[AlaskaAngel]

It is hard to be a member of the group of patients that IS the group that makes up the first set of documented results. This is only the fifth year of standard recommended use of trastuzumab. And even with that, we know there is going to be some uncertainty about the numbers because the testing for HER2 positivity has been so problematic in deciding whose tumors actually were or were not HER2 positive.

But even more problematic is that by not providing results as 5-year AND 10-year outcomes, we end up with the same problem as we do with the predictions involving chemotherapy or hormonal therapy -- which is, that patients only are told the 10-year projection and they don't "see" that some treatments are only protective during roughly the first 5 years. If the results were provided in both 5-year outcomes and 10-year outcomes, then the question of whether or not therapy is beneficial for each individual becomes much clearer.

I explain it this way: If you can see that your outcome at 10 years is extremely likely to be favorable both with AND without the treatment you are considering, and you can see the drop off of effect after just 5 years for the tiny number in your outcome group for whom treatment fails, then you can throw in some of the potential disadvantages of doing treatment (such as chemo brain, increased risks for second cancers due to combination therapies such as chemo and radiation, loss of libido, loss of income during treatment, increased exposure over time through radiation used to check therapy effectiveness, etc. etc.), and you can make a more balanced decision about what therapies to use. This would be far more useful for early stage bc than any other group.

Seeing what the choices truly are also tends to make alternatives like exercise, balancing omegas, eating less inflammatory foods, etc. clearer choices to make on a permanent basis instead of expecting to have the problem "solved" by one or two chemical means. We are just too used to thinking that if we just suffer through a chosen treatment we can go on the way we were before diagnosis and that will solve it all.

Unless they start allowing the results to be used at the end of 5 years for figuring out what we want to choose, it would seem that we will all have to wait until AFTER 2015 when the results come out.

My ten cents.

A.A.