Son could use a little advice ...

[Bob B]

Hello all!

I have just registered at your forum and am very impressed with the kindness and support that you show for one another. I am hoping that you can give me a little advice concerning my Mom's situation.

At 78-years-old, she was diagnosed with breast cancer. I am unable to provide you with the exact specifics at this moment, but will do my best to describe her situation as we have been trying to determine if she is an appropriate candidate for herceptin therapy. She is of the 20-25% group that has the type of her2 cells that responds to herceptin.

Surgery was initially delayed for 6 weeks as the doctor who painfully and roughly needle aspirated her caused a very large hematoma that took time to subside enough for surgery. Ultimately, the remains of the hematoma were removed along with the malignant tumor during her surgery. I am unsure as to the definite determination at this moment, but I think the tumor was 1.2 cm in size, maybe Stage 1 or 2 (does that sound about right?). It was localized and did not spread to the lymph nodes.

My Mom decided to go through chemo, and went through 4 chemo treatments, spaced out at 3-week intervals. She started to fade after the 3rd session and after the 4th she ended up hospitalized, as she could not even sit up in bed. She did recover, though, and then completed 30+ radiation treatments, coming through that well.

We are now trying to determine if she is an appropriate candidate for herceptin treatment, and I feel we have not been getting enough information from her oncologist to make the correct decision. Her oncologist appears to be on the fence and when pressured says. "Well, at her age..." before indicating that maybe she should not have the treatment. I am not confident about this, as well as the oncologist referring us to my mother's heart specialist to determine if her heart is strong enough for the treatment, while her heart specialist, in turn, tells us my Mom's heart is strong and refers us back to the oncologist to make the determination. No help here. Mom had an excellent heart specialist who retired just as this was occurring and now sees a different doctor.

The oncologist tells us my Mom's heart is functioning in the 50-55% range but I am not sure if that is based on the muga scan my Mom had before chemo, an echocardiogram, or what.

The oncologist has told us that 4-6% of herceptin patients end up with a form of heart failure; I then read that 1-4% is the current figure; I've also read that the heart failure rate is higher for those who have had a specific type of chemo treatment. I am unsure at the moment exactly what chemo type/s my Mother did have, but will find out.

If you would, I would appreciate a little advice on:

1 - What we need to know to make the determination concerning heart functioning before herceptin is considered. What % of heart functioning is generally required to start treatment, determined by what tests?

2 - What specific chemo causes a less successful herceptin treatment?

3 - What is the FISH determination and how does that relate to all this? Reading on this site is the first I've heard of it. Comments on any other tests we should know about are welcome, also.

4 - We are in the Toms River, NJ, area. Can you recommend a doctor for a 2nd opinion? I felt very rushed in the one instance I took my Mom to the oncologist's office and was not comfortable with that at all.

Mom went through brain tumor surgery (benign, thankfully, but ever so serious) about 4 years ago and she is here today because of the Grace of God. During the past year she also had to be treated for skin cancer that was unrelated to the breast issue.

Sorry to be so verbose. I apologize for my longwindedness.
I thank all of you for whatever info you may express. I am very, very grateful.
Bob B.