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Old 08-18-2015, 05:53 AM   #1
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Arrow "why did I get breast cancer" starting to be answered & it seems to be 80% bad luck

(the remainder being due to the environment & genetic predisposition) ALTHOUGH I would interpret this differently pointing out it may be that as a bad environment, radiation exposure, or genes which make repair of environmental damage harder or the immune system less robust , etc it takes the combined with 'BAD LUCK increases the likelihood of cancer and until we recognize all of the environmental and genetic causes of increased risk we canno put numbers on these grouos of those more or less likely to be affected.

I added an excerpt from an an editotial/commentary whose conclusions each and every one of you are equally entitled to comment on...

ABSTRACT: Variation in cancer risk among tissues can be explained by the number of stem cell divisions
Some tissue types give rise to human cancers millions of times more often than other tissue types. Although this has been recognized for more than a century, it has never been explained. Here, we show that the lifetime risk of cancers of many different types is strongly correlated (0.81) with the total number of divisions of the normal self-renewing cells maintaining that tissue’s homeostasis. These results suggest that only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions. The majority is due to “bad luck,” that is, random mutations arising during DNA replication in normal, noncancerous stem cells. This is important not only for understanding the disease but also for designing strategies to limit the mortality it causes.

OPEN ACCESS: COMMENTARY: The Implications of "Random Chance" in Cancer Genesis
[JAMA Oncology]
The way to address this is to reconcile the 2 views: bad luck among the stem cells does not imply that the cancer, or the life it affects, has no meaning. The process may be random, but the meaning is in the life and not the disease process. The meaning is in the cherished families, friends, and life’s work left behind. Certainly, we should heed the lessons of epidemiology with regard to behaviors, but let us lift the burden of cancer diagnosis and survivorship from our patients’ shoulders. Cancer is an intricate and complicated biological process. People do not die from it because they are weak soldiers.

Let us advise wariness in the face of societal messages that demand extremes of diet, weight, intake of natural or unnatural substances, exercise, attitude, and an avoidance of stress—whatever that means. Perhaps one day some of these factors will be linked to a reduction in DNA transcription errors—or just as likely, an increase in them. In the meantime, abjure the colonic enemas.

It is perfectly fine for cancer in the abstract to be stochastic; but cancer in the individual should not be deprived of meaning. We need not reject the randomness of mutation-caused cancer, if that is where the science leads, but we can still believe in the deep meaningfulness of the cancer-affected life.
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Old 08-22-2015, 07:18 AM   #2
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Re: "why did I get breast cancer" starting to be answered & it seems to be 80% bad lu

Humans have an overwhelming need to understand the things that happen to them and explain it. We also need a sense of mastery or control, including road maps for avoiding or ameliorating life-threatening circumstances. A huge percentage of human culture arises from these needs.

I especially appreciate the comments from JAMA Oncology. It shows a degree of sensitivity that is rare, especially in scientific disciplines. I especially love the sentence that starts with "Let us advise wariness. . . ."

I'm with you, Lani. I'm not sure we can conclude that 80% of the risk is from random, uncontrollable causes.
4/19/11 Diagnosed invasive ductal carcinoma in left breast; 2.3 cm tumor, 1 axillary lymph node, weakly ER+, HER2+++
4/29/11 CT scan shows suspicious lesions on liver and lungs
5/17/11 liver biopsy
5/24/11 liver met confirmed--Stage IV at diagnosis
5/27/11 Begin weekly Taxol & Herceptin for 3 months (standard of care at the time of my DX)
7/18/11 Switch to weekly Abraxane & Herceptin due to Taxol allergy
8/29/11 CT scan shows no new lesions & old lesions shrinking
9/27/11 Finish Abraxane. Start Herceptin every 3 weeks. Begin taking Arimidex
10/17/11--Brain MRI--No Brain mets
12/5/11 PET scan--Almost NED
5/15/12 PET scan shows progression-breast/chest/spine (one vertebra)
5/22/12 Stop taking Arimidex; stay on Herceptin
6/11/12 Started Tykerb and Herceptin on clinical trial (w/no chemo)
9/24/12 CT scan--No new mets. Everything stable.
3/11/13 CT Scan--two small new possible mets and odd looking area in left lung getting larger.
4/2/13--Biopsy of suspicious area in lower left lung. Mets to lung confirmed.
4/30/13 Begin Kadcyla/TDM-1
8/16/13 PET scan "mixed," with some areas of increased uptake, but also some definite improvement, so I'll stay on TDM-1/Kadcyla.
11/11/13 Finally get hormone receptor results from lung biopsy of 4/2/13. My cancer is no longer ER positive.
11/13/13 PET scan mixed results again. We're calling it "stable." Problems breathing on exertion.
2/18/14 PET scan shows a new lesion and newly active lymph node in chest, other progression. Bye bye TDM-1.
2/28/14 Begin Herceptin/Perjeta every 3 weeks.
6/8/14 PET "mixed," with no new lesions, and everything but lower lungs improving. My breathing is better.
8/18/14 PET "mixed" again. Upper lungs & one spine met stable, lower lungs less FDG avid, original tumor more avid, one lymph node in mediastinum more avid.
9/1/14 Begin taking Xeloda one week on, one week off. Will also stay on Herceptin and Perjeta every three weeks.
12/11/14 PET Scan--no new lesions, and everything looks better than it did.
3/20/15 PET Scan--no new lesions, but lower lung lesions larger and a bit more avid.
4/13/15 Increasing Xeloda dose to 10 days on, one week off.
7/1/15 Scan "mixed" again, but suggests continuing progression. Stop Xeloda. Substitute Abraxane every 3 weeks starting 7/13.
10/28/15 PET scan shows dramatic improvement everywhere. All lesions except lower lungs have resolved; lower lungs noticeably improved.
12/18/15 Last Abraxane. Continue on Herceptin and Perjeta alone beginning 1/8/16.
1/27/16 PET scan shows cancer is stable.
5/11/16 PET scan shows uptake in some areas that were resolved on the last two scans.
6/3/16 Begin Kadcyla and Tykerb combination
6/5 - 6/23 Horrible diarrhea from K&T together. Got pneumonia.
7/15/16 Begin Kadcyla only every 3 weeks.
9/6/16 Begin radiation therapy on right lung lesion that caused the pneumonia.
10/3/16 Last of 12 radiation treatments to right lung.
11/4/16 Huffing and puffing, low O2, high heart rate, on tiniest bit of exertion. Diagnosed as radiation pneumonitis. Treated with Prednisone.
11/11/16 PET scan shows significant improvement to radiated part of right lung BUT a bunch of new lung lesions, and the bone met is getting worse.
11/22/16 Begin Eribulin and Herceptin. H every 3 weeks. E two weeks on, one week off.
3/6/17 Scan shows progression in lungs. Bone met a little better.
3/23/17 Lung biopsy. Tumor sampled is ER-, PR+ (5%), HER2+++. Getting Herceptin and Perjeta as a maintenance treatment.
5/31/17 Port placement
6/1/17 Start Navelbine & Tykerb
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Old 08-22-2015, 09:43 AM   #3
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Re: "why did I get breast cancer" starting to be answered & it seems to be 80% bad lu

Omg! Some common sense observations! Thank you for sharing
I always feel bad for people who spend so much time on "why" and finding obscure cause/ effect. I've always felt, as my diagnostic doctor said, " it's the cards you were dealt"
Keep the faith

Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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Old 08-25-2015, 07:37 PM   #4
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Re: "why did I get breast cancer" starting to be answered & it seems to be 80% bad lu

Thank you for sharing. Of all the reasons I came up with that I deserved to have cancer, I could point out all the people who would have the same reasons and no cancer, even my own mother. So I let that balloon go.
Age 47, TN, Diagnosed 05/09
Her2+, ER/PR-, Stage III, 2 tumors = 1 8cm tumor
Grade 3
Sentinel Node Biopsy-speck present in 1 node
Completed 3 month clinical trial of weekly Herceptin and 1000mg Tykerb daily
Tumor no longer present
Right mastectomy and lymph node removal 09/25/09
No cancer present at time of surgery, none in lymph nodes
Start TCH 10/15, every 3 weeks for 4 months followed by radiation
Finished chemo 01/28/10-YEAH!
Herceptin every 3 wks until end of June
Radiation begins 03/01, 6 1/2 weeks
Radiation complete--Yeah!!
Developed lymphedema after radiation
In hospital for 4 days with pneumonia:(
Herceptin done! 06/24/10
Port Removed 07/08/10
Still in PT for lymphedema and mobility issues
DIEP Reconstruction 05/11
I can be changed by what happens to me, but I refuse to be reduced by it~~Maya Angelou
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Old 08-28-2015, 10:44 PM   #5
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Re: "why did I get breast cancer" starting to be answered & it seems to be 80% bad lu

There are nutritional factors that increase one's risk, but they might be primitive of developing a malignancy and not the actual reason the "break" happened.

I did extended breastfeeding of two children and became very depleted. In a way I represent an extreme since I had a draw on my system for many years, in spite of a decent diet. I've been able to understand more of my risk factors if only to try to address lifestyle and metabolic factors that were working against me such as chronic dehydration and how it affected my electrolyte levels and adrenals. I think getting more blood labs done to check for common deficiencies makes sense though.

I've been amazed at how often, for many medical conditions, nutritional deficits are never mentioned at all. Eating a better diet isn't going to make a damn chink in a deep magnesium or zinc deficit and folks won't know to even address the deficiency of they don't know it is there.

So yeah, it's not your fault but then you might not be making things better with your diet and lifestyle choices.
  • Dx 2/14 3b HER2+/HR- left breast, left axilla, internal mammary node (behind breast bone). Neoadjuvant TCHP 3/14-7/2. PCR 8/14 LX and SND. 10/21-12/9 Proton therapy to chest wall.
  • Dx 7/20/15 cerebellar met 3.5x5cm HER2+/HR-/GATA3+ 7/23/15 Craniotomy.
  • 7/29/15 bone scan clear. 8/3/15 PET clean scan. LINAC SRS (5 fractions) Sept 2015. 9/17/15 CSF NED, 9/24/15 CSF NED, 11/2/15 CSF NED.
  • 10/27/15 atypical uptake in right cerebellum - inflammation?
  • 12/1/15 Leptomeningeal dx. Starting IT Herceptin.
  • 1/16 - 16 fractions of tomotherapy to cerebellum, break of IT Herceptin during rads, resume at 100 mg weekly
  • 3/2016 - stable scan
  • 5/2016 stable scan
  • 7/2016 pseudoprogression?
  • 9/2016 more LM, start new chemo protocol and IV therapy treatment with HBOT
  • 11/2016 Cyberknife to temporal lobe, HBOT just prior
  • 12/2016 - lesions starting to show shrinkage
  • 8/2017 - Stable since Dec 2016. Temporal lobe lesion gone.
  • Using TCM, naturopathic oncology, physical therapy, chiro, massage, medical qigong, and energetic healing modalities in tandem. Stops at nothing.
  • Mother of 2 boys - ages 7 and 10 (8/2017) and a lovely partner with lots to live for.
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Old 08-30-2015, 07:30 AM   #6
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Re: "why did I get breast cancer" starting to be answered & it seems to be 80% bad lu

I don't feel that it is always a waste of time for people to wonder why something happened to them. It is human nature that we want to know why something bad happened so we can do better next time. There is a reason that our bodies have let cancer take over. The medical establishment does not want to deal with the causes. They don't even look. There is a lot we can do. In general, if something is not working out and you want to improve, you need to access the past and then make changes necessary for a better future. Nothing wrong with that.
8/2013 Diagnosed ER/PR Neg, Her2 Pos
FISH 6.86, Grade 2 (3,2,1), 10-15% Proliferation Rate 4.4cm
9/2013 Port Placement, Sentinal Node Biopsy 1/2 Nodes Positive having no extracapsular extension present
Stage IIb
9/2013 TCH
10/2013 TCHP
1/2014 End chemo!
2/2014 Lumpectomy Complete Response
2/2014 - 4/2014 Radiation
9/2014 Last Herceptin
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Old 10-03-2015, 08:24 PM   #7
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Re: "why did I get breast cancer" starting to be answered & it seems to be 80% bad lu

Agness: were you negative for Estrogen and Progesterone? Your profile leaves that info out. ER- PR-? If you were, like me, negative for Estrogen and Progesterone in your initial diagnosis, then breastfeeding or being on the pill played zero part in your getting HER2 breast cancer.
fall 2008: mammo of rt breast worrisome so am asked to redo mammo and have ultrasound of rt breast.I delay it til january 2009 and the results are "no cancer in rt breast. phew."
found plum sized lump in right breast the day before my dad died: April 17th 2011. saw it in mirror, while i was wearing a top, examining my figure after losing 10 lbs on dr. bernstein diet.
diagnosed may 10 2011

mast/lymphectomy: june 7 2011, 5/20 cancerous nodes. stage 3a before radiation oncologist during our first mtg on july 15th says he found cancer on the lymph node of my breast bone. Now stage 3b.
her2+++, EN-, PN-. Rt brst tumors:3 at onset, 4.5 cm was the big one
chemos: 3fec's followed by 3 taxotere, total of 18 wks chemo. sept: halfway thru chemo the mastectomy scar decides to open and ooze pus. (not healed before chemo) eventually with canasten powder sent by friend in ny (illegal in canada) it heals.
radiations:although scheduled to begin 25 january 2012, I am so terrified by it (rads cause other cancers) I don't start til february, miss a bunch, reschedule them all and finally finish 35 rads mid april. reason for 7 extra atop the 28 scheduled is that when i first met my rads oncologist he said he saw a tumor on the lymph node of my breastbone. extra 7 are special kind of beam used for that lymphnode. rads onc tells me nobody ever took so long to do rads so he cannot speak for effectiveness. trials had been done only on consecutive days so......we'll see.....
10 mos of herceptin started 6 wks into chemo. canadian onc says 10 mos is just as effective as the full yr recommended by dr. slamon......so we'll see..completed july 2012.
Sept 18 2012: reconstruction and 3 drains. fails. i wear antibiotic pouch on my job for two months and have 60 consecutive days visiting a nursing centre where they apply burn victims' silver paper and clean the oozing infection daily. silicone leaks out daily. plastic surgeon in caribbean. emergency dept wont remove "his" work. He finally appears and orders me in into an emergency removal of implant. I make him promise no drains and I get my way. No infection as a result. Chest looks like a map of Brazil. Had a perfectly good left breast on Sept 17th but surgeon wanted to "save another woman an operation" ? so he had crashed two operations together on my left breast, foregoing the intermediary operation where you install an expander. the first surgeon a year earlier had flat out refused to waste five hours on his feet taking both boobs. flat out refusal. between the canadian health system saving money and both these asses, I got screwed. who knows when i can next get enough time off work (i work for myself and have no substitute when my husband is on contract) to get boobs again. arrrgh.

I have a blog where I document this trip and vent.
www.nora'scancerblog.blogspot.com . I stopped the blog before radiation. I think the steroids made me more angry and depressed and i just hated reading it anymore
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Old 10-04-2015, 12:41 PM   #8
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Re: "why did I get breast cancer" starting to be answered & it seems to be 80% bad lu

I guess we want control over our lives and health. That makes life less scary. I remember traveling in Peru and Equador, in 1983, where locals seemed indifferent to the dangers of diseases and accidents. I asked them about it and someone explained: "We believe we have two lives as we reincarnate once. Life is so much easier to handle if we assume this is our first life, and as we are poor now, our next life will probably be better."
It gave them so much peace of mind. For a long time I was able to adopt their perspective on life. And then I had kids. Suddenly my survival was so much more important. I found my cancer when my youngest was 3 years old. This discussion has made me aware of this shift in my perspective. I couldn't go back to my South American way of looking at life, because my kids still need me.


Diagnosed age 44, January 2004, 0.7 cm IDC & DCIS. Stage 1, grade 3, ER/PR pos. HER2 pos. clear margins, no nodes. SNB. 35 rads. On Zoladex and Armidex since Dec. 2004. Stopped Zoladex/Arimidex sept 2009 Still taking mistletoe shots (CAM therapy) Doing fine.
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