When do they know Treatment is working or not?

[Chelee]

When have all of you been told that they will know if your tx is working or not? I asked my new oncologist...and she said they won't know till after my treatment plan is over. (I am thinking there HAS to be a way to know long before then?) I asked about tumor makers and she said they are not reliable...so she doesn't do that. There has to be some way of getting an idea. I am stage IIIA...I don't have time to mess around waiting.

Is that what your oncologist do? I find this hard to believe?

Chelee

[R.B.]

You can spend a great deal of time reading on this topic, acquire a much wider knowledge base and no nearer the answers, except knowing that the medical profession is not certain about as much as you might have thougt it was when you first walked through that door.

I am not sure why tumour markers are often apparently not well regarded even as indicators.

There are a lot of potential markers that for some reason never even seen to have got into a development program.

For those with tumours a scan can monitor impact on tumours. Apparently anything under 4mm does not show up so this is no good for micromets.

Essentially chemo for most at inital diagnosis chemo is "preventative" - to kill micro mets and cancerous cells in the wider body - but if you read some sources we all have cancerous cells, but the difference is the body is able to deal with them - and it assumes you have some to kill - and they are the same type as your initial diagnosis and so susceptable to the perscribed chemo......

Lani's post from the NY Times summarises a lot of the controversy.

It must come as a bit of a shock if you start from the perception that chemo is a certain science and of proven worth fro all who receive it.

Sarah Daltons post on the economics of chemo make thought provoking reading - the financial margins for the clinic that administer chemo appear potentially high - I also have a vauge recollection that in the UK provision of chemo was used as an treatment rate measure - these sots of factors could edge doctors or institutional policy on patient treatment in certain directions.

Whats the alternative - does it work - is it worth any down side balance - those are the unanswered questions - cleary it has a place in the treatment arsenal - but for what groups is it truly effective - that is the question.

I am confused and am just a male spectator NOT having to personally face the realities of treatment.

It seems you just have to read all you can, if you have the time, and make the best decisions you can - it cannot be easy for any patient.


DIET

My amateur interest is fats in the diet and impact on BC and health generally.

I would urge you to look at the posts on this site - click on the search button above on the purple bar - on omega three and six, and diet generally.



I wish you every success in your journey.

RB

[Kimberly Lewis]

I have the same question and also am 3a. I have been in treatment since last summer and have switched oncs 2x. I called my insurance Friday to see just what they cover and was surprised to learn that they only cover tumor markers in stage 4 patients. They do however cover PET scans for any stage. From what I read here I understand that many woman "fake" symptoms in order to recieve the tests they want and see other women getting. This is a terrible place to be. I do feel that testing stage 4 is to see if existant tumors are either no longer growing or shrinking and in my case they have cut off any existing tumor they could find. My CT scan and other tests have been clear. It is alarming to me that they never looked at my brain and continue to rufuse further testing when it seems that catching tumors when small would be beneficial!
I am reminded of the time that my mom and dad seperated... she came to stay with me because she feared him. He insisted on seeing her and I called the police only to be told they couldn't do anything till her actually attacked her. Now I am being told they won't protect me by testing till I am actually under attack by palpable or otherwise damaging tumors? The sensation of helplessness and anger is overwhelming. I plan on doing all I can to get tested... will write and let you know if I am sucessful!

[eric]

You may want to ask your doc about the BayerHER2 serum test. You can do a search on this site for additional information.

Warmest regards,
Eric

[heblaj01]

The Bayer test is the only non invasive marker for HER-2 tumours but is not likely to detect early lesions & is cancer type specific.

A new marker is in the development stage by the team of Dr J. Folkman (at Harvard) the originator of the field of antiangiogenesis research.If it comes to fruition it will not only be able to detect microscopic tumours (probably of any origin) before cancer diagnostic by current methods is possible.

It will aso allow preventive treatments by slow but non toxic non specific antiangiogenesis medication.
This preventive treatment strategy (with doxycycline used as an antiangiogenesis agent not as an antibiotic) is already tried on a single young male U.K. patient in remission from a cancer with a 100% risk of recurrence for which there is already a very reliable monitoring marker.
Running perhaps closer to availability to all patients is the recent FACTT highly sensitive method of detecting protein markers such as HER-2/neu in serum.It can potentially detect early tumours. It is however at present cancer specific but could become less so in future development.

Ref:

Extracted from:

Summaries of 2005-2006 BCRF-funded research (by medical facility)http://www.bcrfcure.org/rese_summaries.html

Children’s Hospital/Harvard Medical School, Boston, MA
Judah Folkman, MD

Tumors grow and spread by recruiting their own network of blood vessels, a process called angiogenesis. Over the past year, with BCRF support, Dr. Folkman and his colleagues have have shown that a novel angiogenesis inhibitor, Caplostatin, can synergize Avastin and cause permanent dormancy of human cancer in laboratory models and result in 50% of tumors being eradicated. They have also developed a novel biomarker which is based on angiogenic proteins in platelets and which detects human cancers in models when they are still dormant and less than 1 millimeter in diameter (e.g., pinhead size).

They will continue these studies over the next year, when they intend to determine how breast cancer suppresses angiogenesis inhibitors that are normally in the tumor bed and also are normally present at distant sites, such as lymph nodes, to which tumor cells may metastasize in the future. They will try to demonstrate that the platelet angiogenesis proteome can predict drug resistance months to years before it occurs so that drug resistance can be prevented by adding the appropriate angiogenesis inhibitor.

Further, they will carry out a long-term study of treating primary and metastatic human breast cancers with Avastin plus Caplostatin to determine if these cancers can be eradicated, or if the angiogenic switch can be blocked in dormant non-angiogenic human breast cancers. Finally, they will chemically modify the endostatin peptide so that it has a long half-life in the circulation. Dr. Folk man’s overall goal is to initiate clinical trials of endostatin and Caplostatin in patients with advanced metastatic breast cancer.

[R.B.]

Wow

One sees mention of lots of marker possibilities.

It is good to seem some do get followed up.

RB

[tousled1]

I am stage III and will finish my neoadjunct chemo therapy on Wednesday. I have my surgery scheduled for June 8. I had a CA27-29 tumor marker done on initial diagnosis and then again half way through my treatment. It had doubled but my onc said not to worry about it that they really aren't that reliable and mine was still within the "normal" limit. Last Thrusday I asked for a CA27-29 again and it was. I will get the result next week when I go go chemo. I am very concerned about whether my treatment is working or not because the next stage is IV. I can understand your concern but you must have faith and trust in your oncologist. If you don't feel your are getting what you need then switch oncologists again.

[Sherryg683]

My Oncologist did scans on me every 6 weeks while I was on chemo. He could see that the lung mets had shrunk on the CT scan he did. Mine believes in doing scans on a regular basis as opposed to tumor markers..sherryg683

[tousled1]

My oncologist orderd an MRI, CTscan, and bone scan when I was first diagnosed. In addition I just had a PET scan done today. I finish my neoadjunct chemo Wednesday and am scheduled for surgery June 8.

[callen03]

I did a PET Scan before I started treatement. This scan showed some areas that were not detected on CT Scans, and as a result, I was diagnosed Stage IV.

My oncologist said that he will do another PET Scan after I finish Chemo. He said that it takes time for the changes to be reflected on the scan. I don't understand it, but I trust his expertise. In the meantime, I get CT Scans every two months, though they do not show everything like the PET Scan does.
Good luck with your treatment.