Update

[Hopeful]

Maria,

Yes, I had radiation on the left side. When I was interviewing radiation oncologists, I had one astute doctor that pointed out to me I shouldn't be concerned about the cumulative cardiotoxicity of Herceptin and radiation, as the Herceptin would weaken the muscle while the radiation would affect the blood vessels. It took me three appointments to find a facility that could assure me they could keep my heart out of the radiation field.

Just by luck, I was able to talk to my internal medicine doctor this afternoon. He is board certified in internal medicine and geriatric medicine, so, while not a cancer specialist, he is treating a lot of patients that have cancer and extensive comorbidities. I told him to expect the Muga results and asked his opinion on the LVEF decrease. He said he thought the baseline reading of 74 was more suspect than the follow-up scores (the tech who performed the test this morning agreed with that - she told me they don't pay particular attention to the baseline Muga's, because they expect everyone to be within normal range.) He told me that my latest score of 60 was in the high normal range for a person my age (53). He said I shouldn't worry about it. I have a lot of confidence in this doctor, and he made me feel a lot better. He is also the doctor who referred me to my onc.

Thanks for your support, I appreciate it.

Hopeful

[Hopeful]

I have been looking through articles for the better part of a week to find the reference I referred to in a post early in this thread. Finally, eureka! I think I have it. The link to the abstract of the article, titled, "The Dilemma of the Strive for Apoptosis in Oncology: Mind the Heart" is here: http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract. Unfortunately, the article is copyrighted and not available for free. I wanted to read it badly enough that I ponied up the $30.00. If you do the same, go to page 13, there is a paragraph that reads:

"A promising new technique for in vivo detection of Her2 is radiolabled trastuzumab gammacamera imaging. This approach appears to be valuable for prediction of cardiotoxicity in Her2 positive breast cancer patients when performed before trastuzumab treatment. (99, 100) Radiolabeled trastuzumab scintigraphy may also contribute to our understanding of CHF pathophysiology. Furthermore, since trastuzumab enhances anthracycline induced cardiotoxicity, it may be of value for the detection of cardiac injury by anthracyclines. Serum detection of the shed extracellular domain of Her2 is also interesting in this regard and may serve as a prognostic marker for CHF."

The two cited foot notes are to the following articles:

99. Behr TM, Behe M, Wormann B, Trastuzumab and Breast Cancer. N Engl J Med 2001; 345:995-996.

100. Lub-De Hoog MN, Perik PJ, Gietema JA, et. al. Biodistribution and pharmokinetics of radiolabled trastuzumab in Her2-positive metastatic breast cancer. Proc Am Soc Clin Oncol 2004, 22abstr3063.

Both of these articles are also copyright protected and not available for free. Seems you really need to want to know this stuff to find it out. Anyway, I wanted to follow up with the information I promised. Hope this is helpful to those who are interested.

Hopeful