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Speaking of targeted therapies
In regard to the trend in the thread for treating brain mets which started when Lani posted a report on standards, I always wonder when medical oncologists are going to dump the criteria of the current static system of staging bc, for a more dynamic taxonomy that relates to today's real world.
There's a lot of talk about targeted therapies based on genetic make-up and individual pathology reports, but the current stage-I-to-stage-IV system doesn't accommodate them.
For example, at a major NYC cancer institute I was told at a consultation in mid 2005 after all my treatments were completed in my local, borough hospital (including off-label Herceptin) that all I needed for follow-up was blood work and tumor markers. But no scans.
I left that appointment thinking that hell would freeze over before I wouldn't have any scans. I had 7+ nodes and was HER2+ and ER-/PR-, yet I was put in the same taxonomic classification as a bc patient who has 1+ node and is HER2- and ER+/PR+.
I realized then that the staging system for bc was behind the times, and now it's even further behind. I don't mean to sound-off but there are fundamental flaws in the current, static pigeon-hole system.
Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
Last edited by Joan M; 11-09-2009 at 06:42 PM..
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