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Old 04-29-2008, 11:25 AM   #1
Val Pfeiffer
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Stage IIIB ER/PR(-) ...what are you guys doing post-treatment?

I'd like your opinions....I have kept going with Herceptin since my main treatments ended in August 2005 (see my signature for details). I had one year of triple dose Herceptin every 3 weeks and since then have gone with Herceptin quarterly. I'm not aware of other options for post-treatment in cases like mine where the patient is hormone-receptor negative. I'm considering dropping the Herceptin, and I want to know if there are other things I should consider.

For those of you in a situation similar to mine, what are you doing for ongoing preventative treatment?

thanks!!
Val
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BLOG:
http://valleygirlvnp.blogspot.com/
Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 04-29-2008, 11:47 AM   #2
StephN
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Hi Val -
Good to see you. I had forgotten you were doing the quartely Herceptin.
Has your blood work or tumor markers changed at all during this time??

Have you considered one of the vaccine trials?? There is some improvement in that direction, and new ones on the horizon.

What about diet/supplements? I think you are on board there.

I am also hormone neg, and am extremely thankful to be a responder to Herceptin.

Don't forget about getting regular exercise or joining a walking group.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 04-29-2008, 12:03 PM   #3
Val Pfeiffer
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Thanks, Steph...

** I've never had blood work or tumor markers, so don't know

** Haven't looked into vaccine trials in the last 12-18 months--I robably should read through them again.

** I still teach spin (indoor group cycling), so exercise isn't an issue

** I take vitamins; and I am trying to eat better -- still love junk food :-)

I was hoping that there was some new magical follow up med that popped up since I have been active on this board...one can dream!!!

Val
__________________
BLOG:
http://valleygirlvnp.blogspot.com/
Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 04-29-2008, 04:02 PM   #4
Ruth
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Hi Val ~ I am really impressed with the quarterly herceptin. I haven't had any treatment since August 04 when my yearly Herceptin was over. I eat healthier and am happier in my personal life but other than that nothing new!

I'm curious what others say. I too was ER/PR negative.

Ruth
__________________
[/SIGPIC]~~~~~~~~~~~~~~~~~~~~~~~~~~~

Diagnosed 6/03 nursing daughter
Dose dense A/C 4x
Modified rad mast 8/03
IDC; 3 cm; 10+/16 nodes; ER/PR-; Her2+++
Weekly taxol w/Herceptin (off label) 12x's
40 weeks Herceptin
Radiation 33x
Reconstruction w/ implants 05 & 07
NED
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Old 04-29-2008, 04:42 PM   #5
Yorkiegirl
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I am stage III A and am ER/PR Negative.

I haven't any treatment since I finished my year Herceptin in September 2006.

I do still however see my Onc every 3 months for Blood work and markers.
__________________
Vicki
Texas
Biopsy Dx'd 3-23-05 Age 48
MRM 4-5-05 w/ 2 tumor's 5cm, and 6 cm (right side)
IDC (poorly differentiated infiltrating ductual carcinoma)
5+/16 nodes
Stage III A
Grade 3
ER/PR-, Her2/neu ++
Ki67 78%
Begin Chemo 5-2-05 4XAC Dose Dense , 4X Abraxane Dose Dense (ended August 05)
28 Rad's ended October 13 2005
Started Herceptin Weekly August 2005 for one year
Had a Simple mastectomy left side after Mamo showed incresed micro-calcifications. Jan. 17 2006.
Brain MRI Feb.2006--All Clear
August 28, 2006 Last Weekly Herceptin.
October 2006--Colonoscopy, 6 Polyp's removed--all B9
PET Scan July 2007
Abdominal MRI Oct. 2007---2 Right Kidney Cysts
Core Biopsy-- Lump on Scar Line 1-10-08---B9
Brain MRI 6-2008--All Clear
PET/CT Scan 6-2008
Sept. 8 2008, 4CM area removed from mastectomy scar line. Proved to be B9.
PET/CT Scan-- July 2009 --All clear
August 17,2009 ---Had Port Removed
6 Years NED -- April 5,2011
DX'd with Melanoma left arm 10-10-2011
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Old 04-29-2008, 05:04 PM   #6
Val Pfeiffer
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I had a feeling that I'd hear that others aren't doing anything (simply because there isn't really anything out there). I could probably continue indefinitely on quarterly Herceptin (I have a great health insurance company behind me), but I'd really like to wean myself off Herceptin, but I'm a little nervous about doing nothing.

I'm thinking about talking with my health plan about paying for me to see a nutritionist who can get me and keep me on a program to get me off the Hostess donuts and other crap that I eat every day. I need to find a way to replace the calories I take in from the crappy food--I can't afford to lose weight--I burn a lot of hyper energy. Weird problem to have, but needs to be dealt with.

Anyway, if anyone else is doing something different, please let me know. I'd love to know how much we've decreased our chances of experiencing a recurrence because of the post-treatment Herceptin; and there has to be a diminishing return with the quarterly Herceptin I've been doing, but the data isn't out there yet (right?) to tell us that...

thanks!
Val
__________________
BLOG:
http://valleygirlvnp.blogspot.com/
Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 04-29-2008, 05:51 PM   #7
Becky
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Hi Val

It's good to hear from you again. There are a lot of ways to boost the calories without eatting junk. I admit, I'm jealous as I am a real easy keeper and I remember meeting you twice and you are slim but not emaiciated. Nuts, avocados, white or sweet potatoes are calorie dense and not bad for you. Eat whole milk products (yogurt, milk, cheese) instead of low fat versions (the CLA - conjugated linoleic acids are a good omega "6" to get from whole milk dairy). Chocolate is good.

Winter squashes, pasta, peas, beans all have calories but lots of fiber and antioxidants too.

The nutritionist idea is good. Besides more ideas, that person will be able to help wean you off the sugar that you are addicted to and it may actually take a plan and some work (or maybe like cigarettes - just cold turkey).

Whole wheat crackers with hummus (with alittle olive oil) is a good snack (adding the extra virgin olive oil is extremely healthful but adds a whack of calories too).

If you see the nutritionist, please post on what they are having you do and what some of their suggestions are (not that I can do them since I would gain weight just thinking about it but it would be very interesting).

Stay in touch
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 04-29-2008, 06:33 PM   #8
StephN
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Dear Val -
Wish we had a new "magic" pill or something.

I have to say I am very surprised that your onc does not take any blood for labwork. Seems that if you are on Herceptin that the markers would be a natural to go along with getting the Herceptin.

Maybe you should ask for some blood work to be done just prior to your next quarterly H. Markers are more accurate before the drug. That would give you an idea where your numbers are at least for future reference.

Every 6 weeks I have full labs with two markers - the CA27-29 and CEA.

Good nutrition is really essential for gals like us who can't use a hormone suppressor or other way to shut down the cancer. Read RB's thread on the Greek diet. Even though it is complicated, there are good reasons for balancing the omegas and getting the RIGHT fats.

All the best in going forward.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 04-29-2008, 07:19 PM   #9
sassy
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Hey Val!

No words of wisdom for you. I am triple positive, so have a different situation also.

Just wanted to let you know its good to "see" you again.
__________________
Rhonda (Sassy)
dx age 45
DX 2/15/05 Stage IIb (at surgery)restaged IIIa
Left mast .9cm tumor 5 of 14 nodes
Triple Positive
4 DD A/C
12 Taxol/Herceptin
33Rads
Strange infect mast site one year aft surg, hosp 1 wk
Herceptin for total of 18 months
Lupron Monthly 4 yrs
Neurontin for aches, pains and hot flashes(It works!)
Ovaries removed 11/09 stop Lupron and Neurontin
Arimidex 6 yrs (tried Femara, no SE improvement)
Tried Exemestane-hips got so bad could hardly walk
Back to Arimidex for year seven
Zometa 2X Annual for 7years, Lasix
Stop Arimidex 5/13
Stop Zometa 7/13-Bi-lateral Stress Fractures in Femurs from Zometa
5/14 Start Tamoxifen
3/15 Stem cell transplant to stimulate femur bone growth/healing
5/15 Complete fracture of right femur/Titanium rods both femurs
9/16 Start Evista stopTamoxifen
3/17 Stop Evista--unwelcome side effects!
NED and no meds.......
14YEARS NED!
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Old 04-30-2008, 03:48 AM   #10
Sheila
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Val
Great to see you pop in again....I think you will get different answers depending on whether people hav emets or not.....I wonder what Michelle U is doing....I thing her diagnosis was similar. You look great as always so you must be doing something right!!!!
__________________
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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 04-30-2008, 05:12 PM   #11
lkc Gumby
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Smile

Hi Val,

Interesting that you are still on Herceptin, too. I have neverchanged my Herceptin regimen ( still every 3 weeks ) since Oct 05 I don't have mets, but my onc down here seems to think since I responded so well I should stay on it. Not sure when He'll D/C me.
It's my comfort blanket I guess. The insurances don't balk, they go by the dr rec.
anyway,
I get Zometa every 6 mos as well prophylactively for my bones.and take 2000mgs calcium W/ Vit D I get TM every 6 mos, and PETs annually.
I am on a low fat, no sugar diet, and basically follow the " Breast Cancer diet" I am slim and high energy , so I just eat alot of the " good " foods.
Oh yeah , since I am er/pre neg I swear by Flaxseed, too.
I looked into the new vaccine trial and am waiitng to hear what the enrollment criteria will be. I suspect it will also be for low expressors of HER amplification. ( It will be on your FISH report )
Anyhow, hope that helps!
__________________
Linda

Dxed Stage IIIC May 05, 12 pos nodes
er/pr -neg,Her -pos
LVI
Right partial mast & partial axillary dissection-June14,2005
Right modified mast-no clear margins- June 30, 2005
DD AC x4
Taxotere X4 with Herceptin
Rads x 35( 5 fields )
Left prophylactive mast( atypia & hyperplasia found ),
put on Tamoxifen x 1 yr; D/ced due to endometrial thickening
bilateral recon (saline implants)May 06
Nipple recon July 06
metformin 2010
removal of implants due to severe encapsulation, insertion of gummies 2013
Reclast Q yr
NED!!!
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Old 05-04-2008, 11:10 PM   #12
SherriT
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[this is a copy of my reply from the other thread that has the same 'title']

Val,

I also am also Her2+ and ER-/PR-. My doctor's recommendation was for one year of Herceptin (finished April 2007) and I have had no further treatment since. My doctor has also stated that there really are no further treatments and just to be vigilant in watching my body. I will be having a follow-up CT scan in a couple months, but that is just so we have a bit of a baseline image to follow should another be required down the road--and I tell him I won't be needing another down the road, lol.
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