Appreciate the note, Paul.

[Vicki Z]

Hi Paul,

I wish your mother well on her tests and I hope that the love and support she receives from you and her daughters give her some peace of mind through the testing process.

I am Stage 1, T1N0, her2 3+ and had 5 cycles of FAC and then was switched this past June to 16 weekly cycles of herceptin, taxol and carboplatin. I am one those taking herceptin at an early stage.

My med.-onc. said that some of the findings mentioned at the ASCO conference, in June, were moving in this direction, offering it to earlier stage patients. So, I was guided by those clinical trials, my own interest and research on the subject and her comments to do it as added insurance. It's something I'm grateful to do, but will be glad when the chemo is over.

As you stated to Vi and Vicki (a lot of "V's" going on there!), I believe the movement toward targeted therapies is the trend. Sometimes I feel I know just enough to keep raising more questions. But, that's okay; we need to trust our intuition, ask the pertinent questions and continue seeking knowledge. One thing I do wonder, and will ask my med.-onc., is: does the her2 continue to abnormally signal after treatment is done? If not, how did the process begin in the first place? Sometimes, this research is so new, that the answers aren't there yet.

Yes, I do believe that each new day of research sheds light on the subject and brightens the future for all of us.

Vicki Z in O.C.

[Paul]

Dear Vicki,

Thank you for the kind words in regard to my mom. Your treatment strategy is in line with the M.D. Anderson approach, although it is unclear to me whether you are currently being treated in a neoadjuvant or adjuvant setting. A copy of the M.D. Anderson study results is attached below as a cross-link. The treatment approach appears proactive and highly effective.

In regard to your question, HER-2 breast cancer cells continue to "signal" as long as they exist anywhere in the body. Hopefully, your early stage herceptin/chemo treatment will eliminate all of the HER-2 positive cells in your body. I am not aware of any source that describes why cells become HER-2 positive. I have read several commentaries that state that HER-2 positive breast cancer is not hereditary. It is thought that it is caused by normal wear and tear to the body that ultimately causes a genetic abnormality. Despite that fact, no cause is currently known.

As an aside, keep in mind that 98% of the battle consists of asking the right questions. The ability to ask good questions and "issue spot" will lead you to the necessary sources of expertise such as your doctor, research studies, etc. The research is moving at breakneck speed. We're in a technology era where the medical community may not have the luxury of waiting for 10 year long-term survival data prior to treatment because a new drug or treatment will emerge to replace the old drug or treatment well within that time period. If you regularly participate on the website, you will learn to issue spot very quickly.

I wish you great success with your current treatment. As a South Bay resident, I want to wish you all the best in O.C.

Paul