#metsmonday – A followup

I wanted to follow up on my post from yesterday.

Improvements made in the treatment of breast cancer have gotten many patients to the point of NEAD or potentially cured. One breakthrough has been Herceptin, which changed Her2 positive breast cancer (which I have) from a death sentence far too often into arguably the most treatable form of breast cancer. Herceptin led way to other breakthroughs such as Kadcyla, the “super Herceptin” which combines Herceptin a chemo agent, and in trials now, a “super Kadcyla.” Now Herceptin wasn’t a miracle cure for me but I believe it has kept me alive. Her2 positive cancer before Herceptin often recurred and killed vey quickly. There was even a Lifetime movie about Herceptin.

I have two Her2 positive friends. D was diagnosed at Stage ll and after chemo, Herceptin, surgery, radiation and two years of hormone therapy, she appears to be in complete remission and is currently pregnant with her second child.

Now I believe my cancer was always nastier than D’s. We had such similar stats at diagnosis. Same cancer type, same age, similar family history. We both had large tumors and had chemo before surgery. Both we had two differences. While she had only one potential lymph node positive for cancer before chemo, I had a crapton – probably something like 10 – and they stretched into my Level 3 axillary area. After chemo, I had six nodes that were confirmed to have been positive at one point – two still had cancer in them and four were full of dead cancer cells. That indicates that my cancer was more mutated from the start. Then she had a 2mm residual tumor while I had a 16mm one. That indicates that I had a certain amount of resistance to initial therapy.

Then there’s my friend J. She was initially diagnosed early stage at 27 but was probably Stage IV from the start (some drama about an appearing and disappearing spot on the bone scan). She did early stage treatment and a few extras and the cancer stayed away for five years. She was rediagnosised with mets to the hip two years ago and her hip was in such bad shape she was going to have a hip replacement. She was put back on Herceptin along with the new targeted therapy Perjeta and her hip healed so well she didn’t need the replacement after all. I think she may well fall into the small percentage of Stage IV patients that are potentially cured.

So you have three different women with similar age, family histories, same cancer type, but very different journeys. I write this to illustrate how heterogeneous cancer is even among the same subtype. I would not recommend my two friends go outside of the standard of care unless they progress because going outside of the standard of care carries risks and why risk it if the standard of care works for you? In my case, I’m not on my way to living into old or even middle age (and believe me, I’d take middle age!) doing the standard of care. So it’s time to get more creative.

#metsmonday – A followup

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