HER2+ and no Herceptin Treatment
 

I am curious as to any of the HER2+ group that has been unable for one reason or another to take Herceptin and yet been cancer free for a long period of time.

Re: HER2+ and no Herceptin Treatment
 

I didn't have H in 2005 after chemo. I am still cancer free 7 years later.

Re: HER2+ and no Herceptin Treatment
 

So happy to hear you are doing well seven years later without herceptin!

Re: HER2+ and no Herceptin Treatment
 

Nopositive nodes is important!!!!!

Re: HER2+ and no Herceptin Treatment
 

I had no positive nodes.

Re: HER2+ and no Herceptin Treatment
 

Re: HER2+ and no Herceptin Treatment
 

No Herceptin and cancer free 11 years - I am so happy to hear that Debbie!!!!! God Bless You!!! You give me hope!!! I am not taking Herceptin.

Re: HER2+ and no Herceptin Treatment
 

personally I'd push for Herceptin. in 1999, I asked about getting Herceptin - I had DCIS- cancer only in the breast no node involvement. they said no not unless I was metatastic so.... nearly 5 years later I was metatastic! I believe everyone who is HER2+ should get some amount of Herceptin. Why risk it??? Herceptin is easily tolerated. I've had far more problems and side effects from radiation (heart, lung, etc), chemo (skin, fatigue, etc), femara (bone loss, etc.) than from Herceptin. Actually can't think of one side effect I've had from it. So personally I would yell and scream until they gave me Herceptin but that's me and my experience. Do more, not less. Don't let this mother out of the box! Why risk it? You might be lucky but...
good luck
health and happiness
sarah

Re: HER2+ and no Herceptin Treatment
 

Sarah - did you have a bilateral mascectomy? Thanks for your input. I appreciate it. Therefore, Sarah you started Herceptin five years later? How are you doing now? My fear of Herceptin was the heart issues as I am a senior and my father's family all passed from heart issues in their 60's. I also have some heart related issues. I can't say I will never take Herceptin. I had my bilateral mascectomy in February of this year and still am not sure if my decision not to do Herceptin is the right one, but thank you for your input...Blessings to you. Barbie

Re: HER2+ and no Herceptin Treatment
 

I had a mastectomy, first time around. came back almost 5 years later in same breast!!! Since I was then metatastic, I had heavy radiation and after that breathing issues - fibrosis in my lungs due to it and then later a heart artery collapsed in a spot and I now have had angioplasty and a stent put it. (easy operation, fun to watch!!) all the cardiologists said it was due to the radiation and not Herceptin and not colesterol. The collapse was well within the margins of the radiation and not on the left side where a problem would have shown up due to Herceptin. I took Co-enzyme Q10 religiously after reading about it on this site (but everyone has to do their own research and decide - I'm not a doctor) all through Herceptin and still now and my heart test sonogram and/or muga was good.
Here in France they give you Herceptin if you are HER2+ whatever you are - DCIS, nodes or not. I will always wonder if I had had Herceptin back in 1999 if I would have avoided a recurrence but we must never look back and be grateful for the health we have. I asked about Herceptin back then (I wanted and expected to have it) but the stupid oncologist at City of Hope (now a big deal I hear) said it was totally unnecessary in my case!!! She was wrong. I bet she recommends today.
All choices are ours or should be and all are correct for us.
Things become easier once all is decided and treatment is on. Next anxious moment is when it ends and you're waiting to see if it worked. It does and there are always more choices and treatments coming down which are better and easier.
I am doing nothing right now for cancer except annual testsbut I'm 8 years out from the 2nd time.
For my heart, since the angioplasty, I take plavix and another heart drug and crestor every 2 days although colesterol is not a problem for me at all. Thanks for asking.
I'm a great believer in Herceptin but then when I had my recurrence I was sure I was a goner because I knew how aggressive it is and where it was and could easily go and how particularly difficult to see mine was - no tests showed the cancer the second time around! only with surgery and they knew the margins weren't clean and couldn't get clean. So Dr. Slamon is my hero as well as my oncologist here in France who went beyond protocol to save my life.
Have you had a Muga test? Do you know if you already have a problem? Also could they test you more often? Would that help you? Also keep an aspirin with you at all times and if you have chest pain, chew it and then call an ambulance. Unlikely you'll need it but personally everyone should have aspirin handy.
I'm 66 years old. I'm enjoying life. Love every day!!!!
Health and happiness
hugs and love
sarah

Re: HER2+ and no Herceptin Treatment
 

Barbiecorn,

Another opinion...

I never had trastuzumab myself (due to the failure of my onc to disclose to me my HER2 test results in response to my inquiries).

However, I tend to favor the use of it prophylactically, like Sarah. But in reading Eve's posts elsewhere, with her cardiac issues in taking just trastuzumab without any chemo, I can understand your concerns about that. It is likely that with time Eve's cardiac issues will lessen, but it is difficult to say for certain.

Given the alternative shorter period of use of trastuzumab successfully in the FinHer study, plus your cardiac question, maybe doing a shorter course would suffice, although that study did include chemo as additional protection I think.

I have no idea why I did not need any trastuzumab to stay NED, other than that I was stage I and in my early 50's (and as Rolepaul discussses, I had no positive nodes). I had both DCIS and IDC.

A.A.

Re: HER2+ and no Herceptin Treatment
 

I too am 66 years old. It is too late for me now to get Herceptin anyway but God forbid, if it comes back I will have to deal with it then. I spoke to two women in England who did not get Herceptin and are ten years out with no recurrence. You just don't know. I felt as though what should I do, get a heart attack and die from Herceptin or take my chances. It is an individual decision. One that I may regret at some point but I hope not. Thank you for responding. I never heard of the test you mentioned but I know I have to get an oncologist to monitor me so I will be seeking one out soon. My alt. M.D. suggested this and she is giving me some sort of blood test for cancer (not sure what that is) but I know I need more. Just don't want to do anything like pet scan as that is radiation too. Don't know what test would be safe to do to monitor. My breast surgeon said there really isn't any test that is very accurate except pain but by then, it might be too late. I am not happy with doctors in general. Good Luck and thank you and stay well.. Barbie

Re: HER2+ and no Herceptin Treatment
 

God Bless you A.A. - may you remain NED forever as I hope I do but I am just at the beginning of this - six months out BMX - so who knows. I can only hope I fall into the number of women who never knew they were HER2+ years ago and still survived without Herceptin as you have. I too was node negative - Stay Well....Barbie

Re: HER2+ and no Herceptin Treatment
 

A.A. I am just happy to know that you are okay for so long and did not take Herceptin. It gives me hope that maybe I will fall into this category. (((hugs)))

Re: HER2+ and no Herceptin Treatment
 

There are some pretty reliable tests to check for heart functions if you decide to go the herceptin route...MUGA for one

Re: HER2+ and no Herceptin Treatment
 

Which posts by Eve? Did she have heart issues with Herceptin? What is her user name. I would like to look up her postings about her heart issues with Herceptin.

Re: HER2+ and no Herceptin Treatment
 

Like AA I have also heard that a very short time frame works as well as getting Herceptin for a year (which was the norm). I think they mentioned a month.
You'll need periodic Mammograms, scans or something to monitor you and all will emit some radiation but not like radiation therapy.
It's rare that a cancer patient doesn't receive some radiation therapy.
Definitely talk to an oncologist, more than one if you're unsure of what they tell you. I disagree about pain being the only indication, cancer doesn't hurt unless it's well along and most people are diagnosed long before feeling any pain. For breast cancer it's generally because of a lump (painless) or through a mammogram.
The blood test is good as a baseline and to have taken periodically to check that it doesn't start to climb up but it's not thought of as a reliable enough tool on its own.
I urge you not to rely on alternative therapies alone. Use them in conjunction but follow what has been tested and works. Cancer is serious.
Good luck with your health.
health and happiness
hugs
sarah

Re: HER2+ and no Herceptin Treatment
 

Eve posted some here as a newbie but also some on the BCO forums about it under HER2 positive bc, I think.

Re: HER2+ and no Herceptin Treatment
 

Thanks Ladies and thank you for your concerns Sarah....(((hugs))) I will follow up with an oncologist definitely for monitoring.

Re: HER2+ and no Herceptin Treatment
 

Great.
Stay strong
hugs
sarah

Re: HER2+ and no Herceptin Treatment
 

Here's one of the threads posted by Evebarry:

http://her2support.org/vbulletin/sho...light=evebarry

You can find more by using the 'Search' button' on top of the Board.

Certain breast cancer cells responds to certain chemo agent. Herceptin is not considered a chemo and research has shown it is effective for at least half of the Her2+++ population.

Re: HER2+ and no Herceptin Treatment
 

Hello Jackie,
Could you post the article with the stats for Herceptin and Her2. I was surprised to read it worked 50% of the time.
thanks
Sarah

Re: HER2+ and no Herceptin Treatment
 

I really need to quit mentioning that stat - seems everytime I brought it up, I would be asked to show evidence. (3 times at least!)

While searching for 'that' particular abstract, I came across this one and thought it would be more meaningful to share:

J Pathol. 2012 Jul 18. doi: 10.1002/path.4074. [Epub ahead of print]
Spontaneous and pronase-induced HER2 truncation increases the trastuzumab binding capacity of breast cancer tissues and cell lines.

Recupero D, Daniele L, Marchiò C, Molinaro L, Castellano I, Cassoni P, Righi A, Montemurro F, Sismondi P, Biglia N, Viale G, Risio M, Sapino A.
Source

Department of Biomedical Sciences and Human Oncology, University of Turin, via Santena 7 10126 Turin - Italy.

Abstract

A subgroup of HER2 overexpressing breast tumours co-expresses p95(HER2) , a truncated HER2 receptor that retains a functional HER2 kinase domain but lacks the extracellular domain, thus impairing trastuzumab binding.

We evaluated p95(HER2) expression in 99 frozen breast carcinoma samples by western blot analysis. The HER2-positive cell line BT474 treated with pervanadate or pronase was used as positive control for p95(HER2) expression. Immunohistochemistry was performed on parallel formalin-fixed paraffin-embedded sections of the same case series using antibodies directed against either the intra- or extra-cellular binding domain of HER2. In particular, biotinylated trastuzumab (BiotHER) was used to evaluate the binding capacity of the humanised antibody.

To avoid a subjective evaluation of the score values and the percentage of immunostained cells, the slides were scanned and automatically analysed.

The number of cases with HER2 overexpression (score 3+) and HER2 gene amplification was higher in the p185(HER2) positive/p95(HER2) positive samples than in the p185(HER2) positive/p95(HER2) negative group. Automated analysis confirmed a significantly higher percentage of 3+ scored cells in p95(HER2) positive cases. Conversely, the percentage of 2+ scored cells was higher in p95(HER2) negative cases. The status of the HER2 extracellular domain was then studied using flow cytometry on BT474 cells after pronase enzymatic digestion using trastuzumab and pertuzumab, while the presence of HER2-HER3 dimers was studied using a proximity-ligation assay.

In vitro experiments showed that short-term pronase digestion of BT474 cells produced two HER2 fragments (of 95 and 150 kDa, detectable in tissue specimens as well), increased the binding affinity of trastuzumab, reduced the rate of HER2-HER3 dimers and did not interfere with pertuzumab-binding capacity. In conclusion, the presence of p95(HER2) as detected by western blot analysis does not compromise the immunohistochemical detection of HER2.

Our data suggest that a reduction of the receptor steric hindrance as induced by enzymatic shedding may facilitate the binding capacity of trastuzumab. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Re: HER2+ and no Herceptin Treatment
 

The article below demonstrates the complexity and the efforts to find new ways/medicine to treat the 'resistant' Her2 cases:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3251862/