Decisions...what to do? Chemo related?

[Chelee]

Ok, I've seen two 2nd opinions & of course I need to decide on one & get started. As you all know Dr. Slamon wanted me on TDM1 & no chemo. But with my HMO that isn't going to work out. I can't pay out of pocket. When I called Dr. Slamon's office about this his NP talked to Dr. Sara Hurvitz which works along side Dr. Slamon. She said if I can't do the TDM1 I should go with Herceptin, Zometa & Tykerb. Benefit of Tykerb of course is it crosses the BBB which I like.

Went to the City of Hope onc today...& she said Navelbine, Herceptin & Zometa. I told her what Dr. Slamon's office said about the Tykerb & she wasn't for that? She was also surprised Dr. Slamons office would offer me the TDM1 study because she says you have had to of done other chemo's first and failed to get into that study? (That confused me & I believe she is incorrect about that.) She had no comment when I told her how well the TDM1 trials were doing? Maybe I read her wrong but she shook her head like she wasn't impressed?

My onc orignally said I could take Navelbine, Taxotere, or Tykerb...my choice. The "COH" onc said since my TM'ers have been going up slowly for the last yr thats a good sign that the cancer isn't moving that fast so Navelbine with Herceptin should be fine & easier on me then the Tykerb.

I've only did TCH when first dx. As Chrisy said once, I did a sprint when 1st dx but this time its a marathon I'm gearing up for. So for those of you that have been down this road, & even those that haven't any advice on which chemo combo I should choose would be appreciated. Since I know Herceptin alone works for me since it dropped my TM'ers to 37 in two wks time should I hit this with the Navelbine, or harder a hitter like Tykerb? Is it better to save the big guns for later? (I some times think my onc chooses things by cost because of my HMO.) Whatever is cheaper is what she chooses.

Chelee