[Joan M]

Thanks for posting this.

I eagerly await the results of Steven Chmura's clinical trial of using radiation on MBC survivors with a limited number of mets. Preliminary results are due out next year.

I used a lung wedge resection in 2007, which at the time was considered blasphemy for metastatic cancer, and many MBC survivors felt likewise. As some of you old-timers on this board might remember. I was diagnosed stage II in 2003. Took H off-label, like in the adjuvant clinical trial at that time, or for 52 weeks.

In 2008, the tumor came back in the same area, and I did RFA. It hasn't been in the lung since. A brain tumor in that year was treated by standard of care, and it hasn't come back. So, thus far, I've been ok, as we all know there are no guarantees.

I first learned of oliogometastatic disease when I read in 2007 about clinical trial results in Japan -- I wonder whether the current authors are the same people. I also wonder whether sequencing is an issue: I have never done chemo with MBC, I did the local procedures from the get-go.

Often times, I think our docs throw everything except the kitchen sink at the cancer systemically, and when nothing works anymore they then decide to use local procedures as a last-ditch effort.

My heart goes out to women who have reached a near pCR and then the tumor just sits there until it inevitably starts to grow again. This happened to a sister of one of my girlfriends. One lung tumor. Stable for two years on H. She didn't want to remove it via surgery or RFA (being treated at Sloan Kettering, and they weren't going to suggest that to her, unless of course in a last-ditch effort). Now she's on TDM1.

To paraphrase Eric Winer quoting Lisa Carey: I took the path of least regret. That is, I never wanted to look back and ask myself what would have happened if I had used local procedures early on, EVEN if the cancer had come back.