HONEST OPINION PLEASE!!: Are We Reaching For The Big Guns Too Soon??

[Lani]

Perhaps you think it is his last chance and if he fails it early...

Cancer seems to be harder to treat the more of it there is. Possible reasons are that the center of a large tumor has little blood supply compared to the periphery (so less meds get to it), that there is less oxygen there so it turns up all sorts of nasty genes that let cells adjust to adverse conditions (heat shock proteins), that as the cancer progresses at each step it accumulates additional mutations and "ploidies" that make it even more unlike normal cells in terms of what they need to survive, what it takes to kill them...That is a reason to use the "best guns" you can early on( the explanation usually given for aggressive adjuvant and neoadjuvant theraoy) ...as they make more advances, you may want to be in the best possible position to utilize them

If you are talking about the way oncologist talk about giving one antihormonal and then another and then another rather than chemo to prolong the "quality" lifetime of those with metastatic bc("since they are going to die anyway," they say), I don't know if IBC is inherently less sensitive to antihormonals, or if male bc is inherently less sensitive to antihormonals, but paper upon paper state her2+ bc is less sensitive to antihormonals unless given with at least an antiher2 med in the metastatic setting. Faslodex may end up being the most effective antihormonal in her+ patients (Dr. Slamon has said he believes so in conferences) and is approved in metastatic bc patients who fail other antihormonals. Does that sound like what you and your husband are looking for?

Perhaps you have heard the oncologists talk that "since the patient is going to die anyway let's just give what will make them feel least sick for as long as we can"...but if you look at my multiple posts on how patients with her2+ bc brain mets are doing, and read the posts of the women here who have had brain mets, I doubt you will feel like throwing in the towel at this juncture.

tykerb and xeloda are not the final possibilities...they are just the latest to be FDA approved. Perhaps a trial of pertuzumab, herceptin and Iressa may start soon(the one I quoted earlier that "cured " mice of her2+ breast cancer) should he not do well and need to be on a clinical trial, but there are a lot more combinations of agents for him before that according to those who contribute here.

I think you are afraid it won't work...that is true of every treatment he has had so far. He's still here and you are still there for him.

Utilize every resource on this board and elsewhere to help him.

And ice cream helps everything (at least in the short term!)!!!