[Gina]

and maybe even to primary tumor as well.

Hi, guys,

I know I have not been the posting maniac I used to be, but life, work, and a teenager with LEARNER's permit in Washington, DC, take over and keep one fairly busy...smile.

Yes, very early on, I noticed that my own liver mets were like on a clock. As I was already tracking tumor markers (ca 27/29 and CA 125 and CEA) back in 1998 and 1999 (not serum her-2 till early 2002, but since). Each year, the liver mets would recur at about the same time for 4 consecutive years making my tumor marker graph look more like a heartbeat EKG than some random graph. The numbers went up in about a 90 degree slope each time...then straight back down when I took herceptin.

I had never counted the months from my first DX (November 1997, primary 5cm tumor to right breast with 6 of 14 lymph nodes positive--stage 3b) till my first metastases (late spring, 1999) which would have been around 17 to 18 months, but what I did count was that after doing an entire year (1998) of aggressive traditional chemo CAF plus 100% strength taxotere(remember, back then, her-2 was not checked for and Herceptin was not approved until Nov. 1998) and radiation, all that only bought me 5 months supposedly "cancer free". I was so angry when the 12 tumor mets appeared in my liver the sizes of quarters, nickles, and dimes, after just literally having a completely clean CT 5 months prior... I swore, from that minute on that I would NEVER again do the traditional toxic "chemo" protocol--I was just fortunate to have had a really good oncologist back then, who somehow suspected the her-2 element to my disease, made me get both my original tumor block and my new liver tumor biopsy checked for her-2 and when we realized that I was ER- PR- but her-2 +++then he was willing to let me just try to take the herceptin by itself, without any chemo after I argued with him for days.

In only 5 weeks of standard Herceptin treatment which at that time was a loading dose of 4mg/kg the first week followed by 2mg/kg weekly doses, my tumor markers had returned to normal and the liver lesions, well, quite frankly, they just disappeared off the CT as though they had never been there. Later color photographs of my real liver (please don't even ask what I had to do to obtain those...LOL) did not even note scars where the tumors had been, even though the biopsy scar was still quite visible.

For me, the recurrence pattern was a worsening of the disease from late spring through summer and then sort of a cooling off period from fall and into the winter with the liver mets returning again the next spring and so forth.

One thing to think about though is WHERE the mets happen. For instance, in Chinese Medicine, the spring is a traditional time for the "liver" to show problems. Of course, when Chinese medicine mentions "LIVER" it does not exactly mean what we think of as the liver and tends to include the flow of the immune system up from the kidneys, into the spleen, and includes things like bile, liver, gallbladder and I am not sure what all as I really don't understand Chinese medicine as I am too analytical but it fascinates me nevertheless. My point being that there may be other things that Westerners may not think of that influence the timing of when mets hit certain organs but these factors could certainly include bio-rhythms or circadian rhythms of some sort that the Chinese, through centuries of practice may have picked up on...just a thought.

But I also have to agree with Lani about the bathing suit timeframe as I know A LOT of gals who get their primary dx in October, November, or December. This was true for me also. In Feb 1997, both my own self exams and my annual OB-GYN exam detected no lump. My boyfriend at that time said he felt something as early as April but as he was from Korea and the custom was not to discuss womanly things, he never told me until my DX was confirmed in November...sigh... Anyhow, over the summer, when I went to the beach, I sensed that my bathing suit was not fitting "quite right" and by the time my son had his tonsilectomy in October, there was no denying the very large and very hard lump on the inside upper quadrant of my right breast...when my sister saw it, she insisted that I get to my doctor IMMEDIATELY--I was a struggling single mom with a kid who was sick all the time with strep throat and the last thing I needed was another hospital surgery to pay, but nevertheless, the month after my son's surgery, I was on the operating table, and well, the rest is OLD OLD HISTORY...., but I am still here.

Although I KNOW you are all sick of hearing me say it..., I think the real reason that her-2 cancers at least often seem to display seasonal patterns is because at the very bottom of it all, lies a biological entity that is just as "alive" and just as tied into the seasons and magnetic earth field as we are. It is very common for many living things to show growing seasons through the spring and summer and become more latent or dormant throughout the fall and winter, but as many factors must be accounted for, it is almost impossible to do enough regression analysis to know for sure, but I think very soon, we will find out some real answers.

Thoughts???
Gina