHO.
Susan
Susan
MO: his whole issue has to do with whether a person believes that when the immune system is lowered - whether by chemo or immunosuppressants - will the virus rear its ugly head? T
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Nooo, the whole issue really has to do with whether after researching and weighing the pro's and con's, Cbee should treat her breast cancer now, or decline treatment because of some of the reservations expressed.
To me, this is the core issue, and it sounds like Cbee may want more medical input. - I certainly would.
BTW thanks for the heads-up, so I am following your instructions and not "replying back" to you. Just to Cbee :)
-- Jim
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Nooo, the whole issue really has to do with whether after researching and weighing the pro's and con's, Cbee should treat her breast cancer now, or decline treatment because of some of the reservations expressed.
To me, this is the core issue, and it sounds like Cbee may want more medical input. - I certainly would.
BTW thanks for the heads-up, so I am following your instructions and not "replying back" to you. Just to Cbee :)
-- Jim
I am far from an expert in breast cancer, my only point was that you have to weigh the risks of treating the breast cancer against the rewards, i.e. successful treatment
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Jim, I mean really. It has nothing to do with being an expert on breast cancer. This whole issue has to do with whether a person believes that when the immune system is lowered - whether by chemo or immunosuppressants - will the virus rear its ugly head? The people that don't believe in residual virons after successful tx of hcv will most likely say "no it is NOT possible." The person that does believe in residual virons left over after successful HCV tx will say "its possible for reactivation, but maybe not in all cases - too many other things probably need to be considered. etc."
Now I'm the extreeeeeme,,,,I believe that even "chronic stress, mental trauma, sudden shock such as unexpected death etc" - could possibly reactivate HCV in a person who is SVR. This category, most likely very few people would fall into IMO and thank God,,,but I know "me", my personality, and just how I am and I would in fact have to be careful. I'm very sensitve or some may say not 'senstive" but nutso. And this last category I see myself in.
Please don't reply back. Really cause I'll drive you up a wall if you do - I don't stop- "I'm extreeeeeme." And I have to run now anyhow. bye - bye Jimmmmmmmmmie.
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Jim, I mean really. It has nothing to do with being an expert on breast cancer. This whole issue has to do with whether a person believes that when the immune system is lowered - whether by chemo or immunosuppressants - will the virus rear its ugly head? The people that don't believe in residual virons after successful tx of hcv will most likely say "no it is NOT possible." The person that does believe in residual virons left over after successful HCV tx will say "its possible for reactivation, but maybe not in all cases - too many other things probably need to be considered. etc."
Now I'm the extreeeeeme,,,,I believe that even "chronic stress, mental trauma, sudden shock such as unexpected death etc" - could possibly reactivate HCV in a person who is SVR. This category, most likely very few people would fall into IMO and thank God,,,but I know "me", my personality, and just how I am and I would in fact have to be careful. I'm very sensitve or some may say not 'senstive" but nutso. And this last category I see myself in.
Please don't reply back. Really cause I'll drive you up a wall if you do - I don't stop- "I'm extreeeeeme." And I have to run now anyhow. bye - bye Jimmmmmmmmmie.
I am far from an expert in breast cancer, my only point was that you have to weigh the risks of treating the breast cancer against the rewards, i.e. successful treatment.
Cbee, I'm still unclear how serious your breast cancer is, but if your oncologist said it needed to treated, and is now backing off based on your email, I would definitely seek a second opinion elsewhere. There sometimes is a fine line between a doctor listening to a patient's wishes and just backing away from a problem. Also, if you do find a doctor who listens to your wishes, then you want to be 100% sure you know what you want, and what it is based on. Not sure, based on this thread, that you are there yet -- and needless to say, none of us who have posted here are doctors.
I would hate to see you not treat your breast cancer, without getting another opinion re how important it may be (or may not to be) treat it now.
-- Jim
Cbee, I'm still unclear how serious your breast cancer is, but if your oncologist said it needed to treated, and is now backing off based on your email, I would definitely seek a second opinion elsewhere. There sometimes is a fine line between a doctor listening to a patient's wishes and just backing away from a problem. Also, if you do find a doctor who listens to your wishes, then you want to be 100% sure you know what you want, and what it is based on. Not sure, based on this thread, that you are there yet -- and needless to say, none of us who have posted here are doctors.
I would hate to see you not treat your breast cancer, without getting another opinion re how important it may be (or may not to be) treat it now.
-- Jim
Again, all I remember is a study which cited maybe 4-6 patients who *may* have reactivated due to chemo-like therapy. In my book that makes it rare (given the thousands of SVRs who probably have done chemo) until we have data showing otherwise
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True - not enough data out there AND IF there ARE 1,000's of SVR's out there who have gone thru chemo AFTER achieving SVR and REMAINED SVR after cancer tx THEN this should be recorded somewhere(?),,,,BUT think of this.......a hcv patient goes through tx, is SVR for - lets say 5 years,,,now all of a sudden finds out he or she has cancer - undergoes cancer tx successfully,,,,,hasn't talked to her hep doc in 5 years - just gets a once a year PCR by her PCP - so guess what - her hepatologist never even hears she had gone through cancer tx. Is this possible? I think it could be in some cases.....And if she does go back to the Hepatologist to tell him she successfully cleared cancer and no problem with Hcv comming back - does this info go into some central data bank? I really don't know. Because really Jim, think of it,,you mentioned "a study" where 4 -6 patients may have had hcv 'reactivated," - true thats ONE study and how many people were in this study, cause that answer would be important too.
If there ARE thousands who may be in this situation, the results of their situation is very important and they should not have to be IN a study for that info to get to where it has to go for ALL to see whats really going on when people are faced with this. Unfortunately many of us may face cancer someday if we are 'realists,' not trying to be a pessimist, but even the very drugs we take for the 'cure' may down the road cause a problem and so the patients that do or don't have HCV reactivation should be carefully recorded somewhere. Shouldn't just be recorded when involved in a study. I might be all over the map here, I don't know.
Now to me the Oncologist should connect with the Hepatologist even if the patient hasn't seen the hep doctor in quite some time due to SVR for years..IF he thinks that cancer tx may affect a patients SVR status - BUT will the Oncologist think the cancer tx will in fact affect maybe Occult virons - how would he know this? This (occult issue) is house- divided even amongst the hepatologists it seems? So who knows.
Yeah turkey day was good. I love Thanksgiving. Hope yours was good too.
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True - not enough data out there AND IF there ARE 1,000's of SVR's out there who have gone thru chemo AFTER achieving SVR and REMAINED SVR after cancer tx THEN this should be recorded somewhere(?),,,,BUT think of this.......a hcv patient goes through tx, is SVR for - lets say 5 years,,,now all of a sudden finds out he or she has cancer - undergoes cancer tx successfully,,,,,hasn't talked to her hep doc in 5 years - just gets a once a year PCR by her PCP - so guess what - her hepatologist never even hears she had gone through cancer tx. Is this possible? I think it could be in some cases.....And if she does go back to the Hepatologist to tell him she successfully cleared cancer and no problem with Hcv comming back - does this info go into some central data bank? I really don't know. Because really Jim, think of it,,you mentioned "a study" where 4 -6 patients may have had hcv 'reactivated," - true thats ONE study and how many people were in this study, cause that answer would be important too.
If there ARE thousands who may be in this situation, the results of their situation is very important and they should not have to be IN a study for that info to get to where it has to go for ALL to see whats really going on when people are faced with this. Unfortunately many of us may face cancer someday if we are 'realists,' not trying to be a pessimist, but even the very drugs we take for the 'cure' may down the road cause a problem and so the patients that do or don't have HCV reactivation should be carefully recorded somewhere. Shouldn't just be recorded when involved in a study. I might be all over the map here, I don't know.
Now to me the Oncologist should connect with the Hepatologist even if the patient hasn't seen the hep doctor in quite some time due to SVR for years..IF he thinks that cancer tx may affect a patients SVR status - BUT will the Oncologist think the cancer tx will in fact affect maybe Occult virons - how would he know this? This (occult issue) is house- divided even amongst the hepatologists it seems? So who knows.
Yeah turkey day was good. I love Thanksgiving. Hope yours was good too.
Thank you so much for your thoughts. I emailed my wonderful oncologist last night about my concerns and my decision not to do chemo and received this email response this morning:
"Thank you for the kind update. I understand your thought process and cannot argue with your conclusions. I wish you the very best and will always be here if you need to talk, ask questions, vent, or whatever. I am here to support you and to lend a hand whenever you need me. I am a firm believer that each person should make decisions for herself, and that everyone should be able to be their own guiding force. If I can ever be of use, please do not hesitate to call."
My email stated to him all my concerns, etc. Although he didn't specifically address the Hep C reoccurrence issue, he couldn't argue with my "conclusions" which were all about unknowns. I truly wished I could have found a doctor like this when I was treating for the Hep C - I certainly did not! Perhaps that compassion would have helped me through it.
Thank you everyone for your thoughts. Keep helping each other because it works to have the support of people who know what you are going through.
If you like to read, I'm reading a great book called "Excuse me, Your Life is Waiting" by Lynn Grabhorn. It's a NY Times best-seller. I've had this book for months but was unable to get into it before. Funny what a life-threatening disease can do . . .
I wish SVR to all of you. .
-cbee
"Thank you for the kind update. I understand your thought process and cannot argue with your conclusions. I wish you the very best and will always be here if you need to talk, ask questions, vent, or whatever. I am here to support you and to lend a hand whenever you need me. I am a firm believer that each person should make decisions for herself, and that everyone should be able to be their own guiding force. If I can ever be of use, please do not hesitate to call."
My email stated to him all my concerns, etc. Although he didn't specifically address the Hep C reoccurrence issue, he couldn't argue with my "conclusions" which were all about unknowns. I truly wished I could have found a doctor like this when I was treating for the Hep C - I certainly did not! Perhaps that compassion would have helped me through it.
Thank you everyone for your thoughts. Keep helping each other because it works to have the support of people who know what you are going through.
If you like to read, I'm reading a great book called "Excuse me, Your Life is Waiting" by Lynn Grabhorn. It's a NY Times best-seller. I've had this book for months but was unable to get into it before. Funny what a life-threatening disease can do . . .
I wish SVR to all of you. .
-cbee
n conclusion, our study, while confirming the high prevalence of HCV infection in NHL patients in specific geographic areas, points out that HCV reactivation after chemotherapy is not a clinical problem.
http://bloodjournal.hematologylibrary.org/cgi/content/full/99/2/724
http://bloodjournal.hematologylibrary.org/cgi/content/full/99/2/724
MO: Jim, though they don't give detail this appears to me that they "are" seeing this happen
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They don't give details because apparently they did not have a single viral reactivation in their study or for sure it would be cited.
Again, all I remember is a study which cited maybe 4-6 patients who *may* have reactivated due to chemo-like therapy. In my book that makes it rare (given the thousands of SVRs who probably have done chemo) until we have data showing otherwise.
Now that doesn't mean there may be other reasons someone with liver damage may not want to due chemo -- just referring to the viral reactivation part.
Hope you had a happy Turkey.
-- Jim
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They don't give details because apparently they did not have a single viral reactivation in their study or for sure it would be cited.
Again, all I remember is a study which cited maybe 4-6 patients who *may* have reactivated due to chemo-like therapy. In my book that makes it rare (given the thousands of SVRs who probably have done chemo) until we have data showing otherwise.
Now that doesn't mean there may be other reasons someone with liver damage may not want to due chemo -- just referring to the viral reactivation part.
Hope you had a happy Turkey.
-- Jim
Jim, though they don't give detail this appears to me that they "are" seeing this happen - but who knows how often,,,but Dr. A did tell me SVR is SVR but if having to undergo chemo could be a problem. 2nd paragraph in b/c article
"The researchers indicated in his presentation that poor outcomes in terms of "VIRAL REACTIVATION", premature termination of chemotherapy, and delay in treatment schedules pose a significant risk for this group of patients.
Maybe my mothers Oncologist would know something. He has a very large practice and he must have had somebody who has gone through hep c treatment - then chemo. Even though I couldn't base any info he might give me as "a study" but it might be helpful if I ask him. I'll have to see wait until I see if he's in a good mood though:)
"The researchers indicated in his presentation that poor outcomes in terms of "VIRAL REACTIVATION", premature termination of chemotherapy, and delay in treatment schedules pose a significant risk for this group of patients.
Maybe my mothers Oncologist would know something. He has a very large practice and he must have had somebody who has gone through hep c treatment - then chemo. Even though I couldn't base any info he might give me as "a study" but it might be helpful if I ask him. I'll have to see wait until I see if he's in a good mood though:)
Hopefully, my main point didn't get lost in the article commentary.
Basically what I was trying to say is that you should base your decision to treat the cancer on what the doctors are telling you about the cancer, and not because you think the Hep C may reactivate. As stated, reactivation while apparently possible, is rare, with only a handful of cases cited out of what must be thousands of people who did chemo after becoming SVR.
So, if your doctors are saying to treat the cancer, thats what I would do. If on the other hand, you aren't sure if the cancer needs treatment, then by all means get a second opinion.
All the best,
-- Jim
Basically what I was trying to say is that you should base your decision to treat the cancer on what the doctors are telling you about the cancer, and not because you think the Hep C may reactivate. As stated, reactivation while apparently possible, is rare, with only a handful of cases cited out of what must be thousands of people who did chemo after becoming SVR.
So, if your doctors are saying to treat the cancer, thats what I would do. If on the other hand, you aren't sure if the cancer needs treatment, then by all means get a second opinion.
All the best,
-- Jim
--------------"It's a crapshoot. Since it's a very personal choice, I probably won't do the chemo after my experience doing this treatment."---------------------
As Hep Tx can be a crapshoot. Since starting this tx, and knowing several having gone thru chemo, I have also said I doubt that I'd choose chemo again.
Very sorry for you in this. My totally 'un-scientific' opinion tho is that breast cancer, especially early-hasn't spread to the lymph nodes, is curable. A couple women I know that went thru it said it was not so bad of chemo tx.
Of course as with Hep tx , varies from person to person.
I wish you the best, hate seeing someone go thru this rough tx and than get faced with that.
Good luck in deciding what to do.
LL
As Hep Tx can be a crapshoot. Since starting this tx, and knowing several having gone thru chemo, I have also said I doubt that I'd choose chemo again.
Very sorry for you in this. My totally 'un-scientific' opinion tho is that breast cancer, especially early-hasn't spread to the lymph nodes, is curable. A couple women I know that went thru it said it was not so bad of chemo tx.
Of course as with Hep tx , varies from person to person.
I wish you the best, hate seeing someone go thru this rough tx and than get faced with that.
Good luck in deciding what to do.
LL
Sorry about what's happening.
As far as I can tell, reactivation of HCV from chemo is quite rare -- and therefore your decision should be primarily on the cancer and not the possiblity of reactivation. If memory serves me, only 6-7 documented cases of reactivation in the literature after chemo/immunosuppresive therapy following long-term SVR.
As to the first study above, it seems to contradict itself, or perhaps -- and maybe more likely -- something got lost in the translation, as the study was done in Greece and not sure what language.
The study first states: ""It is known that sustained virological response in patients with chronic hepatitis C is associated with sustained elimination of hepatitis C virus and that late relapse after SVR in HCV patients is doubtful"
It then goes on to identify on a singular case of reactivation, and then concludes:
"This case suggests that recurrence of ΗCV infection in a sustained responder may be probable after immunosuppressive therapy. Prevention is currently impossible but retreatment may be successful."
Obviously -- at least to me -- one case cannot translate into "probable" and my guess is that the word actually used was "possible" and not "probable" -- a major difference --. But in any event, the word used should have been "possible", because that is what's supported by the data.
-- Jim
As far as I can tell, reactivation of HCV from chemo is quite rare -- and therefore your decision should be primarily on the cancer and not the possiblity of reactivation. If memory serves me, only 6-7 documented cases of reactivation in the literature after chemo/immunosuppresive therapy following long-term SVR.
As to the first study above, it seems to contradict itself, or perhaps -- and maybe more likely -- something got lost in the translation, as the study was done in Greece and not sure what language.
The study first states: ""It is known that sustained virological response in patients with chronic hepatitis C is associated with sustained elimination of hepatitis C virus and that late relapse after SVR in HCV patients is doubtful"
It then goes on to identify on a singular case of reactivation, and then concludes:
"This case suggests that recurrence of ΗCV infection in a sustained responder may be probable after immunosuppressive therapy. Prevention is currently impossible but retreatment may be successful."
Obviously -- at least to me -- one case cannot translate into "probable" and my guess is that the word actually used was "possible" and not "probable" -- a major difference --. But in any event, the word used should have been "possible", because that is what's supported by the data.
-- Jim
See: http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijge/vol5n2/hiv.xml
Abstract"
"It is known that sustained virological response in patients with chronic hepatitis C is associated with sustained elimination of hepatitis C virus and that late relapse after SVR in HCV patients is doubtful. Α 47- year old man with chronic hepatitis C genotype 3, achieved sustained virological response after combination treatment with pegylated interferon and ribavirine for six months. Sixteen months later non Hodgkin's lymphoma was diagnosed. After successful completion of chemotherapy for non Hodgkin's lymphoma he presented with HCV infection recurrence of the same genotype. Retreatment with the same schedule resulted in normalization of aminotransferases and disappearance of HCVRNA from the serum. This case suggests that recurrence of ΗCV infection in a sustained responder may be probable after immunosuppressive therapy. Prevention is currently impossible but retreatment may be successful."
See: http://tinyurl.com/2aktua
"...In the present study, Dr. Vicente Carreno and colleagues, from the Foundation for the Study of Viral Hepatitis in Madrid, Spain, tested HCV in hepatic tissue taken from 20 patients who had shown no evidence of the virus in blood for 35.4 months on average.
Nineteen of the 20 samples contained "positive-strand" HCV RNA, the report indicates. Moreover, of these 19 samples, 15 also had "negative-strand" HCV RNA, which is capable of replicating.
Testing of peripheral blood mononuclear cells revealed positive-strand HCV RNA in 13 of 20 samples. Twelve of the 13 samples also contained the all-important negative-strand HCV RNA.
The post-treatment liver biopsy specimens of 15 patients still displayed signs of liver damage. However, hepatic damage improved in all but two of the patients.
Liver necroinflammation was still present in the posttreatment liver biopsy specimens of 15 patients, and fibrosis was present in 7, although liver damage improved in all but 2 patients.
The findings indicate that "these patients did not experience HCV infection clearance, despite apparent clinical disease resolution," the researchers conclude.
They say the possibility of HCV reactivation should be borne in mind if patients undergo chemotherapy or become immunosuppressed, for example. The team cites a case in which HCV reemerged following prednisone therapy, after 8.5 years of negative test results. SOURCE: Clinical Infectious Diseases, November 15, 2006."
Mike
Abstract"
"It is known that sustained virological response in patients with chronic hepatitis C is associated with sustained elimination of hepatitis C virus and that late relapse after SVR in HCV patients is doubtful. Α 47- year old man with chronic hepatitis C genotype 3, achieved sustained virological response after combination treatment with pegylated interferon and ribavirine for six months. Sixteen months later non Hodgkin's lymphoma was diagnosed. After successful completion of chemotherapy for non Hodgkin's lymphoma he presented with HCV infection recurrence of the same genotype. Retreatment with the same schedule resulted in normalization of aminotransferases and disappearance of HCVRNA from the serum. This case suggests that recurrence of ΗCV infection in a sustained responder may be probable after immunosuppressive therapy. Prevention is currently impossible but retreatment may be successful."
See: http://tinyurl.com/2aktua
"...In the present study, Dr. Vicente Carreno and colleagues, from the Foundation for the Study of Viral Hepatitis in Madrid, Spain, tested HCV in hepatic tissue taken from 20 patients who had shown no evidence of the virus in blood for 35.4 months on average.
Nineteen of the 20 samples contained "positive-strand" HCV RNA, the report indicates. Moreover, of these 19 samples, 15 also had "negative-strand" HCV RNA, which is capable of replicating.
Testing of peripheral blood mononuclear cells revealed positive-strand HCV RNA in 13 of 20 samples. Twelve of the 13 samples also contained the all-important negative-strand HCV RNA.
The post-treatment liver biopsy specimens of 15 patients still displayed signs of liver damage. However, hepatic damage improved in all but two of the patients.
Liver necroinflammation was still present in the posttreatment liver biopsy specimens of 15 patients, and fibrosis was present in 7, although liver damage improved in all but 2 patients.
The findings indicate that "these patients did not experience HCV infection clearance, despite apparent clinical disease resolution," the researchers conclude.
They say the possibility of HCV reactivation should be borne in mind if patients undergo chemotherapy or become immunosuppressed, for example. The team cites a case in which HCV reemerged following prednisone therapy, after 8.5 years of negative test results. SOURCE: Clinical Infectious Diseases, November 15, 2006."
Mike
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