Mac and Breast Cancer chemo treatment

Posted by clynnford @clynnford, May 19, 2023

I turned 60 and all hell broke loose. I was diagnosed with Mac & Bronch and now at 61, I was just diagnosed with breast cancer. I have not started any treatment for MAC since I have had no symptoms. Oncologist is hesitant to use Carboplatin in my chemo treatment due to it's immunosuppressant qualities....I'm thinking about just starting the antibiotic for the MAC just incase it flares up however I am not keen on taking the crap ton of meds that seem to be staring me in the face right now!!!
Have any of you been down this road and is there any hind sight info that you can share?

My trip to NJH was scheduled for the end of the month but now I will be sitting in a clinic getting chemo instead!

Thanks!
Cheryl

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Wow, Cheryl, what a turn of events. I hope your treatment goes well. Let me share my (non-medical) opinion with you. I spent way too many months on the Big 3 for MAC, and it was no picnic. If I was asymptomatic, there is no way I would ever consider taking them.
I have a friend in chemo for breast cancer right now, and I cannot imagine asking her to add that regimen. She is doing "well enough," but I believe the additional burden would put her flat on her back.

As far as the oncologist's concern about Carboplatin, perhaps you could ask them to consult with your pulmonologist, ID doc, or even NJH and get their recommendation? My friend who had to use high dose prednisone for a long time for an inflammatory disorder was prescribed just azithromycin 3 times weekly to suppress MAC, when I last saw her, it was working for her.

Good luck with your chemo, and whatever comes afterward.
Sue

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@sueinmn

Wow, Cheryl, what a turn of events. I hope your treatment goes well. Let me share my (non-medical) opinion with you. I spent way too many months on the Big 3 for MAC, and it was no picnic. If I was asymptomatic, there is no way I would ever consider taking them.
I have a friend in chemo for breast cancer right now, and I cannot imagine asking her to add that regimen. She is doing "well enough," but I believe the additional burden would put her flat on her back.

As far as the oncologist's concern about Carboplatin, perhaps you could ask them to consult with your pulmonologist, ID doc, or even NJH and get their recommendation? My friend who had to use high dose prednisone for a long time for an inflammatory disorder was prescribed just azithromycin 3 times weekly to suppress MAC, when I last saw her, it was working for her.

Good luck with your chemo, and whatever comes afterward.
Sue

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Thank you so much Sue. Yes my Oncologist will be getting with NJH. I judt read that antibiotics and chemo are a bad mix, sooo...we'll see. God willing there is way get through to the other side of this storm.
Thank you for your reply,
Cheryl

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I don't have any hindsight to offer as I am just starting down the road of combining chemo, radiation, and antibiotics myself. I can let you know that you are not alone. I have been on the antibiotics for MAC for over a year (starting at age 52 for me), and I am not set to end until October (assuming I stay negative). I have done well with azithromycin and ethambutol, with no major side effects, but struggled with the third, so I am only on the two. Because I was quite ill when I was diagnosed, antibiotics seemed necessary, but I am not sure that I would have made that decision if I were asymptomatic. Unfortunately, I have become septic twice in the past month due to pseudomonas joined by enterococcus faecalis pneumonia and am on my third course of IV antibiotics (cefepime, meropenem, and Zosyn). I am set to start my first leg of combined chemo and radiation for rectal cancer on June 1, which is the day that I will finish my IV antibiotics (unless I fail that course), but I will continue with the MAC treatment. It was recommended that I do a more intensive triple cocktail of chemo after that, but we have decided that I probably would not do well with that at this point, given my propensity to get infections and become septic. It is good that your medical teams will be consulting with each other to ensure that everything is covered. That is so important when multiple issues are involved. This is not my first rodeo so I do know it is possible to get to the other side, even when it seems overwhelming. Good luck with your treatment!

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