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Shaeff
Hi Joannie,
Your question is a hard one to answer. I believe that there are studies concluding that it appeared that Herceptin with chemo was more effective but I did my research four months ago when Herceptin was just coming out and was cut short in the phase 3 studies due to the positive results. I have heard, from my sister-in-law who has had bc for three years now, that a number of people she knows have had serious side effects from the Herceptin. She also knows the inventer and has not taken Herceptin herself until a month ago. However, we are planning on taking it when we finish the effects of the AC treatments (had the last of 4 this past Thursday). The plan is to take it with Taxotere. Next treatment in three weeks will be Taxotere only then the following treatment will be Taxotere with Herceptin. Our case is a little different. We were 6 cm, 2 nodes with 1.5 cm tumors and strong ER/PR and HER-2. Also we had a nottingham scale of 8 out of 9, which isn't good. The Tumor went from 2.5 cm in late June to 6 cm in late July when we removed it via surgery, and mast on one side. Even under our conditions we had a 50% chance that we got it all and chemo wouldn't be necessary. However, we had a 50% chance we didn't get it all so we opted for agressive chemo.
Only you can make the call but if it has been a couple of years and you are still negative, that is a great positive. You may want to look at your old path report and determing your nottingham scale. If it is low then you may be in a saver position than you realize. The original size of your tumor matters also. Since it is not an exact science it is a matter of odds. If it was under 1.5 cm and low on the nottingham scale then chances are about the same that if you took Herceptin then it it would benefit you since you had undetectable cancer versus having serious side effects. Guessing about 2% for benefit and, not guessing, 2 to 5% for adverse effects. First number in the side effects are the percentage of patients with the side effects when taking Herceptin alone. Out of the 7% with heart failure, 5% was serious. I can see why they are recommending you to not take it. However, if you are one of the 2% it would help in your condition, then it would be a great thing. 2% based on a stage 1 tumor with no spread, 5 year reoccurance rate. Its all odds and maybe your gut feelings are telling you where you fall in these numbers.
Adverse Events Occurring in > 5% of Patients or at Increased Incidence in the HERCEPTIN Arm of the Randomized Study
(Percent of Patients)
Single Agent n = 352 HERCEPTIN + Paclitaxel
n = 91 Paclitaxel Alone
n = 95 HERCEPTIN + AC
n = 143 AC Alone
n = 135
Body as a Whole Pain 47 61 62 57 42
Asthenia 42 62 57 54 55
Fever 36 49 23 56 34
Chills 32 41 4 35 11
Headache 26 36 28 44 31
Abdominal pain 22 34 22 23 18
Back pain 22 34 30 27 15
Infection 20 47 27 47 31
Flu syndrome 10 12 5 12 6
Accidental injury 6 13 3 9 4
Allergic reaction 3 8 2 4 2
********Cardiovascular Tachycardia 5 12 4 10 5
********Congestive heart failure 7 11 1 28 7
Digestive Nausea 33 51 9 76 77
Diarrhea 25 45 29 45 26
Vomiting 23 37 28 53 49
Nausea and vomiting 8 14 11 18 9
Anorexia 14 24 16 31 26
Heme & Lymphatic Anemia 4 14 9 36 26
Leukopenia 3 24 17 52 34
Metabolic Peripheral edema 10 22 20 20 17
Edema 8 10 8 11 5
Musculoskeletal Bone pain 7 24 18 7 7
Arthralgia 6 37 21 8 9
Nervous Insomnia 14 25 13 29 15
Dizziness 13 22 24 24 18
Paresthesia 9 48 39 17 11
Depression 6 12 13 20 12
Peripheral neuritis 2 23 16 2 2
Neuropathy 1 13 5 4 4
Respiratory Cough increased 26 41 22 43 29
Dyspnea 22 27 26 42 25
Rhinitis 14 22 5 22 16
Pharyngitis 12 22 14 30 18
Sinusitis 9 21 7 13 6
Skin Rash 18 38 18 27 17
Herpes simplex 2 12 3 7 9
Acne 2 11 3 3 < 1
Urogenital Urinary tract infection 5 18 14 13 7
Back to our case we are betting on a 30% chance of benefit vs a 5% chance of serious side effects (based on Genetechs own warnings) for taking Herceptin alone. We are going with those odds but it is still a gamble. We could be in the 50% class that have already beat the cancer or in the 5% group that will be seriously affected by Herceptin. It is still a great drug but being two years out increases your odd of already having success.
BUT, only you know if it is worth it.
Good luck and either way you decide, it will be the correct decision!!!
Shaeff
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