The scary stuff!!!

[Barbara2]

In April 2007, I asked this question of Dr. Pegram, a well known Dr. who specializes in breast cancer: Do most Her2+ breast cancer patients have a recurrence?

Answer: No. Most don’t. Now days, for early stage breast cancer, stage I or stage II, since Herceptin, most of those patients are not recurring.

The next time I see my onc, I plan to ask him about recurrance: Do all breast cancers eventually recur? I usually avoid these kinds of questions because they make me nervous, but I have to believe he will know of many patients, who are many years out (20 years and more) that have not recurred.

[dlaxague]

However, women diagnosed as Stage 4 from the get go, being chemotherapy naive, they may never recur and the chemo may do its magic the first time as it does in the lower stages of cancer (by erradicating micro mets that we don't even know are there). I stand by my fact and I am sure yours is true to but we are talking about 2 different kinds of Stage 4 patients.

Hi Becky,

Thanks for the great answer to the Estrace-chemistry question (although we still don't know if there's danger in any or all of those chemicals, right?)

I have never heard your statement above. Which doesn't mean that it's not true. But to differentiate between distant mets depending upon whether they are found as initial diagnosis or after primary doesn't make sense to me.

For one example, people recur who didn't have chemo - do they count the same as initial stage IV's? I've never heard the concept of chemo naivety making a difference to prognosis after mets diagnosis. It's more about what/whether the cancer responds, isn't it? It's true that each additional treatment tends to get a shorter and shorter response, but some get years from each treatment while others run quickly thru the options with little response. Still others try treatment after treatment without response and then hit on one that takes them to NED for long periods of time. There does not seem (right now, because we don't understand enough) a lot of logic to the behavior of cancer.

I agree with almost everyone else on this topic. Stats don't tell us anything about our own self. They are useful only for helping to make treatment decisions and after using them in that way the best thing would be to forget them and move on (easier said than done). It's hard to accept the uncertainty that there is no way to know what will happen to any one individual but that's the truth.

The only part of this thread that I adamantly do not agree with is those who are saying that cancer always comes back. You cannot look at a few of your acquaintance and draw conclusions. Look at the many available studies that include thousands and thousands of women and see that many are cured. The rub, of course, is that no one person can know (until they die of something else) if they are in that cured group.

As for prognosis after stage IV diagnosis - treatment is advancing SO quickly there that I don't think useful stats exist right now for these women. Because they are living so much longer (as a group), it will take longer to accrue the stats that apply to them. It's good news, right? Sky's the limit!

Debbie Laxague

[AlaskaAngel]

Because we are HER2 and that is where so much of the research has been focused, I am optimistic that things are and will continue to improve for those of us who are here now.

However, I think it is still a different story for triple negatives especially, but also for other forms of bc.

I have to raise a question about numbers:

From DebbieL:

For one example, people recur who didn't have chemo - do they count the same as initial stage IV's? I've never heard the concept of chemo naivety making a difference to prognosis after mets diagnosis. It's more about what/whether the cancer responds, isn't it?

My question and response:

"It depends". Are we only talking ONLY about recurrence, or are we talking about the likelihood of dying sooner due to having cancer? For one thing, there is an unknown percentage of additional women who die sooner of "other diseases" brought on by cancer treatment -- especially due to things like heart disease with drugs like Adriamycin. There is also an unknown percentage who die from other effects brought on by treatment that are not even as yet acknowledged to have been related to or caused by the treatment for cancer. Those numbers would also, of course, be different for those who are treatment-naïve.

We also do not know which of the treatments that turn out to be ineffective actually may potentiate recurrence; i.e., they may not only not be effective, but also contribute to the recurrence.

Does anyone have the numbers for the people who fall into those categories?

A.A.

[Donna]

Just to add my 2 cents - we are celebrating my Mom's 78th birthday in 5 days - she had bc and a mastectomy - no rads or chemo - and then a recurrence 5 1/2 years later - had chemo and rads and that was over 16 years ago.

I am with Becky and Ma Bubois and my Mom!

Love this thread, good discussion!

Donna