Recurrence vs. Metastatic

[shonda]

I have metastatic disease I have been batteling for 4 yrs now.
I know what recurrence means, but my question is:
What is worse?
I am running out of chemo options at this point as I am on my 5th-6th line.
I did ask my onc last week-- since the mets have now gone to the liver, what happens if they can't be controlled (which I do know that answer), but she said to me that it is unrealistic to think I am going to live another 10 yrs. Not a canidate for surgery since there are 6 and in both lobes.
So lets say we pull them back and reach NED here.. If they showed up again later is that considered a recurrence or just still batteling mets all together.
It sounds to me someone with a recurrence has "more" options then some one who has been batteling with lines of chemo-- bone mets and then liver shows up while on taxol. My onc keeps telling me the cancer finds a way to wiggle around chemo and the more chemo you have the more resistant you become. I am Her2 positive and on herceptain for the last 4 yrs. There has even been mention of being resistant to that. WOW what does a person do when we have used chemo to keep bone mets stable and there is not much left for this organ?
Thanks
Shonda

[Bill]

Hi Shonda! You have posed some very good questions. I would think if you are declared NED and it pops up again that it would be a recurrence, but that's only my opinion. Please, one very important thing to remember is how new breakthroughs are being made all the time and new trials/studies are completed and treatments approved for use. Our knowledge, in all areas, is expanding at an ever-increasing rate. You hang in there, Shonda. Oh, and maybe tell your onc. that you will decide what's unrealistic or not from now on. My thoughts and prayers are with you. Love, Bill

[Nancy L]

There are two types of recurrence---local and distant. If you have a recurrence which is distant, i.e., to another organ, you are forever dealing with metastatic disease---I know because this is my situation. All we can hope for is to stay one step ahead of the next medical discovery. Most of our oncologists have a hard time looking us in the face and telling us the "real deal". But I find strength in knowing the truth.

[Joe]

Shonda,
I've looked up your profile and it told me 2 things:
1. You still have many options available.
2. You live near Dallas.

There are 2 lady oncologists that practice there that we see presenting papers at various breast cancer meetings. That indicates to me that they are very current in cancer treatment. Their names are Drs. Joyce O'Shaughnessy and Cynthia Osborne.

Fortunately they both work for the same practice:

Texas Oncology PA
3535 Worth Street
Dallas, TX 75246
Phone: 214.370.1000
Fax: 214.370.1060

You may also be a candidate for T-DM1 if that drug is released for expanded access in May as expected.

Regards
Joe

[Rich66]

Some oncs don't consider it but..there numerous liver directed therapies (http://her2support.org/vbulletin/showthread.php?p=221053#post221053).

I don't remember your pathology but...
A new biopsy could glean whether hormonal (http://her2support.org/vbulletin/showthread.php?t=38998) therapies may be applicable. At the same time, you could have a sample analyzed for chemo sensitivity (http://her2support.org/vbulletin/showthread.php?p=222355#post222355) to make more informed choices.
Chemos that failed before may work again...either because the break from a drug and/or mutation has made it pathologically more susceptible..or because an onc can try the same drugs with a different schedule..metronomic (http://her2support.org/vbulletin/showthread.php?t=24729&highlight=antimitotic) or gompertzian. There are synergies in combinations with "failed" drugs that may work. And..of course...new drugs and new off label uses of existing drugs (eg. metformin (http://her2support.org/vbulletin/showthread.php?t=39740)) and integrative oncology (http://her2support.org/vbulletin/showthread.php?t=43289) keep the list of options growing.

My thought is if the list is short after 5 regimens, maybe the brain at the helm needs broadening.

($.02)

[BonnieR]

Joe, what a blessing that you were able to make that connection for Shonda.

[shonda]

Thank you Joe for the info. Cynthia Osborne is my oncologist and has been since day 1. She is wonderful.

Thank you all for your thoughts. I know that was alot of questions at once. I think I was really venting also. I may need to update my profile, but I am not sure how to do that yet.

Thank you
Shonda

[Joe]

You are in very good hands. I am sure she will have some answers for you.

Regards
Joe

[TSund]

Hi Shonda,

Dr. O is Ruth's oncologist; perhaps we have sat in the same waiting room at Baylor?

Wishing you the best...

Terri

[pibikay]

I am a new care giver and I am not well eqipped to know the medical terms, as till such time i retired I was a lawyer.Now are all metastatic cases subject to recurrence after they have been initially controlled.
I will be gratefull for some clarification
Thanks
PNK

[Nancy L]

Yes, all Stage IV breast cancer cases are subject to recurrence. There currently is no cure for metastatic breast cancer. But there is a lot of hope for Her2 patients. It used to be a death sentence but now has more treatment options than any other type of breast cancer.

[TSund]

However, there have been a few cases right here on this board who have had extremely long remissions and still to date have no cancer...perhaps this points towards the possibility that a few individuals might conquer the beast?

[pibikay]

Thank you T Sund
I hope my wife will be one of those
As I am non medical non English speakinng person I do not know what and how to post my wife's clinical details
Can some one help
Thanks
PBK