Paul
04-06-2004, 03:08 PM
Gary,
Keep up the good work for your mom. I have a few suggestions as follows:
1. As Lolly mentioned, get a copy of your mom's original pathology report. It may or may not state whether your mom's breast cancer is "HER-2 positive." Again as Lolly mentioned, your mom's original tumor(s) can be tested for HER-2 status assuming the tumor sample was preserved. In essence, it is important to know whether your mom's breast cancer is inflammatory breast cancer, HER-2 positive breast cancer, or the "vanilla" variety of breast cancer. The general or overarching categorization of your mom's breast cancer will affect the nature of her treatment decisions. This website is dedicated to women who are HER-2 positive and most of the comments that you will receive here are directly related to this form of breast cancer.
2. If your mom's original tumor (or a subsequently obtained biopsy, e.g., from the liver) is "HER-2 positive" as measured by FISH testing (Fluorescence In Situ Hybridization), or "+2" or "+3" as measured by IHC testing (ImmunoHistoChemistry), your mom will be eligible to use Herceptin in conjunction with one or more chemotherapeutic drugs (e.g., Herceptin + Navelbine, noting that your mom has already tried taxol and taxotere). In the event that your mom was never tested for HER-2 status and assuming the original biopsy is unavailable, be aware that there is a blood test to measure HER-2 in the blood serum (assuming that a current biopsy sample can not be obtained). But, the FISH test is recognized as the best method for determining HER-2 status. Click on the cross-link below and it should take you to a detailed description of Herceptin (including who is eligible to take it) provided at www.breastcancer.org. Be aware that generally, Herceptin cannot pass through the blood-brain barrier and enter the central nervous system. Accordingly, Herceptin is generally ineffective to battle brain mets but may be very effective in battling bone and liver mets if used in combination with other chemo drugs.
3. Obtain copies of any diagnostic tests performed on your mom recently that discuss the status of her liver and bone metastases (e.g., PET scan, CT scan, MRI, etc.). The ideal tests for determining your mom's current status consist of a FDG-PET scan (from base of skull to leg calf) and a MRI of the brain. I note that your mom will undergo an MRI of the brain this week. Please make sure that you know the exact extent of your mom's mets by diagnostic evaluation relatively soon.
4. Determine whether your mom's breast cancer is estrogen/progesterone positive. This determination should also appear on the original pathology report. If so, and provided that your mom is post-menopausal, there are numerous anti-estrogen drugs available (e.g., Arimidex, Femara, Aromasin, and Faslodex) to assist in the cancer fight.
5. You won't know if your mom has brain mets until you obtain the MRI results. Hopefully, no mets are present. If mets are present, there may be many non-surgerical technologies available to your mom as previously noted including CyberKnife, GammaKnife, LINAC, etc. as mentioned by PattyZ in her April 5 posting below. Additional resources include the American Brain Tumor Association (www.abta.org), the National Brain Tumor Foundation (www.braintumor.org), and The Brain Tumor Society (www.tbts.org). If you register at the ABTA website, you can access its library. The library contains a lot of basic and advanced information on brain tumor treatment options. As I mentioned previously, the most recent edition of Cure Magazine on-line (www.curetoday.com) has a cover article regarding brain tumors and discusses several forms of current and experimental treatment. This website also has an entire section of cross-links dedicated to metastatic brain tumors.
6. Be an advocate for your mom, get copies of each medical procedure performed, and post often on the message board as to your mom's status. If your mom is HER-2 positive, this website is an outstanding resource.
7. Take it one step at a time. This is a marathon, not a sprint. At first, the information is overwhelming. But, with persistence and dedication and the help of this group, you're going to be an outstanding advocate for your mom.
8. Please instill hope in your mom as the pace of biotechnology (as you can see from our articles of interest message board) is moving at a remarkable pace. And, don't forget to read her Christine's inspirational story -- she is, after all, a Stage IV, HER-2 positive breast cancer survivor who has successfully battled brain mets.
Gary, your entire family is in our thoughts and prayers. Don't hesitate to contact us on the board or contact me personally through email.
Warmest regards,
Paul
Keep up the good work for your mom. I have a few suggestions as follows:
1. As Lolly mentioned, get a copy of your mom's original pathology report. It may or may not state whether your mom's breast cancer is "HER-2 positive." Again as Lolly mentioned, your mom's original tumor(s) can be tested for HER-2 status assuming the tumor sample was preserved. In essence, it is important to know whether your mom's breast cancer is inflammatory breast cancer, HER-2 positive breast cancer, or the "vanilla" variety of breast cancer. The general or overarching categorization of your mom's breast cancer will affect the nature of her treatment decisions. This website is dedicated to women who are HER-2 positive and most of the comments that you will receive here are directly related to this form of breast cancer.
2. If your mom's original tumor (or a subsequently obtained biopsy, e.g., from the liver) is "HER-2 positive" as measured by FISH testing (Fluorescence In Situ Hybridization), or "+2" or "+3" as measured by IHC testing (ImmunoHistoChemistry), your mom will be eligible to use Herceptin in conjunction with one or more chemotherapeutic drugs (e.g., Herceptin + Navelbine, noting that your mom has already tried taxol and taxotere). In the event that your mom was never tested for HER-2 status and assuming the original biopsy is unavailable, be aware that there is a blood test to measure HER-2 in the blood serum (assuming that a current biopsy sample can not be obtained). But, the FISH test is recognized as the best method for determining HER-2 status. Click on the cross-link below and it should take you to a detailed description of Herceptin (including who is eligible to take it) provided at www.breastcancer.org. Be aware that generally, Herceptin cannot pass through the blood-brain barrier and enter the central nervous system. Accordingly, Herceptin is generally ineffective to battle brain mets but may be very effective in battling bone and liver mets if used in combination with other chemo drugs.
3. Obtain copies of any diagnostic tests performed on your mom recently that discuss the status of her liver and bone metastases (e.g., PET scan, CT scan, MRI, etc.). The ideal tests for determining your mom's current status consist of a FDG-PET scan (from base of skull to leg calf) and a MRI of the brain. I note that your mom will undergo an MRI of the brain this week. Please make sure that you know the exact extent of your mom's mets by diagnostic evaluation relatively soon.
4. Determine whether your mom's breast cancer is estrogen/progesterone positive. This determination should also appear on the original pathology report. If so, and provided that your mom is post-menopausal, there are numerous anti-estrogen drugs available (e.g., Arimidex, Femara, Aromasin, and Faslodex) to assist in the cancer fight.
5. You won't know if your mom has brain mets until you obtain the MRI results. Hopefully, no mets are present. If mets are present, there may be many non-surgerical technologies available to your mom as previously noted including CyberKnife, GammaKnife, LINAC, etc. as mentioned by PattyZ in her April 5 posting below. Additional resources include the American Brain Tumor Association (www.abta.org), the National Brain Tumor Foundation (www.braintumor.org), and The Brain Tumor Society (www.tbts.org). If you register at the ABTA website, you can access its library. The library contains a lot of basic and advanced information on brain tumor treatment options. As I mentioned previously, the most recent edition of Cure Magazine on-line (www.curetoday.com) has a cover article regarding brain tumors and discusses several forms of current and experimental treatment. This website also has an entire section of cross-links dedicated to metastatic brain tumors.
6. Be an advocate for your mom, get copies of each medical procedure performed, and post often on the message board as to your mom's status. If your mom is HER-2 positive, this website is an outstanding resource.
7. Take it one step at a time. This is a marathon, not a sprint. At first, the information is overwhelming. But, with persistence and dedication and the help of this group, you're going to be an outstanding advocate for your mom.
8. Please instill hope in your mom as the pace of biotechnology (as you can see from our articles of interest message board) is moving at a remarkable pace. And, don't forget to read her Christine's inspirational story -- she is, after all, a Stage IV, HER-2 positive breast cancer survivor who has successfully battled brain mets.
Gary, your entire family is in our thoughts and prayers. Don't hesitate to contact us on the board or contact me personally through email.
Warmest regards,
Paul