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things to consider
Karen, this is of course your decision. And as you say, there is not enough evidence to have crystal-clear answers.
On the other hand, there is not enough evidence to make absolute statements like you did either -- that all HER2+ cancer is resistant to endocrine therapy. It is probably more resistant than HER2- cancers - yes. But that does not mean that endocrine therapy is ineffective for all HER2+ cancers, it only means that it's less effective. ( HER2- cancers can be resistant, or can develop resistance also, btw). For HER2+ cancers, especially when Herceptin in used, endocrine therapy may be very effective, as Herceptin may overcome resistance.
I have not heard of anyone with an ERPR+ HER2+ (triple positive) cancer pathology being told that endocrine therapy was of no use to them. Have others been told this?
Do you know the values of your ERPR? Again, it's not black and white - that continuum from negative to highly positive holds some clues as to probable response to endocrine therapy. Although again - no nice, firm, absolute answers, yet.
My suggestion, if your cancer has a reasonable degree of ERPR positivity, would be to try the endocrine therapy that is recommended to you and see how you tolerate it. Some women have no side effects or easily-tolerated ones. If you're miserable, it's not as if you can't get off the train.
Five year survival. It's not as if that's a magic number, or enough to aspire to - I agree. But I think that it's more that if they follow the studies out longer than that, much of the information is a moot point by the time it becomes available because in most cases, treatment has moved on and what they're reporting on is old news, and perhaps no-longer used anyway.
Debbie Laxague
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