What is going on?

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My friend was diagnosed with metastatic breast cancer in November 23 - the cancer has spread to her lung and possibly lymph nodes. Treatment began in December and she is on Letrozole, Ribociclib and Zoladex. She had to have a 3 week break after her first cycle of Ribociclib instead of 1 week and the Oncologist has now reduced her dosage of Ribociclib as she wasn't managing it very well and has had to have a couple of blood transfusions to improve her blood readings.

She had fluid on her lungs which was being drained 3 times a week originally, however that is now down to once a week and they are removing less fluid each time - which I thought sounded positive.

At her first review with the Oncologist at the start of February she was told that her cancer markers had reduced - again sounds positive.

A couple of weeks ago her cough came back, and then she was unable to get a blood transfusion as they were unable to get a cannula in her veins. When she went back the next day they were still not able to and she also had a temperature.

She had to be admitted to the hospital and they have done x-rays and CT scans to try and find out what is causing the cough but nothing has shown up. She is still in the hospital now.

She has been on an antibiotic drip for a few days and her temperature is back to normal, but she is still coughing and her white blood cells are at the lowest they have ever been.

I am so worried about my friend - I don't understand what is making her poorly - is it the cancer or could it be something separate?

It is all so frustrating as things had taken a positive turn but now it seems less positive.

  • Hi Cloudyday,

    Welcome to the online community. My name is Anne, and I am one of the nurses on the Support Line. I see you have joined some of our forums already. I hope you have found them supportive so far.

    I’m sorry to read of your friend’s diagnosis of metastatic breast cancer and am glad you have reached out for more support. This must be a difficult time for you both. As we are not directly involved in her care, it is difficult to know for sure exactly what is causing her symptoms. Her healthcare team at the Hospital are best placed to answer specific questions.

    However, it may help for you to understand a bit more about her treatment and the side effects which can occur. Ribociclib is a type of targeted cancer drug which can be given to patients with advanced breast cancer to try and control the cancer. Side effects vary from person to person but some of the common side effects include increased risk of infection and anaemia. In your friend’s situation, you mentioned she has received antibiotics and blood transfusions so hopefully these symptoms are being managed well.

    Low white cell counts are very common when on this drug. They do normally return to normal levels before the next treatment is due, although in some cases the dose of drug may need to be decreased or the next cycle may need to be delayed. Sometimes drugs are also given to help increase the white blood cell numbers. Again, your friend’s team will decide how best to manage this.

    You mentioned the cancer has spread to her lungs. When cancer affects the lungs, fluid can build up between the sheets of tissue that cover the outside of the lung and the lining of the chest cavity. This is known as a pleural effusion. Draining the fluid often helps the patient to feel more comfortable and alleviate any breathlessness they may be experiencing. Unfortunately, the fluid can continue to build up and require further draining.

    It can be hard to remain positive at times, particularly when you see your friend experiencing unpleasant symptoms and side effects.  You may wish to read our information on supporting someone with cancer. We understand how difficult and upsetting it can be when a loved one is diagnosed with advanced cancer. I’m not sure what sort of support you have round you, but it is important to take care of yourself during this difficult time.  Talking about things often helps to cope with the uncertainty. Please don’t hesitate to pick up the phone and speak to one of my colleagues on the Support Line. We are here every day from 8am until 8pm and can be contacted on 0808 808 0000.

    Take care for now,

    Anne - Cancer Information Nurse Specialist

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

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