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Ask an Oncology Specialist Nurse | Liz Bradley

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  • purple2020purple2020 Posts: 2

    Hi

    I am having herceptin alone . Previously one year ago had chemo, mastectomy and radiotherapy.

    I am awaiting herceptin number 15, but this has deferred for weekly review to the pressures on the team. I do not have active cancer at the moment. Should I be self isolating ? or should I just undertake social distancing? Should I still attend work? My job does not allow me to work from home. Kind regards

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @purple2020

    Hi

    Thanks for getting in touch.

    Although usually herceptin is very well tolerated in terms of immunity, it can alter your immune system and the way it works so I would suggest that you need to err on the side of caution.

    Work wise, as long as you are not exposed to very close proximity to others in a crowded place and can exercise social distancing effectively then I would suggest that self isolating may not be totally necessary.

    It would be better to be upfront with your employers who are duty bound to be mindful of anyone with lowered resistance to possible infections.

    I hope this helps


    stay well


    Liz 🌸

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Smca

    Hello

    Thanks for getting in touch

    Just to clarify for me - is the concern over the dental treatment or the zoledronic acid itself?

    Wish you well

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • RozaliaRozalia Posts: 8

    Dear Liz


  • DD1DD1 Posts: 2

    I completed chemo in June 2019, followed by 4 surgeries and I have just completed my final treatment of herceptin. (Last week) I developed heart failure as a result of the treatment and I’m now taking ramipril and bisoprolol. Am I classed as high risk? Thank-you.

  • DD1DD1 Posts: 2

    I should also point out that I work in a busy Acute Hospital as a RGN. Sorry!

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Rozalia

    Hi

    Thanks for getting in touch.

    Although usually herceptin is very well tolerated in terms of immunity, it can alter your immune system and the way it works so I would suggest that you need to err on the side of caution. Flu like symptoms., which can be the side effect of herceptin, maybe also masking possible symptoms of coronavirus. I suggest that self isolation as far as possible would be the ideal scenario at the moment.

    In terms of pain relief. As long as you are not sensitive to codeine, then co codamol would be a good option request.

    I wish you all the best for your forthcoming operation and subsequent recovery

    stay well


    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @DD1

    Hi

    Thanks for getting in touch and I can imagine that work is fairly busy for you right now

    Although Herceptin is very well tolerated in terms of immunity, it. An later your immune system and the way it works so I would suggest err on the side of caution until 3 months post treatment.

    Your employer is duty bound to be mindful of your situation and your increased susceptibility to infection so have that conversation in order to protect yourself 💪

    wishing you all the best

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • Geena1Geena1 Posts: 2

    What are abnormal squamous cells? My doctor told me this after a pap smear. I also have a polyp.

  • JM61JM61 Posts: 2

    Hi

    I completed my treatment for primary breast cancer in March 19 having had Chemo, surgery, radiotherapy and 15 further rounds of herceptin and pertuzimab infusions. The only thing I take now is anastrozol and I have 6 monthly zometa infusions. Other than that I am in good health. What I'm struggling to understand from the current Covid-19 communications is wheather I am at increased risk. I am currently li

  • Cmflyersx2cCmflyersx2c Posts: 6

    Hello Liz

    As my wife and I were discussing our current situation the other night, the surgery topic came up. We are confused because we are both of a different understanding of something. We will check into it, but I thought I would run it by you as well.

    If we have a 6 cm long tumor and chemotherapy shrinks it to say 2 cm, when the surgeon performs the lumpectomy, will he take the 2cm plus 1cm to make sure he gets it all or does he still take 6cm plus 1cm regardless of how much it shrunk.

    Thanks

    Matt

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Geena1

    Hi

    thanks for getting in touch.

    I attach the following link which I hope will be useful to answer your question

    best wishes

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @JM61

    Hi

    sorry the end of your message was cut off but I got the jist about your concerns as to whether you are at higher risk of getting coronavirus

    As you completed treatment 1 year ago and are now on hormone therapy and zometa only, your immunity would have returned to a normal level.

    However, if you are concerned it would be a good idea to check this out with your healthcare team.

    stay well

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Cmflyersx2c

    Hi Matt

    Hope your wife is doing okay.

    To answer your question, the role of what we call neo adjuvant chemo or giving chemo prior to surgery is to shrink the tumour down to enable a smaller amount of breast tissue to have to be removed during the operation that your wife will have.

    So yes the surgeon will only have to remove the size of the tumour after chemo has done it’s job plus a margin around the outside not the original size of the tumour prior to chemo commencing.

    Hope that helps

    best wishes


    Liz 🌻

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • JM61JM61 Posts: 2

    Hi Liz

    Thank you so much for your quick response, it has definitely put my mind at rest.

    Janice 🙂

  • RozaliaRozalia Posts: 8

    Hi Liz


    Thank you for your quick response


    Rozalia

  • RichswifeRichswife Posts: 6

    Hi, My husband is due to have brachytherapy on Monday what will he be allowed to do or not do afterwards. He wants to be back at work after a week as he’s self employed but I feel he should have two weeks with his feet up so that the seed areas heal over and none of them come loose. If that makes sense.

    kind regards

    TD

  • CahiraCahira Posts: 1

    Hi Liz and thank you for being here. I was diagnosed with breast cancer in December 2019. I had a lumpectomy in January. Two margins were not clear so I had a mastectomy in March 2020 where no new cancer cells were found but the axillary did show two specks of cancer in the fat. The lumpectomy included one cancer positive lymph node.

    I am going to tell my oncologist to go ahead with the recommended chemocare - Taxotere and Cyclophosphamide. I am 70 years old so the recommendation is infusion every 3 weeks for 12 weeks. Radiation will follow that. An oncotype test was done with a low score which frankly confused me but I realize it is a gray area and I want to do all I can to get this disease conquered.

    I am concerned about side effects because of my age. Being disabled is probably my greatest fear along with pain. I like to stay in shape with exercise and diet. Not always perfect but like to have the choice. I like to be prepared. I hear likely side effects will be hair loss, neuropathy, nail change, etc. Hair loss is not a concern for me. I have had unexplained thin hair for years. However, anything disabling is very important to me.

    I would appreciate any suggestions or assurance you could give me for this next challenge in my life.


    Thank you.

    Teresa

  • Catie60Catie60 Posts: 1

    Dear Liz. I was treated for an occult breast cancer 2017-2018: adjuvant ECT chemo for 8 sessions, right axillary clearance, 15 sessions of radiotherapy. I am now on anastrozole and 6 monthly zometa. I was treated for mouth cancer last year.

    At my zometa appt. last week I was told my WBC was low at 2.1. I’m not sure how low this is and also can I do anything to raise my WBC.

    Thanks

  • PatspPatsp Posts: 3

    Hi Liz,I have a prolapse on my back passage post rectal operation,I have a permanent colostomy, it is not painful only more uncomfortable if anything. I have an appointment with my surgeon next month,is this prolapse anything to worry about?

  • LouiseJLouiseJ Posts: 861 ✭✭✭✭✭

    @Sharyn

    Morning Sharyn,

    Liz here may be able to answer some of your queries regarding your immunity risk.

    Lou x

  • LouiseJLouiseJ Posts: 861 ✭✭✭✭✭
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Richswife

    Hi

    Thanks for getting in touch.

    I have attached a hopefully useful link to answer your question

    I wish your husband all the best with the brachytherapy treatment

    best wishes

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Cahira

    Hi Teresa

    Thank you for getting in touch. I have attached some information about the combination of treatment that you will be having.

    Taxotere or docetaxel as otherwise known can have quite a profound effect on the immune system so you may wish to ask your oncologist if you will be given white cell stimulator injections or growth factor after your chemotherapy particularly in our current climate.

    I attach information on this as well for your reference.

    I note that you are not so concerned about hair loss but taxotere will sadly cause this. Some chemo units offer scalp cooling which can assist with halting hair loss entirely.

    Eating a balanced diet and drinking plenty of water is also key.

    I wish you all the best for your forthcoming treatment

    best wishes

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Catie60

    HI

    Thanks for getting in touch.

    Normal total white cell count is usually anything above 4.5 so yes yours is erring on the low side.

    it would be good to maybe get this repeated in due course as perhaps it could be a one off low reading and could do with being rechecked.

    A low white cell count does make you more at risk of infection and so you should be considering yourself as one of the vulnerable groups with our current coronavirus pandemic.

    There isn’t anything you can do personally to raise a low white cell count.

    Wish you well

    best wishes

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Patsp

    Hi

    Thank you for getting in touch.

    I am sorry but I am not able to offer advice on your rectal prolapse but I am glad that you getting this checked by your surgeon

    I do wish you well

    best wishes

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • Sharpy2808Sharpy2808 Posts: 1

    Dear Liz. I finished radiotherapy December 2019. Is my immunity compromised with the Coronavirus pandemic

  • ETJETJ Posts: 1

    Hi thank you for taking the time to listen.

    My name is Eileen and I am hoping you can help me with my concern over pain in my elbow. I was diagnosed with breast cancer Sept 2018 which was treated with surgery followed by chemo and then radiotherapy which finished in June 2019. I am taking currently taking letrozole each day. I am back exercising regularly and find that I have reduced range of movement in the arm on the side of my surgery but more concerning to me is severe pain in the elbow on the other arm which does not seem to be getting any better. Is there anything I can do about this?

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @Sharpy2808

    Hi

    Thanks for getting in touch. Although not as immune depleting as chemotherapy, it would still be wise to err on the side of caution with regards to considering your immunity to be compromised.

    Usually three months post treatment is about the time we say that the body restores its own natural immunity so stay indoors for a bit longer while we hit the peak of the pandemic.

    Join us this evening at 6pm for our webinar if you would like to for any other corona queries.

    Best wishes and stay well

    Liz 🌻

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @ETJ

    Hi Eileen

    thanks for getting in touch. I am sorry that you are suffering with severe pain in your opposite elbow to the side you had breast cancer treatment on. I do understand that any pain or twinge after cancer treatment can automatically ring alarm bells but of course, to rationalise it, most likely could be some kind of joint inflammation.

    However, it would be very difficult for me to offer advice about the pain and I do recommend that you get this checked out by the medial team caring for you. 

    My very best wishes though 

    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
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