Patient: Description of condition (onset, main symptoms, hospital visited, etc.): I am 36 years old, had radical mastectomy for breast cancer in the middle of March this year, with two metastases in lymph nodes, two invasive lobular carcinomas, no cancer thrombus in the veins, masses 2.5*2.0CM and 1.5*1.0CM. immunohistochemistry results: ER(+), PR(+-), CerbB2(++) TOPOII(+), Ki-67(+) FISH test result is HER-2 gene amplification Had 4 AC regimen of chemotherapy, but due to severe liver function impairment, liver disease specialist hospital told that no further chemotherapy, now also need to take oral hepatoprotective drug lamivudine 1, want to seek the next best treatment plan 2, liver function has been impaired whether it is possible to use Herceptin for further treatment, but not with chemotherapy I don’t know whether it is effective or not. 3, if the use of thymidine has any effect on breast cancer.
Department of Integrative Medicine and Medical Oncology, Beijing China-Japan Friendship Hospital.
1. If liver function is severely impaired, chemotherapy is really not recommended.
2. Herceptin and chemotherapy together can only increase the efficacy by about 10%, and the efficacy of single drug application is even worse.
3. According to the immunohistochemistry result: ER(+), PR(+-), so endocrine therapy is the best choice at present.
4. Thymidine can be used intermittently.
Patient: Dr. Cheng: Hello! First of all, thank you very much for your timely reply.
Patient: I would like to ask the following questions: 1. My FISH test result is gene amplification, is it bad? 2. How should I use thymidine and how long should I inject it once in a cycle? Is it better to use the imported one or the domestic one? 3.I am taking Samphenoxan, I started taking it at the beginning of September, but I haven’t got my period this month, it’s been two days already, I don’t know if I am suitable to take this medicine?
1, FISH amplification is to determine whether it is an indication for Herceptin, not a good representative of good or bad.
2. If your financial situation allows, you can take Zithromax twice a week. Stop using it for one month.
3.Regularly review the endometrial thickness, if there is any problem, gynecological examination, change the endocrine drugs.
Patient: Thank you very much, Dr. Cheng! My doctor in Dalian area has advised me to use Herceptin as monotherapy, but when I asked whether liver function would be dangerous, the doctor did not say clearly. I’m asking you to help me with an idea, what is the next step of treatment that will benefit me, what will happen to my liver function if I use Herceptin, I am now a hepatitis B carrier, I used to be a small triple positive carrier, now I am a large triple positive, in the middle of July this year, the highest glutamic oxalacetic transaminase reached 1200, the highest glutamic propionate more than 700, now I need to take oral hepatoprotective lamivudine antiviral for life, do I dare to use it in such a situation? Dr. Cheng, do you think thymidine is better for breast cancer or for liver function? I had a small cyst in my right ovary during my checkup on September 30, and I haven’t had my period. I am looking forward to your reply! Thank you very much!
Department of Integrative Medicine and Oncology, Beijing China-Japan Friendship Hospital.
1. Theoretically, Herceptin monotherapy is suitable for you, but we have to consider the economy, this drug is very expensive.
2, . Herceptin side effects are mainly cardiac, but there is also damage to the liver.
3, thymidine mainly has a role in improving immune function, but lasting use instead of suppressing immunity.
4. There is no need to change the endocrine drugs yet.
Patient: Dr. Cheng: Thank you very much for your comprehensive answer! Through the communication with you, I have learned a lot more about myself and what to do in the future, so I feel very comfortable and not as anxious as I was a few days ago. What I need to do now is to adjust my mindset, build confidence and face every day happily. Because my son is still too young, especially obedient and understanding, he needs me very much. Can I ask you one more question about diet? I feel very weak after chemotherapy, and I don’t know how to take care of my condition, can you give me some advice? And is there any benefit or disadvantage to eating sea cucumber for my condition? Thank you once again, Dr. Cheng!
Beijing China-Japan Friendship Hospital, Department of Traditional Chinese and Western Medicine and Oncology.
1. Since your liver function is not good, so the diet should be light and easy to digest. Such as yam, lotus seeds, bitter melon, barley are all good. 2. Try to eat vegetarian, sea cucumber is not much useful, and because the sea water is seriously polluted, sea cucumber is even more inedible.