What's next?

Helen · 01-25-2006, 04:58 PM

I finished 8 rounds of chemo combination of taxotere and carboplatin with Herceptin last December 28, 2005. I had a PET/CT scan last January 16 and the result came back ........ "Inferior right hepatic lobe focal activity on prior study is notably improved; very mild residual irregular active hypodensity remains" is what the report says. My oncologist told me today that we will continue with Herceptin weekly. I am being given a chemo break. Is that good or bad if I am still not NED? Will Herceptin only help to becoming NED eventually? Should I consider liver resection?
May I have your advice on what I need to do next?
Thanks.

Helen
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Her2 +++, ER/PR-, Left modified radical mastectomy, 1.7 cm tumor with no lymph nodes involvement.
Originally diagnosed in May 2005, 8 months after giving birth at stage 1, restaged in one month after all CT/PET scans were performed to stage 4 due to one spot in my liver.

al from Canada · 01-25-2006, 06:31 PM

It sounds like the PET says you have active disease. Going on herceptin alone is OK provided that you have a monitoring process in place, like another PET within 30 days of quiting chemo. If there is progression, I would push for a targetted therapy clinical trial or another chemo like xeloda. From experience: don't wait 2 months for that 2nd scan! The other scenario is quit chemo and go directly into a clinical trial without skipping a beat.
If you are too nervous about going off chemo totally, tell your onc you want to try xeloda, as it is a much friendlier drug.

Good luck,
Al

eric · 01-25-2006, 07:18 PM

Not to confuse matters but why not take advantage of an opportunity to give your/her body a needed break? Tough call and I certainly don't know what is best but I would consider the toll that chemo might have and the positive impact of taking a break. Just a thougt but I think the best piece of advice is that once you decide, don't second guess yourself. Best of luck with whatever you decide Helen.

Eric

LauraP · 01-25-2006, 07:35 PM

Helen, I may be asking a silly question, but is the size of the lesion to a point where your doctors would feel comfortable to do a liver resection? Your report sounds like the chemo has helped to shrink it, but I was not sure if that was a decision you could be facing.

I had a 1 cm mass on my liver that was found pre-chemo. It was not determined to be cancerous until I had finished 4 rounds of EC and 12 rounds of Taxol + Herceptin. We had a resection done laparascopically (sp?) in September. Then we started 4 months of carbo, taxotere and herceptin. I just finished that chemo had a PET/CT on Jan 13th and received the news that I am NED. I am moving forward with Herceptin alone, but feel really comfortable with that because the mass is gone.

Although a resection might sound scary, the procedure was not as big of a deal as I thought. The recovery was doable as well. Like I said, I may be asking a silly question if you are not ready for that procedure, but it also might be a viable option and would make you feel comfortable with moving forward with Herceptin alone.

Blessings to you regardless of you decision. I hope my post has helped in some way!

Laura

Helen · 01-26-2006, 11:40 AM

Hi Laura,
To answer your question ..... the lesion is 1.8 cm based on the CT scan taken in November. It is at the tip of the right lobe of my liver and the liver surgeon I consulted with back in August said it can be removed. He wanted me to finish my chemo first before seeing him again. I am not comfortable with just Herceptin with an active disease. My onc told me that we stop chemo so I was thinking of liver resection as another option to get it out. I am not even sure if this is a good way to do it.
Thanks for your advice.

Helen

Esther · 01-26-2006, 11:49 AM

Helen in March of 2005, I went on what was to be a short chemo break. I was not NED yet from my liver lesions, I had 3 small ones left. I had my liver enzymes and CA 27-29 checked every 3 weeks.

Within 2 months on just Herceptin, my liver went NED!!! It has remained NED since then with just Herceptin every 3 weeks.

So this may be a viable option for you at this time.