Dilemma -- Tx Choice for Recurrance now IDC

RoseK

Hello,

I'm making an inquiry on behalf of my sister who does not live in the US and who does not have reliable internet access where she lives/works in Kenya.  But her doctors, tx, etc is done in Israel.  She is considering 2 treatment options and she is very unsure about what to do.   I'd like to know if anyone has had a similar and recent experience to hers who faced the same or similar tx options. 

My sister was diagnosed with DCIS 5 years ago.  At that time she had  a lumpectomy and radiation, and then 4 years and 10 months on Tamoxifen.   She had a recurrence near the lumpectomy scar in the left breast discovered during her recent 6 month medical check in Sept 09.   Now it's  IDC. 

She had a bilateral mastectomy on September 22.  Pathology report shows that that tumor was .9 centimeters (less than 1 centimeter: 9 millimeters), HER-2 strong positive (+3) and moderately strong positive on estrogen (+2).  Progesterone is negative.  A sentinel node biopsy was done on the left breast, the problematic breast, and they were clean.  A node from the right breast was also examined and that was to be found to be benign. 

My sister writes "my oncologist (the team she has been with for 5 yrs.) recommends that I undergo 12 weeks of chemotherapy with weekly administration of Taxol and Herceptin followed by a continuation of Herceptin every 3 weeks for a total of 1 year.  I decided to go for a second opinion with the head of the oncological ambulatory care at another  hospital.  She recommended that I undergo 12 weeks of chemotherapy also but with TCH, which is Taxotere, CARBOPLATIN  and Herceptin, followed by a continuation of Herceptin every 3 weeks for a total of 1 year.  Her opinion (as well as my surgeon's) was that TCH would better "blast" any remaining cancer cells than Taxol and Herceptin and, that it is better to blast the disease first since I may not have a second chance later. "

My sister also writes  "TCH - Taxotere, Carboplatin and Herceptin chemo vs. Taxol and Herceptin chemo.  What chemo is more appropriate for my situation relating to chances of longer term survival?  The reason I am asking is that I have heard of many instances where "appropriate" chemotherapy was given (in my case, Taxol and Herceptin) and, in any case, metastasis followed.  Therefore, is it better to do the more aggresive chemotherapy of Taxotere, Carboplatin and Herceptin (TCH) instead of the more "appropriate" chemotherapy of Taxol and Herceptin to provide more chances of avoiding metastasis?  What is the thinking in the U.S. on this subject?" . 

I would appreciate  if anyone who  has had a similar diagnosis and faced similar treatment options can share their experience, offer any guidance so she can feel more settled in her heart about what to do.  This whole thing is very daunting since she must travel for tx,  far from where she has been living and working.  There is so much on her plate between the logistics of traveling and being away from home and work for this extended period.  I am hoping to find some online support or email buddy and information for her to access.  

Thank you for your help.  Thank you for reading and considering this.

debbie6122

Dear Rose, I know you must be so frantic about your dear sister, I wish i knew some good advice for you, i just wanted to send you some hugs. I know there will be several ladies to come along to offer you some advice and comfort, i personaly wouldnt know what tx is more appropiate for your DS but you have come to the right place, if she is unable to come on you can be her advocate, you are welcome anyway, stay strong there are lots of good stories of survial here we are, i will be sending hugs and prayers your way

debbie

KerryMac

Maybe try posting this on the HER2 board - i know I went through chemo with several HER2+ girls, they did TCH. Good luck to your sister.

RoseK

Thank you both for responsding and for the suggestion to post on HER2 board. I really appreciate it. 

LuAnnH

I am stage IV and have been for 3 years right now.  The herceptin is a must for her because she is HER2 positive, the rest of it is a judgement call.  Carboplatin is a good drug for er/pr neg HER2 neg.  Nothing saying it is not good for her though.

If it were my choice I would do the taxotere/herceptin and see what happens.  If it doesn't do well you can always add in the carboplatin later.  Hope this helps.  You should post this on the stage IV board also, you will probably get more responses on that forum for your sister.

robyn33

See my signature for my tumor characteristics.  I did the TCH regimen--not that I thought it was any more effective, but it was supposed to result in fewer cardio side effects.  I'm young (42), so I didn't want to add more problems to the heap.  The TCH was a very "doable" program.  I'm not saying it was easy, but I got through it okay.  I wish your sister best wishes and good luck with her decision.

 Robyn