[Becky]

I cannot answer if hormone positive Her2 mediated cancer spreads to the brain any differently than being negative but I can make some comments. I keep up with this because I am ER positive (but PR negative). Being hormone positive is a good thing. It is good because there is medication to stop and slow cancer cells that are hormone positive (the aromatase inhibitors - like Arimidex, Aromosin and Femara as well as Tamoxifen). In conjunction with Herceptin, you are blocking at least 2 known growth pathways (3 if you are also progesterone positive which most are if they are ER positive). This is a very good thing.


Secondly, the (anti) hormonal drugs DO cross the blood brain barrier and that is a good thing too so there is some protection that being hormone negative does not have.

The Arimidex itself can take your hormone levels to almost non existant if you are postmenopausal (you can't take this drug if you are premenopausal anyway). Some ways to get your estrogen as low as it can go include:

1. be at a normal or below normal body weight
2. exercise
3. eat a high fiber diet (because bowel movements trap excess estrogen in the colon and if you "go" more often, it carries estrogen (and carcinogens) out of the body before they can be re-absorbed).

Lastly, be cautious about soy and flaxseed (but not the oil). You can eat a couple of servings a week of them (I do of flaxseed) but don't have several servings per day of each of them (they contain phytoestrogens and there isn't enough data on whether they are good or bad for women who already have breast cancer that is hormone positive. There is some minor information that it can be preventative).

So, even though many Her2 + women are hormone negative, it is a much better prognostic factor to be hormone positive.

I am sure you have read many of RB's posts on balancing the Omega 3s and 6s. I am a firm believer in this as it modifies the inflamation factors that are fed by the Cox 2 pathway (which also is relative to the cholestrol and insulin factor pathways) so... eat fatty fish, walnuts, flaxseed & oil (the seed in moderation due to being hormone positive - you can boost this with fish oil tablets) and use only olive oil as your fat. Watch all processed foods big time. Take an extra vitamin D and one whole aspirin (or ibuprofen if you can't take aspirin) as a Cox 2 inhibitor. Get walking and breath in the new Spring air.

Also, it is well documented that Her2 + disease that is also hormone positive is not as aggressive as hormone negative disease (but this is a general statement and every one of us is an individual - with breast cancer so... I think you get my point).

I hope I have helped.

Warm regards

Becky