HER2 Support Group Forums - View Single Post - for Jean and others-Topo2a identifies those patients needing anthracylines

Lani · 05-11-2006, 12:01 AM

What you are receiving is AHEAD of state of the art care. The article was just listed with the Library of Medicine of the Library of Congress today! The talk by Dr. Slamon in December at San Antonio regarding topo II testing and potentially withholding Anthracycline treatment from all but those who tested topo IIa positive was his preliminary results that were not yet published--they got their WORLD PREMIERE THERE. Most oncologists don't even know they have access to topo IIa testing and it was not until today that the paper was published for them to peruse if they didn't make it to San Antonio. What I find interesting is that a very large number of oncologists who presented papers in San Antonio did not necessarily stay to hear the talks of others. The abstracts were available in a book to them and a CD ROM later, but not the whole papers and not the whole meeting unless they paid over $1000 for the CDs of all the talks.

You must remember that after they learned H pylori caused the vast majority of ulcers about five years passed before they stopped doing stomach surgeries to treat ulcers and placing patients on various medicines and diets for ulcers.

Breast cancer is an area too important to let things go slowly so if we educate patients through this site they can prod their oncologists to find out more--remember doctors are always worried about malpractice cases and malpractice cases are based on the fact that a doctor cannot be found guilty if practicing the "standard of care in the community" a fact which makes oncologists hesitant to change to new ways even if they look like they will be superior until their professional society sanctions and endorses the new way of treating patients.

Why don't you post where your topo II testing was done, how many (unstained) slides had to be sent in (vs a whole block),and how you arranged it so others can take advantage of this. Let's move the treatment of breast cancer forward. TMD lists it as topoII was yours listed as topo IIA?

You might want to ask your oncs about radiation recall dermatitis. It is usually described with an anthracycline, but can happen with other chemos when given AFTER radiation therapy I think. Always better to think preventatively when possible.

According to the studies I have read, you will have decreased your chances of cardiotoxicity tremendously by not taking the anthracycline before the herceptin. Was your tumor on the left side (ie radiation therapy may have involved the heart)?

Congratulations on getting to skip an anthracyline. Let's hope with more exact molecular diagnoses of individual's tumors many individual patients get to skip toxic treatments that would not even be effective in their case.

Good luck!
Lani

05-11-2006, 12:01 AM	#5
Lani Senior Member Join Date: Mar 2006 Posts: 4,783	Jean What you are receiving is AHEAD of state of the art care. The article was just listed with the Library of Medicine of the Library of Congress today! The talk by Dr. Slamon in December at San Antonio regarding topo II testing and potentially withholding Anthracycline treatment from all but those who tested topo IIa positive was his preliminary results that were not yet published--they got their WORLD PREMIERE THERE. Most oncologists don't even know they have access to topo IIa testing and it was not until today that the paper was published for them to peruse if they didn't make it to San Antonio. What I find interesting is that a very large number of oncologists who presented papers in San Antonio did not necessarily stay to hear the talks of others. The abstracts were available in a book to them and a CD ROM later, but not the whole papers and not the whole meeting unless they paid over $1000 for the CDs of all the talks. You must remember that after they learned H pylori caused the vast majority of ulcers about five years passed before they stopped doing stomach surgeries to treat ulcers and placing patients on various medicines and diets for ulcers. Breast cancer is an area too important to let things go slowly so if we educate patients through this site they can prod their oncologists to find out more--remember doctors are always worried about malpractice cases and malpractice cases are based on the fact that a doctor cannot be found guilty if practicing the "standard of care in the community" a fact which makes oncologists hesitant to change to new ways even if they look like they will be superior until their professional society sanctions and endorses the new way of treating patients. Why don't you post where your topo II testing was done, how many (unstained) slides had to be sent in (vs a whole block),and how you arranged it so others can take advantage of this. Let's move the treatment of breast cancer forward. TMD lists it as topoII was yours listed as topo IIA? You might want to ask your oncs about radiation recall dermatitis. It is usually described with an anthracycline, but can happen with other chemos when given AFTER radiation therapy I think. Always better to think preventatively when possible. According to the studies I have read, you will have decreased your chances of cardiotoxicity tremendously by not taking the anthracycline before the herceptin. Was your tumor on the left side (ie radiation therapy may have involved the heart)? Congratulations on getting to skip an anthracyline. Let's hope with more exact molecular diagnoses of individual's tumors many individual patients get to skip toxic treatments that would not even be effective in their case. Good luck! Lani