[chrisy]

Hi Karen,
First, let me echo the earlier sentiments: Good for you! What a fabulous response to the chemo!

As a matter of fact, many Stage IV Her2+ gals do go on maintenance Herceptin after the initial chemo treatment. My oncs differed slightly in their criteria but both agreed to hit it hard at first, then stop the chemo and maintain on herceptin alone. I had 6 cycles of Taxol/Carboplatin/Herceptin that looked like this: 3 weeks of all 3 then 1 week herceptin alone. Six times, so in all about 6 months. Midway through, a scan showed about 50% reduction; after cycle 6 there was further reduction but still some visible spots that they believed to be necrotic (dead) tissue that would fade out. Tumor markers were never that meaningful for me, so they don't rely on them. I think it's a blessing that you do have this as another measure of what's going on...in your case the dramatic decrease would seem to support the idea that what is still "visible" might not be active cancer any more but rather dead cancer (the only good kind).

In the case of Stage IV cancer, many feel that less is better in terms of chemo - it is a marathon not a sprint, and it is important to keep your body's own resources strong. So for many folks, the strategy is hit actively progressing disease, then pull back and maintain.

How long someone is able to maintain on herceptin is different for everyone. Some get nice long rides, others find they have to change horses sooner. You don't know until you know, but I think the strong response you had is a good sign. Be hopeful.

Much love,
Chris