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Old 08-19-2006, 04:13 PM   #1
nitewind
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I have another question

I'm back again with another question. Is it possible to get just herceptin treatments without chemo? I'm still going back and forth on making a decision about chemol. I thought I decided but then today I'm just listening to my gut feeling. I'm supposed to start chemo on the 29th. Scared to death and can't stop my mind from spinning. thanks for all the help.

ER/PR-
HER++++
No nodes involved
thanks again
Susan
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Old 08-19-2006, 04:55 PM   #2
chrisy
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Dear Susan,
Perfectly natural to have your head spinning and to be scared. But remember, you want to give yourself the best chance possible to beat this for good and NEVER have to deal with it again in the future. You said your doctor recommended the chemo - how do you feel about this doctor? Do you trust him/her?
Her2+++ is a sneaky cancer and with chemo plus Herceptin, you have a better chance to knock it out for good. It's up to you how aggressively you want to fight this disease.
Don't be afraid of the chemo - I think you had many responses to your earlier post that chemo is "doable", and it will be for you, too, if this is your decision.
One other thought - you can always stop it at any time. Maybe try it for on he 29th, see how you feel. You can always stop.
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June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 08-19-2006, 05:25 PM   #3
RobinP
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Unfortunately, there no studies on Herceptin alone as adjuvant therapy in early stage disease. However, there are studies done on the mets population that indicates that chemo plus Herceptin is more effective than chemotherapy alone. So for right now that standard of care for her2 positive bc is Herceptin and chemo, anything less would be sub standard care. Personally, I would have a hard time doing a sub standard treatment for an aggressive bc like her2 positive that was hormonal negative. Not to alarm you but, breast cancer that is er,pr negative is usually very aggressive, growing faster and spreading readily. You might look at breastcancer.org and look up hormonal negative in the search in order to see just how effective chemotherapy is in particularly hormonal negative bc.
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Old 08-19-2006, 07:56 PM   #4
Dianaq
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Do you know what the studies are with just chemo alone vs. heceptin alone?
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Old 08-19-2006, 05:33 PM   #5
Rendi69CA
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Susan, I am getting hercpetin without chemo. I ask my doctor lets try it with out chemo and he agreed. I had 8 treatment and I will fine out this Thursday if it is working. Good Luck.
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04/97- breast bx. diagnosis breast cancer.
05/97- radical mastectomy; 5cm tumor & 11 lymph nodes.
10/97- City of Hope, high dose chemotherapy.
11/97- 36 radiation therapy.
01/98- NED; tamoxifen.
02/02- breast reconstruction.
08/04- recurrence; mets to rt lung; thoracentesis; femara.
09/04- thoracentesis; ER/PR +, Her2+++.
10/04- total abdominal hysterectomy.
02/06- mets to 9th rib; monthly zometa; arimidex.
06/06- medi port insert; weekly herceptin.
10/06- 3 weeks herceptin treatment.
02/07- mets to liver; arimidex
11/07-liver clear
02/08-chemo taxol/herceptin weekly treatment
12/08-taxol not working
01/09-navelbine/herceptin weelky
03/09-navelbine not working
04/09-xeloda/tykerb
09/09-30 radation to neck; xeloda/tykerb not working
11/09-Gemzar/herceptin weekly
04/10-tykerb/herceptin weekly
06/10-cancer spread to left lung;stop treatment; tap
07/10-right lung collasps; TDM1
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Old 08-19-2006, 05:43 PM   #6
Becky
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Susan


How large was your tumor? If close to or larger than 1cm, chemo (now with the added benefit of herceptin) is for you. Getting an anthracycline and a taxane show dynamite results and adding Herceptin to the taxane portion of your treatment could eliminate the disease forever. It is always better to get rid of it the first time.

Chrisy mentioned trying chemo once. You should go all the way (and at least get 4 roundsor more).

It's a hard decision but you are asking me my opinion and that is what I would tell my sister or best friend to do.

Hugs and kindest regards

Becky
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Old 08-19-2006, 06:37 PM   #7
nitewind
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Thanks again, everyone. I never even thought about the fact that I could stop if I wanted to (just an option) I think what I'm really afraid of is the facts about being prone to infections. I am very prone to urinary tract infections, matter of fact, I'm taking an antibiotic right now. Last year I had one so bad the doc was going to send me to a urologist but I fell, broke my hip and ended up in the hospital, somehow the infection went away. I know that no one can guarantee anything, but like I said, I'm so afraid of infections, that's what's really holding me back. Should I be starting chemo with an infection? I hope you ladies don't get sick of me before I even start any treatments. I do appreciate all your help.

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Susan
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Old 08-19-2006, 08:08 PM   #8
Dianaq
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Susan, My ong. said most studies have been done w/node pos. people. I was just wondering if you have heard anything of studies w/her2 pos. node neg.? Does Chemo even add anything to her2+ node -?
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Old 08-19-2006, 09:04 PM   #9
RobinP
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The standard of care treatment for hormonal negative her2 + bc prior to Herceptin was chem, AC. Now Herceptin is added to the mix with great increases in survival, at least so far. Nobody knows how Herceptin alone will delay or stop relapse. Time will tell, but in the meantime, the old standard, chemo, is given with Herceptin, given all the unknowns with Herceptin.

PS You may want to go to adjuvantonline.com for your relapse risk but I know that for even an invasive 1cm and under, the risk is about 10% for someone hormonal negative bc .This is pretty high even for small disease due to the er, pr negative status.
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Old 08-19-2006, 09:29 PM   #10
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Susan,

This is a scarey time and there is much you should look at and consider. As for the rist of infection,you will most likely be given Neulasta or Neupogen (sp?) to help build your white cells during treatment. Although infection is a concern, you can take precautions and meds to assist in building your immune system. I would not think risk of infection should outweigh the probable benefits of treatment.
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Old 08-19-2006, 09:46 PM   #11
Val Pfeiffer
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I agree with those who have said that it may be best to do whatever you can right now to prevent a recurrence--the more aggressive the better. That said, you need to do what you are comfortable doing.

Chemo is doable, as others have said. I bought 8 or 9 wigs--different colors and lengths--and tried to have fun with it. I was able to work full-time while getting weekly chemo. I also continued to teach my spin classes three times a week. Everyone is different, but I felt that six months of chemo was well worth it to increase my chances of a longer life. Good luck with your decision, and ask as many questions on this board as you'd like :-)

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Dx 11/04, Age 42, ER-/PR-, HER2+++
3 months weekly Herceptin, Taxol. Carboplatin
Significant tumor shrinkage
Mastectomy 3/05; Stage 3b, 9 cm tumor, 5/8+ nodes
3 more months weekly Herceptin, Taxol. Carboplatin
7/05 30 radiation treatments, IMRT planning approach
Started 1 year of Herceptin 9/05
9/06 Began quarterly triple doses Herceptin. Brain & breast MRIs semi annually.
* * * * * * * * * * * * * * * * * * * * * * * * * * *

6/08 Right breast, intraductal carcinoma, high nuclear grade associated with comedo necrosis; extensive diffusely involved the entire biopy specimen. ER+, PR-, Her2 unknown at this point, 07/08 mastectomy.
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Old 08-20-2006, 01:16 PM   #12
VaMoonRise
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Do the Chemo!

Susan,

I beg you to do the chemotherapy along with the Herceptin. I don't want to scare you but I feel I must tell you my story because I don't want you to end up like me.

I was first diagnosed with DCIS stage "0" in March of 2004. I underwent a lumpectomy and radiation treatments. They even went back in a second time to recheck the margins. I was assured that I was now cancer free. I went for regular checkups and mammograms every six weeks and everything was going great, my life was starting to return to normal. I felt so blessed to have caught it early. Then in December of 2005 I started with a terrible pain in my right side just above my waist. I knew it wasn't my appendix as I had it removed as a child. I went to my doctor to have it checked out and they determined that it was my gall bladder. I went in to have the gall bladder removed by my oncologist surgeon, the same surgeon who did my lumpectomy. When he opened me up to remove the gall bladder he was shocked to find cancer spread extensively throughout my liver. I am now stage "4" and have mets to the spine as well as to the liver. All it takes is for one stray cell to enter into the blood stream or into the lymphatic system.

I wish to God that when I was first diagnosed as stage "0" that I had been put on Herceptin and given chemotherapy treatments. If I had I may not be stage "4" right now.

Being HER2 positive and ER PR negative means you have a very aggressive fast growing cancer. I beg you to take the advice of your oncologist and the women on this site and treat your cancer as aggressively as you possibly can NOW so that you have a better chance of not progressing in the future.

I too have had a history of UTI infections and even had a problem with them when I first started chemo. I even went to a urologist and had several tests done. I am on medication that helps to prevent UTI's, frequent urination and discomfort. The benefits of chemotherapy far out weigh the risks of infection. Infections can be treated and cured, cancer can't.

Like you I was terrified when I went for my first chemo treatment but it was nothing like I had feared. Everything went smoothly and the side effects have been mild to moderate and very tolerable. Like someone else already said if it gets to be too much and you just can't handle it (which I doubt very seriously will happen) you can always stop or have the doses lowered.

I truly hope you will decide to be aggressive in your treatments. If I could do things all over again and had the options that are being offered to you I would jump all over them.

I wish you all the best. My thoughts and prayers are with you.

Big Hugs,
Nicola
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Old 08-23-2006, 10:19 PM   #13
KathyA
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yes to chemo

You go girl!!!!
Nitewind - what a great name!!!

Prayers and blessings

KathyA
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Old 08-24-2006, 11:14 AM   #14
dawn
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I just finished my 6 chemo treatments. and I too was scared to death in the beginning. But now that its done, I can honestly say it wasn't that bad. For the first few days, I was a little tired and stomach sick but by the end of the first week I was back to myself. Yes, I lost all my hair, that I loved dearly, but now thats not such a bad thing, and its great to go somewhere and get ready in 10-15 minutes, no hair to worry about!! You have to look at the positive side of things. Like everyone else is saying you want to give yourself the best chance possible and I believe chemo is the way to go. I have to start my rads in 2 weeks, 25 of those. Tamoxifen for 5 years and then after the rads I have herceptin every three weeks for a year. Im not going to complain, so far everything is showing good and I trust and believe in my doctors that they are doing everything possible for me to beat this thing. These are just my feelings on how I dealt with it. Good luck in your decision, do what you think is right for you.

All the best
Dawn
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Mar 2006Stage IIIA, Her2/Neu 3+++, Er & Pr positive, 8 of 18 pos 03/14/06: Mastectomy 04/19/06 started Chemo adriamycin, chlophosphamide, taxotere 25 rads
Nov 1, 06: 3 years Tamoxifen, Herceptin (1yr)
Jan 2009 Femara mets to bone aromasin and aredia
June2009: Full Histerectomy
2/22/2010 6 spots in liver 2 mm-10 mm: switched to xeloda and Herceptin will continue with Aredia J
Scan February 2011 new onc, switch to abraxane
April 2011 NED clear organs, 3 spots on bone scar tissue.
Scans August 2mm spot on liver and lungs. now on to tykerb/xeloda
Dec 2011 scans nothing on lungs, liver down to 1 2 mm spot. j
une 2012 another spot on liver on to cisplatin/gemzar.


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