[Joan M]

Thank you all for your responses and insight.

I've read on the board and as Barbara H. mentioned, that the side effects of the MCC-DM1 trial tend to be tolerable. The printout of the protocol for the phase I trial that the onc gave me doesn't say anything specifically about measurable disease so I'm not sure whether my tumor is too small although the onc implied that it is.

Julie, thanks for your note about chemo being an option anytime, but surgery isn't. I'm going to mention that tomorrow to the surgeon.

I know that Sloan-Kettering does RFA of the lung and chemoembolization of the liver but I'm not sure whether they do the latter for the lung. It's interesting as Barb pointed out that Cancer Center of America does not offer surgey as an option but offers chemoembolization, RFA and photodynamic therapy. I've never heard of photodynamic therapy.

Chrisy, thanks for your thoughts on reducing the dose of Xeloda. If I decide to do chemo it seems like Xeloda will be it, so it's good to know that adjusting the dose downward to control side effects is normal. The onc also mentioned about the synergy of Herceptin combined with other agents even though I've progressed on Herceptin.

I like the idea of going for a local treatment and following up with some systemic treatment.

My own onc leans toward systemtic treatment but she would be supportive of my decision if I wanted to do surgery again. I'm just not sure how much weight the surgeon at Sloan will put on her colleague's recommendation.

It's very frustrating as Pat mentioned, and yesterday I was feeling overwhelmed and afterwards felt like I was throwing a hissy fit. Thanks for your patience and hearing me out!

I'll let you know what happens when I meet with the surgeon tomorrow.