5th cycle

Sebenarnya dah lama dah nak update.tp maklumla 4th cycle ni cikgu aida gaban ni konon nak masuk kerja, jadi agak bz sketla dgn keja.pdhal pas sek je dah ponek xlarat wat apa.adala projek karipap dan donat sekali.tula biggest achievement pasal budak-budak ni suka makan.yg lain xde apela sgt.last masa 4th cycle tu, lepas cherryberry yang membuatkan aku temenung lima mlm di bilik temenung, aku didatangani ' kawan rapat' yang sangat-sangat heavy hingga hampir-hampir den nak pitam di sekolah. kedatangannya pilak tu selama hampir seminggu.hasilnya semalam (22/4) semasa nak amik darah dr viktor cakap , aiyaamoi..manyak pucat la ini hali. dan hasilnya hari ni ( 23/4), tahniah2 result bloodcount hb low.tapi masih bertahanla, sbb episod kawan karib datang tu  so walaupun hb 8, kimo tetap diteruskan dengan bantuan ubat ubatan dekat selori mainan cik kerinting. alhamdulillah kimo kalini berjalan lancar.dek disebabkan theva dibilik lain jadi aku mengisi masa main candy crush yang baru jadi kegilaan dan sekali sekala diinterview team  dari bcwa, HO dr diyana yang supercool dan nurse2 yg sangat peramah dan talak sombong.alhamdulillah kul12.30 dah leh balik dan siap sempat masak nasi ayam bodoh dalam masa sejam.tp mood talakbaikla..semua benda aku nak upset esp bab akhlak muna dengan makcik atun dia serta sikap org yang susah sangat nak bayar hutang.Aku ni tiap bulan bergolok bergadai nak bayar utang but somebody else couldnt care less.muna n makcik mmg issue lama.aku x tau nak wat cemana.aku treat makcik ok jetapi kenapa dia mcm treat makcik tu macam hamba dia. yaallah,bantulah aku mendidik anak kesayanganku ini.
24/4
oh ya baru ni senior irshad yg bc survivor,kyat cakap dia her2 positive.maksudnya dia xleh amik tamoxifen sbb tamoxifen cure er pr positif shj.utk cure her2 kena ambik herceptin  which cost u a bomb.masa amik darah 22/4 haritu, dr viktor baru bagi surat referense ke hkl utk radiotheraphy di hkl nant. Kalini baru dapat result her2 test.alhamdulillah aku negatif tp theva positif.theva dah diam dengar tentang dia kena amik herceptin for 15 times dalam masa setahun. selain mahal ubat ni pun susah nak dapat,setakat ni hanya di hkl.one injection can cost up to 6k even with subsidy.phewww..kalau 15x total dia 90k..aduhhhh.ya allah ringankanlah tanggungan kyatt dan theva...tulah aida kalo ko pk ko susah,ramaaaaaaaiiii lg yang susah sebenarnya...syukur-syukur ya allah.

berikut tentang herceptin

Herceptin

Herceptin is used with the usual chemotherapy regimen like doxorubicin, cyclophosphamide, and paclitaxel, or as single agent.

This is what patients can expect from the drug:

• Clincal trial with HER2-positive metastatic breast cancer showed:

Herceptin + chemotherapy – Median survival is 25.1 months.
Chemotherapy without Herceptin – Median survival is 20.3 months.

Conclusion: Prolong survival by 4.6 months if Herceptin is added to the chemo-regimen. Take note, Herceptin does not cure breast cancer.

• After one year women treated with:

Herceptin + chemotherapy – 79% of patients were alive. Chemotherapy without Herceptin – 68 % of patients were alive.

Conclusion: 11% more patients are alive after one year if Herceptin is added to the chemo-regimen.

• After three-and-a-half years women treated with:

Herceptin plus chemotherapy – 87% were disease-free. Chemotherapy without Herception – 71% were disease free.

Conclusion: 16% more women are disease free after 3.5 years if Herceptin is added to the chemo-regimen.

Reference: http://www.gene.com/gene/products/information/oncology/ herceptin/factsheet.html

http://www.herceptin.com/herceptin/patient/index.jsp

The Side Effects of Herceptin

Herceptin treatment can result in heart problems, including those without symptoms (reduced heart function) and those with symptoms (congestive heart failure).

The risk and seriousness of these heart problems were highest in people who received both Herceptin and a certain type of chemotherapy (anthracycline).

Some patients may have serious infusion reactions and lung problems. Such reactions may occur during or within 24 hours of receiving Herceptin.

Worsening of low white blood cell counts associated with chemotherapy has also occurred.

Other side effects are: chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling; feeling short of breath, even with mild exertion; swelling, rapid weight gain, coughs or wheezing, white patches or sores inside the mouth or on the lips, fevers, chills, body aches, flu symptoms, nausea, vomiting, diarrhoea, headache, tired feeling.

Reference:  http://www.gene.com/gene/products/information/oncology/ herceptin/factsheet.html

http://www.herceptin.com/herceptin/patient/index.jsp  

http://health.yahoo.com/breastcancer-medications/trastuzumab-injectable/ healthwise—d04357a1.html#d04357a1-sideeffects

dan TAMOXIFEN

What is tamoxifen?

Tamoxifen blocks the actions of estrogen, a female hormone. Certain types of breast cancer require estrogen to grow.

Tamoxifen is used to treat some types of breast cancer in men and women. Tamoxifen is also used to lower a woman's chance of developing breast cancer if she has a high risk (such as a family history of breast cancer).

Tamoxifen may also be used for purposes not listed in this medication guide.

Important information about tamoxifen

Do not use tamoxifen if you are pregnant. It could harm the unborn baby. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) while you are using this medication and for at least 2 months after your treatment ends. You should not use tamoxifen if you are allergic to it, or if you have a history of blood clots in your veins or your lungs, or if you are also taking a blood thinner such as warfarin (Coumadin).

Before using tamoxifen, tell your doctor if you have liver disease, high triglycerides (a type of fat in the blood), a history of cataract, or a history of stroke or blood clot. Also tell your doctor if you if you are receiving chemotherapy or radiation treatment.

If you are taking tamoxifen to reduce your risk of breast cancer, you may need to take your first dose while you are having a menstrual period. You may also need to have a pregnancy test before you start taking tamoxifen, to make sure you are not pregnant. Follow your doctor's instructions.

Taking tamoxifen may increase your risk of uterine cancer, stroke, or a blood clot in the lung, which can be fatal. Talk with your doctor about your specific risks in taking this medication.

To make sure this medication is not causing harmful effects, your doctor may want you to have mammograms and to perform routine breast self exams on a regular basis. Your liver function may also need to be tested. Visit your doctor regularly.

Before taking tamoxifen

You should not use tamoxifen if you are allergic to it, or if you have:

·         a history of blood clots in your veins or your lungs; or

·         if you are also taking a blood thinner such as warfarin (Coumadin).

To make sure you can safely take tamoxifen, tell your doctor if you have any of these other conditions:

·         liver disease;

·         high cholesterol or triglycerides (a type of fat in the blood);

·         a history of stroke or blood clot;

·         a history of cataract; or

·         if you are receiving chemotherapy or radiation.

Taking tamoxifen may increase your risk of uterine cancer, stroke, or a blood clot in the lung, which can be fatal. Talk with your doctor about your specific risks in taking this medication. FDA pregnancy category D. Do not use tamoxifen if you are pregnant. It could harm the unborn baby. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) while you are using this medication and for at least 2 months after your treatment ends.

Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment.

It is not known whether tamoxifen passes into breast milk or if it could harm a nursing baby. However, this medication may slow breast milk production. You should not breast-feed while taking tamoxifen.

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How should I take tamoxifen?

Take tamoxifen exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medication with a full glass (8 ounces) of water.

Tamoxifen can be taken with or without food.

If you are taking tamoxifen to reduce your risk of breast cancer, you may need to take your first dose while you are having a menstrual period. You may also need to have a pregnancy test before you start taking tamoxifen, to make sure you are not pregnant. Follow your doctor's instructions.

Use tamoxifen regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. You may need to keep using this medication for up to 5 years.

To make sure this medication is not causing harmful effects, your doctor may want you to have mammograms and to perform routine breast self exams on a regular basis. Your liver function may also need to be tested. Visit your doctor regularly.

Store tamoxifen at room temperature away from moisture, heat, or cold. Do not freeze.

See also: Tamoxifen dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking tamoxifen?

Avoid eating soy or soy products without first asking your doctor.

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Tamoxifen side effects

Get emergency medical help if you have any of these signs of an allergic reaction to tamoxifen: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using tamoxifen and call your doctor at once if you have a serious side effect such as:

·         sudden numbness or weakness, especially on one side of the body;

·         sudden severe headache, confusion, problems with vision, speech, or balance;

·         chest pain, sudden cough, wheezing, rapid breathing, fast heart rate;

·         pain, swelling, warmth, or redness in one or both legs;

·         nausea, loss of appetite, increased thirst, muscle weakness, confusion, and feeling tired or restless;

·         unusual vaginal bleeding or discharge;

·         irregular menstrual periods;

·         pain or pressure in your pelvic area;

·         blurred vision, eye pain, or seeing halos around lights;

·         easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

·         fever, chills, body aches, flu symptoms;

·         new breast lump; or

·         upper stomach pain, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious tamoxifen side effects may include:

·         hot flashes;

·         bone pain, joint pain, or tumor pain;

·         swelling in your hands or feet;

·         vaginal itching or dryness;

·         decreased sex drive, impotence, or difficulty having an orgasm;

·         headache, dizziness, depression; or

·         thinning hair.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Tamoxifen side effects (in more detail)

Tamoxifen Dosing Information

Usual Adult Tamoxifen Dose for Breast Cancer:

For the treatment of metastatic breast cancer in women and men:
20 to 40 mg orally Dosages greater than 20 mg should be given in divided doses (morning and evening).

For the treatment of women with Ductal Carcinoma in Situ, following breast surgery and radiation:
20 mg orally daily for 5 years.

To reduce the incidence of breast cancer in women at high risk for breast cancer:
20 mg orally daily for 5 years.

Usual Adult Dose for Breast Cancer -- Adjuvant:

For the treatment of node-positive breast cancer in postmenopausal women following total mastectomy or segmental mastectomy, axillary dissection, and breast irradiation:
10 mg orally 2 to 3 times a day for 5 years.

Usual Adult Tamoxifen Dose for Breast Cancer--Palliative:

10 to 20 mg orally twice a day

A beneficial response may not be evident for several months after initiation of therapy.

Usual Pediatric Dose for McCune-Albright Syndrome:

For use in girls age 2 to 10 years with McCune-Albright Syndrome and precocious puberty:
20 mg once a day. The duration of treatment is up to 12 months.

Usual Pediatric Dose for Precocious Puberty:

For use in girls age 2 to 10 years with McCune-Albright Syndrome and precocious puberty:
20 mg once a day. The duration of treatment is up to 12 months.

What other drugs will affect tamoxifen?

Many drugs can interact with tamoxifen. Below is just partial list. Tell your doctor if you are using any of these medications:

·         bromocriptine (Parlodel);

·         cimetidine (Tagamet);

·         clozapine (Clozaril, FazaClo);

·         cyclophosphamide (Cytoxan, Neosar);

·         isoniazid (for treating tuberculosis);

·         letrozole (Femara);

·         methimazole (Tapazole);

·         nicardipine (Cardene);

·         pioglitazone (Actos);

·         rifampin (Rifadin, Rifater, Rifamate, Rimactane);

·         ropinirole (Requip);

·         ticlopidine (Ticlid);

·         tranylcypromine (Parnate);

·         anti-malaria medication such as chloroquine (Arelan) or pyrimethamine (Daraprim), or quinine (Qualaquin);

·         an antibiotic such as terbinafine (Lamisil);

·         an antidepressant such as bupropion (Wellbutrin, Zyban), clomipramine (Anafranil), desipramine (Norpramin), duloxetine (Cymbalta), fluoxetine (Prozac), imipramine (Tofranil), paroxetine (Paxil), sertraline (Zoloft), or tranylcypromine (Parnate);

·         a heart rhythm medication such as amiodarone (Cordarone, Pacerone) or quinidine (Quin-G);

·         HIV or AIDS medicine such as delavirdine (Rescriptor) or ritonavir (Norvir); or

·         medicine to treat psychiatric disorders, such as aripiprazole (Abilify), chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), haloperidol (Haldol), perphenazine (Trilafon), or thioridazine (Mellaril).

This list is not complete and other drugs may interact with tamoxifen. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Next Page → Side Effects

More Tamoxifen resources

·         Side Effects

·         Recommended Dosage

·         Pregnancy Warnings

·         Drug Images

·         Drug Interactions

·         Support Group

·         10 Reviews - Add your own review/rating

·         Tamoxifen Prescribing Information (FDA)

·         tamoxifen Advanced Consumer (Micromedex) - Includes Dosage Information

·         tamoxifen MedFacts Consumer Leaflet (Wolters Kluwer)

·         Nolvadex Prescribing Information (FDA)

·         Nolvadex Monograph (AHFS DI)

·         Soltamox solution MedFacts Consumer Leaflet (Wolters Kluwer)

·         Soltamox Prescribing Information (FDA)

Compare Tamoxifen with other medications

·         Breast Cancer

·         Breast Cancer, Adjuvant

·         Breast Cancer, Male

·         Breast Cancer, Metastatic

·         Breast Cancer, Palliative

·         Breast Cancer, Prevention

·         McCune-Albright Syndrome

·         Precocious Puberty

Where can I get more information?

·         Your pharmacist can provide more information about tamoxifen.