2nd Opinion With Dr. Pegram

I went to UCLA last week, and had an appt with Dr. Pegram for a second opinion. Dr. Pegram was recommended to me as one of the top researchers in the country, and intimately knowledgeable on Her2+ BC patients. He works in conjunction with Dr. Slaman, who was the force behind Herceptin.

He was a marvelous man, and had a great impact on me. I'll summarize a few of the things I came away with:

He doesn't feel that there is any advantage in a stage 4 BC patient toughing it out on chemo until reaching NED. NED for a stage 4 is different, as there is no cure, and the cells will always be there. Stable disease is as desirable a point as NED once you reach stage 4. The goals at this point have become length and quality of life.

He doesn't discount the possibility that today's mets patients may live 10-20 years and more managing the disease.

Crossing the blood brain barrier is still an area with alot of questions, there are some drugs in trials now that appear to be showing some promise, but nothing concrete has been proven yet.

As far as brain mets is concerened, he thinks the most important detection tool is a series of simple neurologic tests that your onc can do at your regularly appts. Brain mets can appear and start to grow in as little as a two month time period.

He believes that your body will reach a point where it needs a chemo break, and that periods of time with just Herceptin, as long as the disease is stable, are an acceptable form of treatment.

Hope this input helps, as I was also formerly considering NED to be the Holy grail of cancer, and his input has made me shift my thinking to considering this a chronic disease to be managed, while still maintaining a great quality of life.