Is radiation really necessary with Herceptin

[Sherryg683]

My Oncologist mentioned to me once in passing, that he did not feel that radiation would be necessary in my case because I would be on Herceptin indefinately. I told him that was part of my bargain with my surgeon on the lumpectomy, that I would have radiation after my chemo was over. My Oncologist has set me up to start radiation next week. Now I'm wondering if it is indeed necessary. Do any of you have any knowledge or experience of being able to skip radiation if you are on something like Herceptin for the rest of your life. I'm pretty sure I'm going to get it done, I would just like to have some other opinions. I"m going to discuss it further with my Oncologist on Thursday...sherryg683

[tricia keegan]

Hi Sherry I am almost finished rads and am on herceptin for a year.I'm sorry I hav'nt heard anything about this but now that you mention it maybe it is possible to skip the rads,unless they feel any cells around the tumour area would'nt be zapped efficiently.I really don't know much about it but will be interested to see what responses you get.
Tricia

[Lani]

RADIATION THERAPY IS FELT TO BE MORE EFFECTIVE AT PREVENTING LOCAL RECURRENCE THAN IT IS AT PREVENTING DISTAL METASTASES (ALTHOUGH IT IS FELT TO DO BOTH) AND I AM CERTAIN YOU WOULD LIKE TO AVOID BOTH!

Remember Herceptin is felt to be effective in only 30% of her2 patients, even if they are FISH positive and that the tumor may become resistant to Herceptin with time as well.

The question you must pose to yourself is--what side effects are possible, how do I place a weight on the possibility of those side effects, what benefits are possible, how likely are those benefits and what risks do I feel I can accept taking. If two things might help, should I do only one of them?

Any good radiation therapist will be willing to discuss those questions with you, but only you can decide. I believe there is a website of the American Society of Radiation Therapists (I don't remember the exact name of the organisation, but if you google this I think it is something close to this) with information for breast cancer patients.

There are new ways to get radiation therapy including IMRT (Intensity Modulated Radiation Therapy), APBI (accelerated partial breast irradiation) etc if you are near a major cancer center with state of the art equipment and doctors. When given with the latest techniques, even if it is your left side, there is not felt to be any long-term risk to the heart. "Respiratory gating" techniques can decrease the risk radiation exposure to your lungs. Taking Trental and vitamin E for 1-2 years after the radiation can decrease your chance of getting scarring down deep from the therapy.

Since you are on Herceptin indefinitely, I assume you are Stage IV. I have no idea how the radiation therapy affects the immune system ie whether in a beneficial way by exposing antigen for the immune system to recognize and attack the cancer or by decreasing the numbers/types of immune cells you need to do that.I have not found any papers which really seem to understand that. But overall, all studies I have read have found it to be helpful, not harmful for breast cancer patients.

I am certainly not an oncologist, but I try to be well-read and pass on articles to others. Hope this helps

[Marlys]

Sherry, I had a lumpectomy, my tumor was Her+++, E+++,P+, sentinel node biopsy was negative. I had A/C x 4, rads X 30. After I finished radiation is when I started on HErceptin every 3 weeks. There was never any question about not getting radiation therapy as it aims specifically at the site of the disease. I think there are other threads here about this. I would want radiation therapy if I were you!
Wishing you well! Marlys

[Cathya]

Sherry;

I think that Lani covered pretty much everything but what if you develop heart problems on herceptin and have to stop taking it. At the beginning of my treatments I felt quite happy and secure receiving herceptin....nothing to indicate that my muga would drop....but it did and now I am off herceptin. My tumor was on my left side and I had another one in my supraclavicular node. In hindsite I wish I had research the radiation and questioned the after effects and what other means of taking it there were. I question whether my heart became weak from the radiation and that effected the herceptins impact. The side your cancer is on is certainly one important consideration.

Best regards,

Cathy

[Cathya]

Sherry;

By the way, radiation was a MUST in my case as the second tumor was inoperable and the chemo was not felt to be an effective enough certainty.

Cathy

[R.B.]

Lani's post is informative as usual.

I have previously posted some stats which you might be able to find with the search engine.

There has been mention in the media of new techniques - seeding, and topical delivery by balloon.

The issue of the questions as to how effective is radiation for distant spread has been raised, what is risk of existing micro spread ........

Will herceptin be effective for your particular circumstances?

I would guess that location is a factor - proximity to chest wall - type of surgery - tissue scaring - current health status...............

A huge amount to consider, and at the end of the day a very individual decision in a landscape that is emerging and changing and where answers are not definative.

RB