Very Late Herceptin for early stage

[CLTann]

Hi,


For those of you who have been disease free for four years, you really are in very good situation. Those adjuvant therapies, regardless which one you opted, are aimed to kill the stray cancer cells which may have migrated to other areas. In general, four years are more than sufficient time to have incubated the metastasis from these stray cells. Therefore, if nothing happened for four years, you are basically cured. Good maintenance diet including flaxseed, fish oil, exercise (to make yourself strong), should allow your body to fight off any new intruders. As you probably know, everyone is encountering daily new threat of cancer cells. It is up to your own immune system to take care of the daily threat. Therefore, to get into Herceptin after four years of disease free is an unnecessary cardiac risk. Most strong medicine carries with them risks and unreversible damages.

Ann

[RobinP]

Bjj,
In this country, you would have been given chemotherapy initially at diagnosis with any IDC over 1cm. Your risk of relapse would have been lower if you had done so. Given the fact that you want treatment now, there is no reason why it should not be considered by your oncologist. If I were you I would look for someone willing to treat you now before you are further out in treatments. Good luck with your pursuits be tenacious!

Fondly,Robin

[RobinP]

CLTANN,

Thank you for your response. I know that Christine, Joe's wife, had a relapse of a small her2+ that was only just over 1cm after 9 years of DFS. Obviously, breast cancer is not a disease that is considered cured after 4 years, particularly her2+ breast cancer. Yes, it is more likely to relapse sooner; however, that does not preclude it from relapseing later, as in Christine's case. Also, my oncologist's sister relapsed with her+ breast cancer for a 1-2 cm breast cancer after 11 years of DFS.

Yes, I agree that you must keep your immmune system in top notch shape with an excellent diet etc. to help fight any disease. However, no matter how healthy you are, HER+ breast cancer can and has relapsed in healthy individuals. Therefore, it must be treated appropriately. Herceptin is very specific treatment for a very specific type of cancer HER2+. Herceptin has been proven to increase DFS in early stage her2+ bc patients as evident in the HERA trail. Later, treatment with Herceptin in the metastatic population is less effective at only 25%. Therefore, early treatment with Herceptin is appropriate in the adjuvant setting and should be considered after adjuvant treatment prior to a relapse as suggested by the PI of the HER trail, Edith Perez.

According to Larry Norton, a leading breast oncologist at the pestigious Memorial Sloan Kettering, Herceptin after adjuvant treatment is appropriate and has little cardic toxicity. Cardiac function should be monitored while on Herceptin. Yes, it would be nice if we had a lot of very data on the side effects of Herceptin. But we don't. However, we do know we could relapse at anytime with cancer. So what prevents us from trying to delay that uncertain relapse when the evidential risk of cardiac damage is minimal at least in the short run and apparently even longer as evident by the use of long term Herceptin in the metastatic population. Anyway, I suppect that the cardiac damage will be much less in the adjuvant setting than the metastatic setting as Herceptin is used more frequently and longer in the later.

[Ginger]

Could somebody tell me - What is DFS? Thank you.

[RobinP]

DFS denotes disease free survival, in other words, time where your cancer has not relapsed from initial stage.

[Lolly]

"...Anyway, I suppect that the cardiac damage will be much less in the adjuvant setting than the metastatic setting as Herceptin is used more frequently and longer in the later..."

I think this is an excellent point and would like to add that most of us in the metastatic setting on Herceptin are also on/off various chemo combo's which no doubt add to the cardiac risk.

<3 Lolly

[RobinP]

Lolly,

I agree that the cardiac damage would be much less in the adjuvant setting, particularly if Herceptin would follow AC as opposed to commitant use with anthracyclines which are already cytoxic.