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Old 08-31-2007, 10:26 PM   #1
CLTann
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Second Anniversary NED, with no chemo and no radiation

I realize I am a minority here, opted for no chemo and no radiation although HER2 positive. Today is the beginning of my third year, a very significant road marker.

The benefit derived from chemo and radiation is less than 4% among stage 1 patients with no node involvement for non-recurrence. I chose not to get these treatments since the side effects could sometimes be worse than the benefits. Of course, it is a personal choice but many patients felt the more severe and harsh ammunition are generally better. I strongly feel that their extreme view may not be entirely sound. Doctors will never discourage a patient from electing a harsh treating plan because they don't want to be sued later.

I am actively engaged in medical profession as a hospital staff pharmacist. In this forum, my view is in the minority. I just want others to know that sometimes there are sound reasons for not accepting certain treatments.

I had my annual mammogram done today. The result was negative for the other breast. The radiologist asked me to go to routine x-ray labs in the future since he felt that my chance of recurrence is very low and the higher degree of expertise is not necessary. This advice gave me more confidence in my outlook.

I believe my daily build-up of immune health and Femera are doing their parts in helping me reaching this significant road marker. I am active in the this forum to share my views with others who could use a different angle in fighting this dreadful disease.
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Ann

Stage 1 dx Sept 05
ER/PR positive HER2 +++ Grade 3
Invasive carcinoma 1 cm, no node involvement
Mastec Sept 05
Annual scans all negative, Oct 06
Postmenopause. Arimidex only since Sept 06, bone or muscle ache after 3 month
Off Arimidex, change to Femara 1/12-07, ache stopped
Sept 07 all tests negative, pass 2 year mark
Feb 08 continue doing well.
Sep 09 four year NED still on Femara.
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Old 08-31-2007, 10:53 PM   #2
mcgle
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Hi Ann

Congrats on reaching this landmark.

My dx was similar to yours in that I received neither chemo nor herceptin. However, I did have radiation, as a wle was recommended instead of a mastectomy.

My preferred hormone treatment is tamoxifen, which is causing me no side effects whatsoever. Don't like the sound of all the aches and pains AIs are responsible for!

Time will tell whether our treatment was sufficient.

Mcgle (UK)
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Old 08-31-2007, 10:53 PM   #3
Alice
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Thumbs up

Hi There,
It is good to hear from you and share your experience. I think some people assume that hey don't have a choice in their treatment. I opted for chemo and radiation but my case was much different than yours, stage 3 highly agressive cancer. It seems that the people that choose not to just accept the standard course of treatment do not share their experience. I am glad to hear that you are doing well. Keep it up!
Alice
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Old 08-31-2007, 11:21 PM   #4
Chelee
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Ann, Big congratulations on being two years out. That's great! All any of us can do is make the best decision for ourselves depending on our DX at the time. I felt my decision was made for me since I had 5 positive nodes.

But I am so glad your working on year three. Way to go. May you walk down that never ending road of NED. Again, big congratulations girl.

Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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Old 09-01-2007, 03:31 AM   #5
kcherub
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Hi, Ann!

Congratulations on your 3-year status!

I do have a question...would you mind sharing where you found the 4% statistic? Your signature notes "postmenopause", but would you also mind sharing how old you were when you were diagnosed? As you will see from my signature, I was pretty young when diagnosed.

Thank you for any information you can provide!
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Krista
Diagnosed 3/29/2007 @ age 34
Stage 1, Node Neg. (SNB), Grade 2, 1.4 cm. IDC
ER/PR 90%+ HER2 +
6 TCH started 5/25/2007, ended after #5 due to steroid "reactions" and neuropathy in feet and hands
BUT--#6 CH w/o Taxotere
Begin Herceptin alone 9/28/2007
30 rads completed 12/19/2007
Finish Herceptin 5/9/2008
Stopped Tamoxifen early--HATED it.
Married 17 years
13-year old son
3 embies on ice (from 1999)
GA, USA

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Old 09-01-2007, 05:44 AM   #6
CLTann
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Kcherub,

There are many published articles comparing the statistics of non-recurrence factor from various treatment. The Adjuvant! is one I can easily recall, with numbers and graph for you to study.

At the time of my dx, I was 59. Older age is a favorite factor for non-recurrence, perhaps due to less hormone in the body. Also, the body has already adapted to the low hormone status, the addition of A.I. is not much a shock for the body.

If I were younger, with nodes involvement or elected lumpectomy, I probably would have chosen chemo regimen with radiation.

I also realize that there are plenty of women who did the same choice as I did. They do not participate in this forum since they felt they have no reason to be in a support group. To these women, they believe their cancer has been eradicated. In most cases, they are right. This factor moves me into a minority position in this very useful and informative forum.

Good luck.
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Ann

Stage 1 dx Sept 05
ER/PR positive HER2 +++ Grade 3
Invasive carcinoma 1 cm, no node involvement
Mastec Sept 05
Annual scans all negative, Oct 06
Postmenopause. Arimidex only since Sept 06, bone or muscle ache after 3 month
Off Arimidex, change to Femara 1/12-07, ache stopped
Sept 07 all tests negative, pass 2 year mark
Feb 08 continue doing well.
Sep 09 four year NED still on Femara.
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Old 09-01-2007, 07:06 AM   #7
tousled1
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Ann,

Congratulatins on your two year mark!
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Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 09-01-2007, 07:48 AM   #8
Sheila
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Ann
Congratulations on your anniversary....as you can see by my bio under my name, this is a tricky disease....I recurred very quickly.....none of us know! You are very lucky!!!!!!!!
__________________
"Be kinder than necessary, for everyone you meet
is fighting some kind of battle."



Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 09-01-2007, 09:06 AM   #9
lexigirl
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Great news Ann! I am so happy that you are doing really well! Makes my day!

Hugs,
Lexi
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Old 09-01-2007, 09:43 AM   #10
StillHere
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Ann, Congrats! and thank you for sharing your treatment decision and outcome so far with us.
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04/05 Onset 49, DCIS, solid, Hist 2/3, Nucl 2/3, 7cm R Brst
04/05 E & P + HER2+++
05/05 Mediport
05/05 Cytoxan & Adriamycin every 3wk x4
08/05 Taxol every 2wk x 4, Herceptin every wk x1yr
10/05 Bilat Mast - my Choice
10/05 3/19 lymph nodes Pos, Stage IIIa
11/05 Rad x 37 Rx, R Brst & Axcilla
02/06 Herceptin stopped (L vent HF 40)
03/06 Started & Stoped Arimidex after 2 mos.-QOL side effects
05/06 Started Tamoxafin
06/06 Bilat Free Flap Reconstruction
12/06 Cardiomyopathy reversed-HF normal
01/07 Bilat Saline Implants
07/07 CA 27-29 steadily rising from 28 in 12/06 to 46 in 7/07
07/07 PET Scan NED, but inflamation at prev surg site.
09/07 Started Femara
10/07 CA 27-29 down to 39
06/08 CA 27-29 down to 32
09/08 Lg joint pain & QOL side effects from Femara, will live w/ to keep CA markers within normal range.
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Old 09-01-2007, 10:11 AM   #11
nancy dip
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Immune Health

Hi Ann,
I would be interested to know what you do/take to build up your immune health. Also, what/how much exercise do you take. You seem to be doing something right!! Congratulations and long may it continue. Nancy Dip
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Old 09-01-2007, 10:43 AM   #12
AlaskaAngel
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Thumbs up treatment choices

Hi Ann,

Congratulations on being diagnosed early enough to have more choices, and your independence in pursuring a successful outcome with a disease that is so individual.

I do want to post a link here that may be helpful to others who are trying to make a decision in similar circumstances. I am one who did chemo as well as rads, but believe in hindsight that the choice I made was the wrong choice for me personally.

http://www.communityoncology.net/jou...es/0308487.pdf

Best wishes for many more years of being NED,

AlaskaAngel
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Old 09-01-2007, 11:12 AM   #13
BonnieR
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Congrats Ann! When I was first diagnosed, and even after my mastectomies, it was thought for awhile that I needed no further treatment. (one of my second opinions believed that I did not require anything else). Then doubt began to creep in and I entered a gray area because the test results, including Oncotype, were showing that although my cancer was Stage 1b, it was highly aggressive with a strong chance for recurrance elsewhere. And then the pathologist discovered more cancer than previously thought. I figured these were all "signs" I could not ignore so I now find myself receiving chemo prophylacticly. I guess I will always wonder if I made the right decision. And the story is still unfolding.......
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Bonnie

Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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Old 09-01-2007, 11:29 AM   #14
Hopeful
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Ann,

Congratulations! The 2 year mark is very significant. I am only 14 mo. post dx, and hope to be able to join you at your acheivement in another 10 mo.

I post here frequently, and I, like you, declined chemotherapy for my postmenopausal, highly hormone positive, her2+, stage 1 bc. My oncologist was willing to treat me with Herception without chemotherapy, so I did recieve a year of that. I also had a lumpectomy and radiation, and the radiation I am still troubled by. I tried very hard to get partial irradiation instead of whole breast, but was unable to achieve that. I also take an AI.

I am of a similar view as you, that harsh treatments can do more harm than good when not warranted. I try to give a balanced perspective, but respect everyone's right to make their own decisions on treatment. I read a fascinating article a few months ago about the psychology of treatment decisions made by cancer patients. It stated that, psychologically, individuals are motivated to aviod regret, and that failing to take an action (i.e., chemotherapy or other harsh treatment) would cause regret if the patient experienced a recurrence. Thus, people at even low risk are motivated to have the harsh treatment so that, if they do recur, they will not have regrets about their tx plan. I guess I am one of the odd balls for whom that line of reasoning does not hold water.

Best of luck to you for a great life continued NED!

Hopeful
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Old 09-01-2007, 03:50 PM   #15
CLTann
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Nancy Dip,

Regarding my daily supplements, I take curcumin, flaxseed freshly ground, ganoderma (a type of mushroom) extract, omega 3 including olive oil, vitamins, vegetable/fruit predominant diet, very little red meat, adequate proteins from beans including soy and its derivatives, turkey and fish. I am a true believer of ganoderma. I walk everyday but not excessively. Milk and egg are included. Good nutrition is important to fight the disease.

Every person has cancers cells in the body and the immune system kills them. This is a constant fight and we must have our troops ready to do the battle everyday.

Alaska Angel's thread on the ER positive cancer is very interesting. Although there is no quantitative advantage cited for chemo, the article implies the chemo can only give a negligible recurrence edge of around 1 or 2%.
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Ann

Stage 1 dx Sept 05
ER/PR positive HER2 +++ Grade 3
Invasive carcinoma 1 cm, no node involvement
Mastec Sept 05
Annual scans all negative, Oct 06
Postmenopause. Arimidex only since Sept 06, bone or muscle ache after 3 month
Off Arimidex, change to Femara 1/12-07, ache stopped
Sept 07 all tests negative, pass 2 year mark
Feb 08 continue doing well.
Sep 09 four year NED still on Femara.
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Old 09-01-2007, 05:07 PM   #16
Cristina19
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This was perhaps NOT the thread for me to read today because I just had my first round of chemo (TCH). Today is the proverbial 3rd day when everyone seems to feel like crap.

I agonized about doing chemo or not. I was offended (to put it mildly) that I was told that after a mastectomy I would run a 1-2% chance of recurrence if node negative. I had the mastectomy because the DCIS was so "extensive." I was relieved that I was node negative (1 sentinel node -) and when I returned to my doctor for the pathology report I received a different story:

extensive DCIS, 1.2 cm mass, ER +, PR-, HER2 +++ with a high (20%-30%) chance of recurrence.

When I asked my oncologist why I was told that mastectomy would leave only a 1-2% chance of recurrence AND asked that he please reconcile the very divergent recurrence percentages, he said, "I don't know where you got that number from."

Perhaps no one can tell us with any accuracy what the future holds but I hate that I could never seem to get any reliable information upon which to make my decision. In the end, at the age of 37, I made my decision out of fear and the hope that I could look into a future without cancer. In my gut, I don't want to be doing this. (By the way, the "gut" doesn't ever seem to tell me that what I'm doing is right or wrong; it just says, "I don't want to!")

Sorry for whining,
C.
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Old 09-01-2007, 05:47 PM   #17
dhealey
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Ann, Congradulations on your annivesary of being NED. I think we all have to chose what is right for us as an individual. What works for one doesn't necessarily work for everyone. It has to be a decision that comes from the heart that you are doing whats right for you. I get all kinds of opinions from others that aren't even dealing with this disease. It usually goes in one ear and out the other. I chose bilateral mastectomies and 4 months of chemo because mine was so aggresive. I also do supplements and walk many miles every day to help keep me strong in mind and body. I will reach my one year anniversary in Oct. Yea!!! It's been a very, very long year!
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Debbie in North Carolina
Diag 10/2006-high grade invasive ductal carcinoma- mastectomy L breast
2.5 cm tumor ER/PR pos-Her2+++
4 rounds A/C, 4 rounds Taxol
Herceptin every 3 weeks until Jan. 2008
6/18/07 prophylatic mastectomy R breast
8/2007 started aromasin/stopped arimidex (side effects)
12/07 stopped aromasin due to side effects (now what?)
Finished herceptin 1/8/08
started tamoxifen for 2 years then will switch to femera
allergic to tamoxifen started femera 4/2008
June 20, 2008 portacath removed
Learnig to live life to the fullest!
Stopped Femera due to side effects
July 28, 2008 start trial for breast cancer vaccine
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Old 09-01-2007, 05:48 PM   #18
Patb
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Ann
I see you changed from Arimidex to Femara. I am really having problems
with aches and pains on Arimidex, 10th month. I asked my oncologist about Femara and she said its the same as Arimidex. I think I still
would llike to try it. She suggested Aromasin? I am also on Herceptin
and I think this is contributing to the problem.
patb
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patb

Diagnosed June, 06, Stage I, Grade3, ER+PR- Her2positive, No Nodes. A/C X 4. Radiation 33 with boost, Herceptin every two weeks until Nov.
07, Arimedex for 5 years. Mugas and Echo and chest xRay. Bone scan of whole Body, and Back of Brain and spine MRI.
CT scan of Lungs every six months
due to two small places. December
2009, bone scan due to bone pain.
Follow up test in 2010.
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Old 09-01-2007, 06:27 PM   #19
CLTann
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Patb,

If your onc is willing to try another A.I., do it. Many women have done that and some, including myself, experienced relief from side-effects. We all understood that the different AI brands are basically the same in their chemical composition. Somehow, there are subtle differences. Any physicians should be open-minded in allowing the patients to make the change. What harm does the change do?
__________________
Ann

Stage 1 dx Sept 05
ER/PR positive HER2 +++ Grade 3
Invasive carcinoma 1 cm, no node involvement
Mastec Sept 05
Annual scans all negative, Oct 06
Postmenopause. Arimidex only since Sept 06, bone or muscle ache after 3 month
Off Arimidex, change to Femara 1/12-07, ache stopped
Sept 07 all tests negative, pass 2 year mark
Feb 08 continue doing well.
Sep 09 four year NED still on Femara.
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Old 09-01-2007, 06:50 PM   #20
BonnieR
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Christina, it is natural to feel as you do. Especially just a few days after a dose of chemo. I expect just about everyone here who is receiving chemo would identify with you. I don't WANT to be doing it either. But I feel I NEED to be doing it. It may be more disconcerting because some of us fell into a "gray area". At least I did. There was no right or clear cut answer. I weighed things and made a decision. As someone pointed out, if it becomes unbearable I can always quit.
But I also looked back in my journal and, after what seemed an eternity, but was really just a few days, the discomfort from the chemo lifted and I began feeling alot better and I saw that I CAN do this....so can you. Keept the faith...
__________________
Bonnie

Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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