HER2 Support Group Forums - View Single Post - What Does the Medical Profession Mean by "Standard of Care?"

Becky · 10-06-2009, 09:50 AM

To me it means the accepted protocol. For example, when I was diagnosed in 2004 standard of care was not "segmented" to Her2 neg and Her2+ (since Herceptin could not be used in the adjuvant setting). Therefore, standard of care was as such:

No nodes, less than 1cm tumor - masectomy or lumpectomy with rads

larger than 1c but less than 2 with no nodes - 4 AC (plus rads if lumpectomy)

as soon as a positive node or greater than 2cm tumor - 4AC and 4 Taxol.

Herceptin changed protocol since the trials also included TCH so TCH or AC followed by TH became standard of care for Her2+.

My cousin just finished treatment - her2 neg and a medium oncotype (lobular so she had double masectomy. Her affected side had 3 tumors (all 1.2 cm or smaller - 2 were the same ER+PRneg and another was ER+PR+). No nodes - got 4 taxotere+cytoxan which is becoming standard of care too (as oncs are getting away from adriamycin especially for Her2 neg women).

It will get more and more complicated as more tumor markers are discovered too.

Standard of care is really " what is done now". But now means alot of choices too.

10-06-2009, 09:50 AM	#3
Becky Senior Member Join Date: Sep 2005 Location: Stockton, NJ Posts: 4,179	Re: What Does the Medical Profession Mean by "Standard of Care?" To me it means the accepted protocol. For example, when I was diagnosed in 2004 standard of care was not "segmented" to Her2 neg and Her2+ (since Herceptin could not be used in the adjuvant setting). Therefore, standard of care was as such: No nodes, less than 1cm tumor - masectomy or lumpectomy with rads larger than 1c but less than 2 with no nodes - 4 AC (plus rads if lumpectomy) as soon as a positive node or greater than 2cm tumor - 4AC and 4 Taxol. Herceptin changed protocol since the trials also included TCH so TCH or AC followed by TH became standard of care for Her2+. My cousin just finished treatment - her2 neg and a medium oncotype (lobular so she had double masectomy. Her affected side had 3 tumors (all 1.2 cm or smaller - 2 were the same ER+PRneg and another was ER+PR+). No nodes - got 4 taxotere+cytoxan which is becoming standard of care too (as oncs are getting away from adriamycin especially for Her2 neg women). It will get more and more complicated as more tumor markers are discovered too. Standard of care is really " what is done now". But now means alot of choices too. __________________ Kind regards Becky Found lump via BSE Diagnosed 8/04 at age 45 1.9cm tumor, ER+PR-, Her2 3+(rt side) 2 micromets to sentinel node Stage 2A left 3mm DCIS - low grade ER+PR+Her2 neg lumpectomies 9/7/04 4DD AC followed by 4 DD taxol Used Leukine instead of Neulasta 35 rads on right side only 4/05 started Tamoxifen Started Herceptin 4 months after last Taxol due to trial results and 2005 ASCO meeting & recommendations Oophorectomy 8/05 Started Arimidex 9/05 Finished Herceptin (16 months) 9/06 Arimidex Only Prolia every 6 months for osteopenia NED 18 years! Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"