[Christine MH-UK]

Hi Guest,

I am very concerned that this whole things has just gotten too divisive and am deeply troubled that one patient with secondary breast cancer may have decided to give up herceptin, which definitely has been proven to lengthen survival in patients with secondaries. Personally, I must say that I believe in herceptin not just because of the scientific studies but because I know somebody whose mother was given six months to live with liver mets and she is still doing well three years later. Is she cured? No, but without herceptin she would have been long since dead.

It's not that surprising that there are no studies of how women would do without treatment, since such a trial would be highly unethical. There are women who reject conventional treatment, but they are probably atypical in many ways.

Yes, there is a cardiotoxicity problem, but the 1/4 figure applies to one particular treatment, anthracycline, cyclophosphamide and trastuzumab. The figure for paclitaxel and trastuzumab was half that.

Maybe Hortobagyi has conflicts of interests, but what about the Finnish doctors who don't seem to have gotten anything from Roche/Genentech except criticism, partly because they showed that with herceptin a little goes a long way? I asked my oncologist if he had any conflicts of interest when he recommended herceptin (I had to, since the Sanofi-Aventis saleswoman was present and I don't want them thinking that we are a bunch of pushovers on drugs) and he looked very shocked and hurt and said no, that that would be unethical. I must apologise next time.

So, yes, herceptin has been hyped, but the big question with it isn't whether it is effective against primary breast cancer, but the most effective use for it. And, of course, nobody who really knows about herceptin would use the word cure, in part because on every trial somebody's cancer has come back.