[chrisy]

My doctors (one is a top researcher in Breast Cancer) had a different opinion, which was to hit it hard (TCH) for a limited time (6 cycles), then try and maintain on Herceptin alone. Then if/when the cancer recurs, you can still get synergy by adding the chemo back. Or try other, more targeted approaches.

We considered it a "less is more" approach which takes into consideration the importance of conserving your body's personal resources and strength. As you know, with Stage IV it is a marathon, not a sprint.

Everyone's situation is different of course, and I've also found that if you get 2 opinions you have to be prepared for (at least) 2 possible recommendations! However, both of my oncologists basically concurred on the combo treatment followed by maintenance. In my case (as in yours) the chemo smacked things into remission. I was able to maintain on herceptin alone for 2 years after that. Like you, I was "chemo naive" at Stage IV diagnosis (with I think much more extensive liver involvement than you) but I don't know if that was a factor.

At a minimum, your doctor may consider a chemo holiday appropriate. And of course you can get other opinions. And in the end, it's your decision!

In retrospect, I think the course I took was a good one for me - and is a fairly standard approach. I enjoyed a complete remission for a couple of years; then had options to go back into a traditional chemo again or choose to participate in trials of more targeted agents (which I did).

All that has allowed me to "buy time" in a way that has not interfered with my participation in life. One thing my oncologist has said to me on each occasion (even now, following a questionable scan) is "you have a lot of options".

And I think at this point, this is true for you as well.

Take care