[Lani]

Chelee I think the problem here is lack of knowledge(noones fault, they just don't know)

As all the information about the side effects of Tykerb listed on its package insert cover the side effects of Tykerb given together withCapecitabine
(the only FDA-approved way Tykerb can be prescribed) noone can separate out which side effects are due to Tykerb alone.

Among those side-effects are those involving platelets--those blood elements that make bleeding stop. Each "chemo" or targetted therapy has its own profile of how likely it is to cause each or any of the blood cells to decrease and it is likely that some patients are more prone to experience this effect than others.

One reason they might not want you to have tykerb might be because they don't want you to bleed to death from your surgery.

Another may be because they have not yet worked out the effects of her2/her3 on bone healing. They seem to have an effect on bone and cartilage development in the embryo and the bone healing process has a lot of similarity to bone/cartilage development in the embryo. Rods, plates, and/or screws are not enough to hold the bone up indefinitely--the bone needs to heal to keep the construct from rebreaking.

I think perhaps a big part of the problem is the mindset that oncologists and oncologic surgeons may have about those who are Stage IV. If they can't "cure" them they immediately switch into the "palliative mode" which seems to put their built-in spedometer on slow. They seem to have only two speeds

I remember the first breast cancer conference I attended where Dr. Daniel Hayes said that those who were stage IV were incurable and in addition they survived only two years on average, He lectured that since they weren't going to be cured anyway, the only decisions to be made were whether they survived slightly longer or more comfortably by giving one drug at a time, combining drugs, or finding out which sequence of drugs made the patient more comfortable ie, the more tolerable one's first vs the more effective ones first.

Thing are changing with her2 targeted therapies,particularly the expectations and prospects of those who are StageIV--look at how long-lived some of the Stage IV ladies on this board are-- some doctors don't seem to have "gotten it" yet, I guess

I only rattled on to guess as to why no one seems as eager to get the systemic treatment going right away as you are.

Hope this helped.