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Old 01-18-2013, 03:14 PM   #1
Dakini52
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Question Herceptin Forever???

I'm a little confused and am hoping someone here can help me out. I had a local recurrence to the chestwall 3 years ago. Had surgery, radiation and have been on Herceptin since then. My oncologist recommends that I remain on it indefinitely. I have only heard of this being done when a person is Stage IV. I'm looking for information that might help me understand this. Although I love my oncologist, he recently told me that when he was in medical school any recurrence was considered metastatic. This is not at all what my research of the subject tells me so I need your help
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Old 01-18-2013, 04:40 PM   #2
KDR
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Re: Herceptin Forever???

If I understand your post, you have HER2 positive breast cancer and it spread to your chest wall. You had surgery and then recurred again on the chest wall. I'm not into staging, and I say that fervently as so many S4s rid themselves of breast cancer and so many "early" stagers wind up S4. Because we have the single-cell theory, cancer should be looked at systemically, as a whole.

Yes, I think you should be on Herceptin as long as you can.

Best
Karen
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Old 01-18-2013, 04:53 PM   #3
Midwest Alice
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Re: Herceptin Forever???

Hi, I'm on Herception for ever too.
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Alice
04/08 age 50 III IBC Her2+++ ER/PR-8cm 14/14 Double M, Body and Brain CT/PET clear, ? on spine,Muga 53
06/08, 4 A/C, Neulasta
08/08, Herceptin/tax 12 every week
10/08, CT/PET clear, ? on pelvis, hips, MUGA 43, started Enalaprial for heart, Herceptin every 3 weeks
11/08 33Rads; 12/08 MUGA 48
2/09 MRI spine and bone scan, old mets to spine, Chest x-ray, blood work, IV NED,regular CPAP use,Zometa x6, first -flue like symptoms 2 days;Herceptin x3; stage 2 lymphoedema..sleeve and glove
4/09 Brain MRI - CLEAR; MUGA 54
7/09 chest ultrasound,
10/09 PET, brain and spin MRI NED Herceptin only. MUGA 59!!!
1/11 Hip replacement 7/11 Hip 2 replacement
4/12 4 years!! Herceptin
6/12 start reconstruction finish in 12/12
2/14 Herception - 6 years!!!

1 Corinthians 10:13 "No temptation has seized you except what is common to man. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you
can stand up under it."

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Old 01-18-2013, 05:07 PM   #4
Joan M
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Re: Herceptin Forever???

Your recurrence was considered local because it spread to the chest wall, but it has not spread to an organ, which is considered distant spread. Your oncologist sounds progressive to me, since he/she treated your chest wall spread with surgery and radiation, which immediately rendered you NED, or no evidence of disease, and allowed you to take only Herceptin and not chemotherapy, as well.

Sometimes, the cancer can start in the chest wall and spread to other areas, and often times we unfortunately don't know whether any of the cancer cells escaped into our system. It's very fortunate that you are NED and able to take only Herceptin and no chemotherapy. I think your oncologist wants you to stay on Herceptin for awhile to ensure that the cancer stays away.

How long should you stay on it is anyone's guess. I wish I had a crystal ball! If it were me, I wouldn't take the chance just yet of discontinuing Herceptin.

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!!
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Old 01-18-2013, 05:24 PM   #5
Dakini52
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Re: Herceptin Forever???

Thanks so much for the response. I was originally diagnosed in 2006, and after surgery, radiation, chemo and Herceptin went 3 1/2 yrs before the recurrence in my chest wall. I have been on Herceptin for 3 years now and am still status NED. My question I guess is because I keep seeing the news that 1 year of Herceptin is all you need and am trying to see how that applies to me. Joan, I believe your advice is wise since I have had the recurrence and will continue taking my 3 week rounds of Herceptin and be grateful :-)
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Old 01-18-2013, 05:30 PM   #6
Dakini52
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Re: Herceptin Forever???

Well, I was IIB, 5cm, 2 of 10 nodes so it is wonderful to hear that others are doing so well!
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Old 01-18-2013, 05:33 PM   #7
Dakini52
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Re: Herceptin Forever???

The initial breast cancer didn't spread to the chest wall; that is just where the recurrence was located. I'm convinced to continue on with the Herceptin :-)
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Old 01-21-2013, 06:10 PM   #8
CoolBreeze
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Re: Herceptin Forever???

You don't have a metastatic recurrence and aren't stage IV. What you are is a person who doesn't ever want to be Stage IV, so if herceptin will accomplish that, then I say go for it. It may be a few years down the road you can take a break but for now, I'd just be grateful you have this chance!
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08/17/09 Dx'd.
Multifocal/multicentric IDC, largest 3.4 cm, associated ADH, LCIS, DCIS
HER2+ ER+/PR- Grade 3, Node Negative

10/20/2009: Right mastectomy, reconstruction with TE
12/02/2009: Six rounds TCH, switched to Taxol halfway through due to neuropathy
03/31/2010: Finished chemo
05/01/2010: Began tamoxifen, the worst drug ever
11/18/2010: Reconstruction completed
12/02/2010: Finished herceptin
05/21/2011: Liver Mets. Quit Tamoxifen
06/22/2011: Navelbine/Zometa/Herceptin
10/03/2011: Liver Resection, left lobe. Microwave ablation, right lobe - going for cure!
11/26/2011: C-Diff Superbug Infection, "worst case doctor had seen in 20 years"
03/28/2012: Progression in ablated section of the liver - no more cure. Started Abraxane, continue herceptin/zometa
10/10/2012: Progression continues, started Halaven, along with herceptin and zometa.
01/15/2013: Progression continues, started Gemzar and Perjeta, an unusual combo, continuing with herceptin and zometa
03/13/2013: Quit Gemzar, body just won't handle it. Staying on herceptin, zometa and perjeta.
04/03/2013: CT shows 50% regression in tumor, so am starting back on Gemzar with dose reduction, staying with perjeta/herceptin/zometa. Can't argue with success!
05/09/2013: Discussing SBRT with Radiology due to inability of bone marrow to recover from chemo.
06/07/2013: Fiducial placement for SBRT
07/03/2013: Chemo discontinued, on Perjeta, Herceptin and Zometa alone
07/25/2013: SBRT (gamma knife) begins
08/01/2013: SBRT completed
08/15/2013: STABLE! continuing with Perjeta, Herceptin, Zometa
06/18/2014: ***** NED!!!!***** continuing with Perjeta, Herceptin, Zometa
01/29/2014: Still NED. continuing with Perjeta, Herceptin. Zometa lowered to every 3 months instead of monthly.
11/08/2015: Progression throughout abdomen and lungs. Started TDM-1, aka Kadcyla. Other meds discontinued. Remission was nice while it lasted.

5/27/18: Stable. Kadcyla put me right back in the barn. I have two teeny spots on my lungs that are metabolically inactive, and liver is clean.

I’m beating this MFer. I was 51 when this started and had two kids, 22 and 12. Now I’m 60. My oldest got married and trying to start s family. My youngesg graduates from Caltech this June. My stepdaughter gave me grandkids. Life is fantastic.
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Old 01-22-2013, 08:21 PM   #9
Dakini52
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Re: Herceptin Forever???

Thank you for the wise advise :-)
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Old 01-23-2013, 08:24 PM   #10
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Re: Herceptin Forever???

https://www.caring4cancer.com/go/bre...ast-cancer.htm

Stay on Herceptin! Good advice from your oncologist, but bolstered by the research we do as a team. Stay positive.

KDM
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