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May 14, 2012 08:56AM
May 14, 2012 09:00AM
Until trastuzumab (Herceptin) was used, HER2 positive used to be one of the worse types of breast cancer to have. Those who not only are HER2 positive but also hormone receptor negative (like Sassa) are helped by Herceptin but not endocrine therapy, so they have a more dangerous form of breast cancer than those who are ER/PR positive. Sassa is right about her form of the cancer.
Your question is a very good one, Blythers. Whether or not a therapy is very useful, many people tend to think the more toxic (awful) a treatment is, the more effective it is, which is not accurate, but it does make them feel like and believe they are at least using something to try to beat the disease. There is nothing wrong with that, other than it is important to understand that chemotherapy in general is given to a huge number of people with early stage breast cancer, most of whom get no benefit from it and many of whom have side effects from it.
You will hear some say that when Herceptin is given with chemo, it makes the chemo more effective. However, that is not yet certain. The reason is not yet certain is because the trials that were done with chemo and Herceptin did not include stage I breast cancer patients, and also did not test whether or not Herceptin used alone was as effective, more effective, or less effective than chemo plus Herceptin.
So it is more accurate to say instead that chemo plus Herceptin works better than chemo used alone.
Initially, it was easier to get trastuzumab without chemo, but once the trial results were used for approval by the government based on the use of chemo plus trastuzumab, insurance companies tended to go along with that.
Again, those who are triple negative have good reason to focus on the use of chemotherapy as part of the treatment. The stardard recommendation even for those who are not triple negative is for chemo plus trastuzumab.
I did chemotherapy myself because my oncologist was not honest with me about the value of it for triple positive patients. At the time I did treatment, trastuzumab had not yet been approved and was still in trials. I asked specifically about participating in any clinical trials, and he failed to tell me that there was a trial for trastuzumab that I would have been eligible to participate in. At the time I did treatment, the only treatments available to me were radiation, Adriamycin/Cytoxan/5-FU, and tamoxifen. The aromatase inhibitors were not yet available to those like me who did not have mets. So I did rads, CAFx6, and some tamoxifen.
At present, there is a clinical trial being done that uses trastuzumab alone for bc patients over age 70. Hopefully that will provide better information about the use of trastuzumab alone.
You should not postpone treatment very long. If the unknowns of using trastuzumab alone for early stage triple positive bc are preferable to you, you should know that others have refused chemo and have been prescribed trastuzumab.
12/3/2001, DCIS/IDC, Left, 1cm, Stage IA, Grade 3, 0/1 nodes, ER+/PR+, HER2+ (IHC)
1/3/2002 Lumpectomy: Left; Lymph node removal: Left, Sentinel
3/12/2002 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Fluorouracil (5-fluorouracil, 5-FU, Adrucil)
11/15/2002 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)