Foolish Assumptions

[Heartbroken]

My Mom had a HER2/neu+3 mass removed about a year ago. During surgery, the surgeon decided (despite my request) to avoid doing a sentinel node mapping/removal. Only one node (enlarged) was removed, and found to be clear. No further treatment was recommended.
Then came the surprise HER2+ status from pathology. I proceded to get her radiation therapy, as I feared the unknown status of the remaining axillary nodes, and wanted to prevent a recurrence at all cost. I asked the oncologist if she could receive Herceptin to be safe. He said she didn't qualify because she had no evidence of disease. All was well until another enlarged node was found to be positive upon biopsy a few weeks ago. Now she is about to have the axillary dissection she should have had a year ago. I am wondering what chance she has for success with Herceptin as a single agent therapy now. She is not healthy enough to undergo any other type of chemotherapy, but her heart is in pretty good shape for her age.
I am wondering if anyone has any suggestions as to what other therapies/clinical trials might help her now. I'm not ready to lose my Mom just yet.

[Rich]

Maybe the lapatinib results this friday will offer a better than Herceptin monotherapy. (Fingers crosssed) My mom is in pretty much the same boat. Strange, I had to push surgeon for a SNB also...standard proc for all but our moms.

[Kathy]

Your mother may indeed have success with just the Herceptin. I had a recurrance after 19 years--I'm now 60-- and am HER2+++ and estrogen +. I have been receiving just Herceptin and various estrogen blockers successfully for 2 years--just recently having more problems and am now having radiation for bone mets. Keep us posted
Kathy

[Lani]

Maybe there will be more trials of herceptin with other agents for the hormone sensitive her2neu tumors (chemo does not work as well for hormone sensitive tumors they think) and for the frail/elderly etc. Have you thought of getting your mom on a vaccination trial? The trial for node positive pre-metastatic at Windber is now allowing patients receiving herceptin to get vaccinated I think. Also, there are studies showing olive oil improving the efficacy of herceptin treatment. But first be sure her previously resected tumor is tested for FISH, as that is the test which indicates herceptin's efficacy.

Hope this helps,
Lani

[Lani]

Maybe there will be more trials of herceptin with other agents for the hormone sensitive her2neu tumors (chemo does not work as well for hormone sensitive tumors they think) and for the frail/elderly etc. Have you thought of getting your mom on a vaccination trial? The trial for node positive pre-metastatic at Windber is now allowing patients receiving herceptin to get vaccinated I think. Also, there are studies showing olive oil improving the efficacy of herceptin treatment. But first be sure her previously resected tumor is tested for FISH, as that is the test which indicates herceptin's efficacy.

Hope this helps,
Lani

[Heartbroken]

Just an update. Mom went in for an axillary dissection and had a good number of nodes removed under the same arm as the original surgery.
The surgeon stated that there seemed to be more than just a few nodes involved and most likely positive. Seemed ironic that she tolerated this second surgery so well, after not having the chance to have the procedure she needed in the first place.
So, in essence, she has NOW had the surgery that could potentially erradicated the entire tumor involvement had it been done the first time around. I cannot emphasize enough, that when you ASK for aggressive treatment, you need some assurance from your doctor that they will follow through with it. The biggest single mistake, was that the surgeon ASSUMED incorrectly, that the original tumor would be ER+ and would be manageable with estrogen blockers. The surgeon actually stated later, that the decision not to do a sentinel node biopsy the first time around was a mistake. Hardly any consolation to my Mom. Now we go down the road to try to get Herceptin and maybe even lapatinib, as she still cannot tolerate any standard chemotherapies. I will keep you posted if anyone cares to hear the follow-up reports.

[Barbara2]

Yes, please keep us posted. God bless.