Home Cancer Expert Q&A Hub Ask a Healthcare Professional

Ask an Oncology Specialist Nurse | Liz Bradley

124

Comments

  • RobertARobertA Posts: 1,264 mod

    @Malcolm_1954

    Hi Malcolm

    I hope you don’t mind my commenting on your post. Firstly, I am delighted to hear that your treatments have been effective and that you are now cancer free. That is fantastic news.

    Have you had or are you receiving ADT (androgen deprivation treatment) following your chemo and radiation treatment?

    My Prostate Cancer feeds on testosterone and so I have ADT infusions which stops my body from producing it. This has caused a number of side effects, one of which is Gynaecomastia which sounds similar to your condition. I did not ask for any treatment for the condition and it seemed to settle after a couple of years. If you are experiencing discomfort, it may be worth your while discussing it with your doctor.

    It is good to see you posting from South Africa. We are a friendly community, you are very welcome and I hope you will keep in touch.

    Rob

  • Malcolm_1954Malcolm_1954 Posts: 2

    Thank you Rob, very much appreciated. I don't believe that I received any ADT treatment. I will speak to my doctor. I am glad to hear the condition settles in time.

    Regards,

    Malcolm.

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    Hi @Malcolm_1954

    I apologise for my late reply.

    Any drugs you may have taken to suppress testosterone production can cause this problem.

    sometimes it is permanent but fingers crossed it will improve.

    Muscle strengthening exercises for that area may also be useful.

    Best wishes

    liz 🌻

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

    Have had stage 4 breast cancer for over 20 years, multiple bone secondaries and then last year spread to peritoneum and pleura. Commenced Abemaciclib/Fulvestrant combo in August 2019 in addition to longstanding Xgeva. Not too bad in terms of side effects and obviously working as tumour markers keep decreasing and ulcerating sternal tumour healing! But my hair has turned to straw just in last few months- very dry. Am using oil shampoos and hair masks. Any suggestions please? Thanks

  • Blanka_CBlanka_C Posts: 391 Community Admin

    Hi @Rosiet,

    Just wanted to welcome you to the community and share a couple of articles to look at before @LizzyB73 replies with further advice! :)

    This one is full of tips from our community, including product recommendations:

    Hope this helps a little in the meantime!

    Best,

    Blanka

  • schnoodlemumschnoodlemum Posts: 2

    Hi Liz, please may I ask your advice. I was diagnosed with IDC HER 2 + stage 2b in April. I had a mastectomy 4 weeks ago 25 lymph nodes removed of which 24 were affected. I was advised I would be having Herceptin and Pertuzumab (6 cycles over 18 weeks) followed by radiotherapy. I am unable to have taxols or vinca alkaloids due to a muscle wasting condition. My Oncologist has rung today and stated these two drugs are not given without taxols as per recommended by the government. My case is being discussed again tomorrow. I also had a heart attack in 2015 so they are also concerned about the side effects. Please can you advise me if these two dugs can be given alone and how effective the treatment would be. I had an echocardiogram before the op and my heart was fine. Thank you 💞

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @schnoodlemum


    Thanks for getting in touch and I do hope you are recovering well after your mastectomy. In my own experience we have always given herceptin and pertuzumab concurrently with taxol and I have not ever giving the two drugs on their own. I guess the concern is that you did have a heart attack in 2015 and herceptin can damage the heart muscle although this would be checked on every 3 months with ECHO cardiograms.

    Is Taxol a definite no for you? Maybe the conversation at the multi discplinary team meeting will be that the benefits to keeping your breast cance away outweigh the risk to making your muscle condition worse

    Giving a patient anti cancer treatment is always a fine balance between risk and benefit and so hence the discussion tomorrow about your case hopefully will lead to a concensus.

    I can only imagine that this is leaving you feeling slightly in the dark right now but hopefully a plan will come good for you soon.

    I really do wish you well and if we can help further do get in touch


    Best wishes


    Liz

    🤗

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

    @Rosiet

    I do apologise for my delay in getting back to you and I can see that Blanka has already sent some articles which I hope are of help

    Dry hair due to long term anti cancer treatment is very common.

    Using an neutral pH shampoo and conditioner can help ( not baby shampoo as it is too alkaline) - and use a wide tooth comb to avoid pulling hair out at the roots. Leaving warm olive oil on your hair and wrapping in a warm towel is also useful.

    I wish I had a magic cure for this one as it can be very distressing to body image and ultimately how you feel about managing living with cancer.

    On the plus though I am so pleased to hear that you markers are decreasing which means the dry hair thinners are working :)

    sending all my best


    Liz


    🤗

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • VivViv Posts: 21 ✭✭

    Hello I also have HER2Positive +++ think that correct it does not react to medication other than herceptin and chemotherapy

    when I was first diagnosed I was told that my herceptrin would be for a year it’s now been changed to 6 months my oncologist told me that it was the same for every one I have one left I have finished with the chemotherapy which was 12 weeks of pacataxol I only

    had a few cells found after my mastectomy In the breast tissue two lots and a micro dot in the centinal nod so only 3 were removed in total Mine was a grade 3 . My herceptrin was with my chemo now it’s by itself I was also prescribed radium which I declined silly maybe but I am in the UK and live on an island Which meant I would have to stay in a hotel for three weeks my hospital don’t do radium so a high risk of catching the virus. If I had agreed to the radium my herceptrin would of been stopped and given after.

    its a rough journey and at time’s you don’t realise how unwell you feel but it does get better and you do begin to feel you again.

    they will have a meeting about you and it will be sorted out the stress is just awful I had kidney cancer very small MRI had the kidney removed before my chemo was started knowing how aggressive our cancer is it truly was a terrible time but you know we do get through it and you will as well.

    fingers and toes crossed for you that it will all work out for you


    love Viv

  • schnoodlemumschnoodlemum Posts: 2

    Hi Liz,

    Thank you for your reply and the information. Taxols are a definite no for me and Vincristine has also been listed as high risk. My Oncologist has an idea for a plan but is waiting for heart scan results.

    Please can I ask the average waiting time for treatment to commence following a mastectomy? I am still have issues with a possible infection so I am on antibiotics but naturally worried about waiting for the plan to be confirmed.


    Many thanks,


    Karen

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    @schnoodlemum

    Hi

    Usually chemo would start about four to six weeks post mastectomy but as you mentioned you currently have a wound infection, this would need to heal first.

    good luck with it all

    best wishes

    Liz x

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • ChlogambleChlogamble Posts: 6

    Hi Liz,

    Hoping you can help me as you’ve re-assured me before!

    I was previously told by my chemo nurse to continue taking Vitamin C and D tablets. I had a call with a nutritionalist this week who has told me to stop taking them as Vit C can reduce the effectiveness of chemo. I’m 4 chemos down on the FEC-T regimen and only took them after 3 days when I started the accofil injections. Should I be worried that my chemo may not have worked so well? Silently panicking! I won’t be taking them for the last two.

    I’ve left a messsge for my oncologist but have yet to hear back.

    Thanks so much

    Chloe

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    Hi @Chlogamble

    Thanks for getting in touch. I will link you in with @Amber_Thomas_RDN , live better with’s registered dietician who will be much better placed to answer this one.

    We would always advise patients to continue with Vitamin D as this can be very protective but I will hand over to Amber to advise you on vitamin C.

    Wishing you well with the rest of your chemotherapy

    best wishes


    Liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • Amber_Thomas_RDNAmber_Thomas_RDN Posts: 43 Cancer Nutrition Specialist

    Hi @Chlogamble ! And thanks for putting us in touch, @LizzyB73 :)

    I hope I can put your mind at ease on this subject.

    I assume your nutritionist told you to stop taking vitamin C during treatment, because of it's antioxidant qualities. Using supplement forms of antioxidants like Vitamin C tabs during cancer treatment is somewhat controversial, as there is no clear cut answer if it can help, hurt, or do nothing.

    That said, we don't have clear answers if vitamin C actually affects your chemo. I refer to it as a "theoretical risk." Most conventional cancer centers I'm aware of prefer to play it safe and recommend against supplement use during treatment.

    I've included an article that provides a little more information. Please let me know if you have any further questions!


    Registered Dietitian | Cancer Nutrition Specialist | Online Nutrition Coach

    websitehttps://www.cancernutritionsolutions.com

    instagramhttps://www.instagram.com/amber.thomas.rdn/

  • BlissBliss Posts: 2
    edited July 2020

    Hi Liz , I'm new here, so apologise if this question is in a wrong forum.

    I have a family history of stomach cancer which has taken many lives..

    I myself recently have had many symptoms, sickness (blood) acid reflux, eating slowly and stomach/chest pain..

    Yesterday I had an urgent endoscopy procedure which they took 4 biopsies from one particular area from my understanding, I had the sedation..

    After the procedure the consultant explained they found no ulcers, no tumors but there is gastritis.. but also explained I need another urgent endoscopy in about 2 weeks..

    5 minutes later a nurse gives me my endoscopy report.. I don't understand it. I am under the impression that they have found something worrying hence a re-book. 

    Also under the diagnoses it states stomach: cancer and non erosive gastritis. I called a nurse over and said does this mean I have cancer & she said yes, and walked away.. the consultant didn't explain this.. or is it a misunderstanding? This is my question.. the consultant stated he found no tumors, so how can a report of cancer be stated on my endoscopy report?

    Is it a case of they didn't want to tell me? Or are waiting for the biopsy to then explain to me?, If this is the case why if I have cancer of the stomach or if not would I need another endoscopy done? I assume I wouldn't need another procedure to look at the gastritis again as this has already been diagnosed, but with the cancer it does state this on my report but the consultant didn't mention any of that.

    In your own opinion, in easy persons language without medical jargon , how do you read my report? I will post a picture of it here with addresses and confidential information cut out..

    @LizzyB73 Any help would really be appreciated, by anyone.


  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    Hi @Bliss

    Thanks for getting in touch and after reading your story, I can understand your concern.

    I agree that the gastroscope report is quite worrying for someone who is not familiar with the terminology it contains,

    I will try and break it down into more basic terms and as I understand it to read.


    Indications - the reason why you had a scope was because you are suffering with blood in vomit associated with pain and acid reflux.

    The scope was successfully introduced to the correct part of the stomach and duodenum .

    Biopsies were taken and the upper part of the stomach showed recent bleeding

    The middle part of the stomach was less inflamed and was not bleeding. There was a specimen taken for H pylori, this is a bacterium that can cause symptoms of pain, nausea and vomiting and inflammation of the stomach lining. This is not cancer but could potentially lead to stomach cancer in the future. However it is treatable with anti acid medication called PPIs and antibiotic therapy

    In the diagnoses section I personally feel that this should have read ? Cancer and not the word cancer as without any results of the biopsies taken it would not be something that is definitive, this must have been very alarming for you.

    In the advice and comments it states that the likely cause of your blood in vomit is due to the localised area of inflammation which possibly is caused by H Pylori infection but that biopsy results would give the definitive answer so cancer can not be ruled out.

    It also states that - assuming the biopsies show no concerning pathology which is medical jargon meaning that they are wishing to rule out stomach cancer.

    I can only imagine how stressed this has made you but hopefully the results will come back as a case of H pylori infection only and not anything more sinister.

    As a result, you have been put on a proton pump inhibitor tablet to reduce the inflammation and they wish to re scope you to check this is working and also in view of your family history.

    I hope that this has been of some help and please get in contact again if you need anything clarified and I will do my best to help

    all the best

    Liz

    🌻

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • FrannyFranny Posts: 7

    Hi Liz

    I wanted to ask you what you think is the best cream or oil to use on a post op scar following a mastectomy. I have been told to massage the area with moisturiser after 4 weeks?

    Kind regards

    Fran

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    Hi @Franny

    I hope you are doing well following your mastectomy

    I have attached an article that may well be of use for your query

    I hope you recover quickly

    best wishes


    Liz 🌸🌸

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • FrannyFranny Posts: 7

    Thank you so much for your quick reply Liz.

    Thank you, I am getting better day by day.

    Kind regards

    Fran

  • BlissBliss Posts: 2


    Thank you @LizzyB73 you are correct about everything.

    But my concern is with the diagnoses.. it states stomach: cancer and non erosive gastritis

    The word cancer doesn't bother me.. what I don't understand is the consultant told me he didn't find any tumors.. so why is cancer on the diagnosis?

    I understand very well that nothing is conclusive until the biopsy results come back.. but has the consultant put down 'cancer' because he thinks I have it (in his own personal view) from the endoscopy? If so again why did he mention there was no tumors found? Is it the case that not all cancer are tumors?

    I understand there is something wrong hence the 2nd booking.

    Thank you x

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    Hi @Bliss

    In my personal experience of working in healthcare , a Consultant would not usually say to a patient no tumours found and then write cancer on a scan report. They would usually say something along the lines of , yes we found something concerning or sinister and need to rule out it being cancer.

    As this report has left you confused as it contradicts what you were told, can you call the hospital you were scanned at and ask to speak to the endoscopy lead nurse who hopefully would be able to help you?

    I am sorry that I cannot offer complete clarity and can only base an opinion on what is written down.

    I wish you all the best

    Liz

    🌼

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
  • PML263PML263 Posts: 7

    Hi there I had breast cancer in 2016 and had been ‘clear’ until 23.6.20 when in hospital with pneumonia a routine CT scan showed I have bone cancer (from Breast cancer)

    I’m taking Palbociclib chemo tablets with Denosumab injection. I only started this treatment a week ago and finding that I’m extremely tired and having problems with bladder control.....is this normal?

    Thanks Pam

  • VeritercVeriterc Posts: 19

    Liz

    I had breast cancer over ten years ago. Treatment finished, and no-one told me that years later I would present with so many long-term side effects (major heart op; osteoporosis, neuropathy, nausea, etc). I

    Handling all the complex problems I encounter, when one drug disagrees with another, constant cough (I managed to finally get an X-ray and that was OK, but cough is still driving me mad), I have to pay to get an annual check-up from Oncologist, as NHS won't give me one. Where are the CNS we were promised!

    I started a website www.aftercancers.com, hopefully to tell others what we can do to get care. e.g. The Marsden organised annual DEXA scans, and one day informed I had Osteoporosis, "there is nothing you can do about it". My job took me to Italy where I found out there is a lot - even though I have 14 fractures.

    I still get skin flare-ups - was told it was due "to your age". This time a French hospital tested me and told me what to do.

    So, do you have any hints and tips on how patients like me, who often feel abandoned, can search out care for ourselves? I managed to reverse lymphoedema (and wrote about it on aftercancers.com) so I no longer have rugby-player legs, but would like to know what I can do about fatigue (still knocking me out years after) and neuropathy.

    As a patient who moved from London to Oxford, I didn't realise that I would be completely cut off - and have to google, search and phone helplines whenever I get a problem! Once I find a solution I write about it under the categories on my website, so anything general you can tell us about what those of us who feel forgotten can do, would be very helpful.

    Thank you Verite Reily Collins [email protected]

  • RozaliaRozalia Posts: 8

    Dear Liz

    I am 71 and 6 days ago I had a double mastectomy and lympnode biobsy(right side). I had very big breasts, 44K, hence the reason for removing not just the breast with the tumours but also the healthy one. (My request to avoid back/hip problems). I have not had any reconstruction and don't invisage this being an option in the future. I have been given a compression breast wrap to wear. Iniatially I had some bleeding but this has now stopped but I do have a very long scar running from well under my armpits on both sides. The scar looks neat and seems quite flat. It is about 30 inches. I don't have any drains and although there is alot of bruising there are no large swellings. I presume the compression breast wrap is to help avoid swelling and liquid build up. I don't find it particularily comfortable as it is tight and it rolls up. I am wearing large dressings to avoid any rubbing.Althoughan NHS patient I had my operation in a private hospital My breast care nurse checked the bleeding and removed the plaster covers yesterday. She also cleaned the wound and putsome dressings between the scar and the compression wrap. The NHS hospital doesn't use compression wraps, it seems to be something the provate hospitals are using. My querries are

    1. What is the purpose and advantages of the compression breast wrap?
    2. How long should I wear it for? Although not very comfortable I will wear it for as long as it is helping.
    3. Will it help me avoid lymhodeama?
    4. My breast care nurse gave me some dressing pads but I have found I need to use 4 to cover the wound. Where can I get more? Could my GP perscribe them? I would like to put on clean dressings every day after my bath/shower.

    My surgeon is very nice and approachable as is my breast nurse but in this busy covid time I don't want to be a nuissance ringing up so I would be very gratful for answers and any advice you are able to give me. I am doing the exercises given to me and although I have some intermittend electric shock type pains and some aches I am pretty good. I have even been out for short walks.

  • Blanka_CBlanka_C Posts: 391 Community Admin
    edited July 2020

    @PML263 @Veriterc @Rozalia

    Hello Pam, Verite and Rozalia,

    Hope you're having a great day. I just wanted to let you know that Liz received your messages and she will get back to you as soon as possible. It's taking a little longer than usual as she's very busy helping patients during these times. ♥️

    In the meantime, if there's anything I can help you with, please let me know. I'm not a healthcare professional myself, but we've written hundreds of articles, all reviewed by nurses & doctors and I'll do my best to point you in the right direction. :)

    Best wishes,

    Blanka

    Community Admin @ Live Better With

  • Strawberry42Strawberry42 Posts: 1

    HI Liz.

    I have a concern around hair colour. I am allergic to PPD which causes a bad reaction. Could you reccomend a semi permanent hair colour that is genuine with no hidden baddies . I have shoulder length brown hair very gray at roots, I have tried Henna Powder which turned my hair grey any advice would be very helpful. Thank you.

  • LizzyB73LizzyB73 Posts: 112 Oncology Specialist Nurse

    Hi @PML263 Pam

    Thanks so much for getting in touch at what must be a very difficult time for you. It is very common to feel tried when starting palbociclib but I have not experienced patients having issues with bladder control.

    I would recommend that you discuss this difficult side effect with your consultant to see if this is something that can happen.

    I wish you well with your ongoing treatment.

    best wishes

    Liz 💕

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

    Hi @Veriterc Verite,

    Thank you so much for getting in touch and I am totally in agreement with you that those experiencing long term side effects of cancer treatment are often forgotten. Some NHS hospitals are now offering late effects outpatient clinics where patients such as you can tap into support and helpful strategies for managing difficult symptoms.

    What a fantastic idea that you have taken measures to set up a website for those who are in a similar position to yourself.

    Maybe it would be really useful if we had a webinar on this subject at live better with, where we could invite all those on the forum who maybe have similar issues and can offer support to each other with some strategies on how to manage such effects as

    • bowel and bladder changes
    • neuropathy
    • fatigue
    • self image changes

    let me know what you think and I can put this forward to @Blanka_C as another idea for a topic for a forthcoming webinar.

    Best wishes

    Liz 💕

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

    Hi @Rozalia

    I do hope you are feeling okay so soon after having your double mastectomy operation.

    You queried about the binder that is on following your operation. Yes this is to prevent build up of blood and fluid but is usually only worn until your first review by the breast team. I would suggest that you make contact with them so that you know exactly how long to leave it on as some Consultants do things differently and I would not wish to advise against what their preferred protocol is.

    The breast care team you are under would much prefer to be called and to offer advice for you so you are okay with everything and please do not feel you are being a nuisance - this is their job and they would want to hear from you.

    Your breast care nurse should also be able to provide you with more dressings as you need them.

    I wish you all the best with your continued recovery and please stay in touch with the group as this forum is very supportive should you need anything further along the line.

    best wishes


    Liz 💕

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

    Hi @Strawberry42

    Thanks so much for getting in touch.

    I will try and find out for you as I am not an expert on hair colouring contents sadly.

    I will come back to you if I am able to find the answer for you

    wishing you well

    liz 💕

    Liz Bradley
    Oncology Specialist Nurse | Oncology Service Manager @ Springfield Hospital
This discussion has been closed.