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Hi Ann:
I have been reading your conversation string.
Are you ER positive? The purpose of Tamoxifen is to mop up the naturally produced ER in your body. Many (majority) of HER2+++ people are ER negative. Tamoxifen has a limited statistical benefit for people who are ER-. But the standard treatment protocall is to recommend it. After reading the literature and statistical benefits of Tamoxifen, I declined to use it because the life-extending benefits were so minimal compared to the side effects.
I would however in your case consider using Herceptin. The drug is so new that there is no statistical evidence available to consider for your very early stage of cancer. However, based what I've read, I have made some extrapolations. The main extrapolation that I've made is that the earlier you take Herceptin, the more effective it is at preventing and/or prolonging the appearance of a reccurance. Herceptin is also most effective when taken with a taxane (which is a type of chemo). The Herceptin/Taxane combo is where you get your highest statistical bang of 52% increase in probable life expectancy. Herceptin alone, which is very easy to take in terms of side effects has a lower benefit in terms of life expectancy incease, but is still the most effective drug available for HER2. Far more effective than Tamoxifen.
You should do a bit of statistical research based on your very early (lucky you!) stage. You can do this research right on this site. Check out the "Submitted Articles" Forum. It's like a personal library for HER2. Some of the articles have links that will take you to sites that allow you to plug in your personal data and come up with survival data as well as potential treatment plans to compare to what you are actually doing. (You can check under my name as I have actually posted one of them)
You have already made your biggest decision which was to have a mastecomy. Doing that alone gave you your biggest survival bang - even if you should choose to do absolutely nothing else. You have to consider that you are more likely NOT to have a reccurance than to have a recurrance. So that if you choose to medicate yourself further whether with Tamoxifen or Herceptin or anything else, chances are that you didn't need the medication anyhow. Extra medication only helps if you are one of the unlucky ones. But you can never tell if you are the one who will get hit or not. You can also look at it as extra "insurance" to boost your personal probable survival stats.
Bottom line, I would suggest that you go for Herceptin, and keep your eye open for any advanced stage vaccine trials that come available. And if you are ER- (and you are experiencing high levels of discomfort such as vaginal dryness and/or hot flashes) I would consider dropping the Tamoxifen.
Regards,
Merridith
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