please give me accurate information so I can breathe again...
Hi. I just got my path report for my bi-lat mastectomy : Left breast was clear (prophylactic mastectomy). Right breast had clear margins (closest was 1.5cm). I am Stage 2 (nuclear grade 3, tubal grade 3, mitosis grade 1), so overall Grade 2 1.5 cm tumor multi-focal IDC, 2/21 nodes (sentinel of 1.5 cm plus 1 level 1 node), ER-/PR- and HER2+ (very, apparently). I made the mistake of looking online and read TERRIBLE prognosis stats and gave myself a big panic attack. Before this I was feeling positive and optimistic, damn it. I am a juvenile diabetic who is only 31 with a beautiful 4 year-old daughter. My doc seemed really pleased that I was HER2+, but all these websites seem super negative about my chances of staying cancer-free. What do I believe? My lovely husband is so unhappy that I've looked this stuff up, but I don't know how to leave it....please give me some guidance/current information.
P.S. My mom had stage 2 IDC at age 50 with er+/pr+/her2+ with chemo and radiation and nothing else. She is 8 years cancer-free.
Comments
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Hi digid, Being HER2+ used to be unfavorable, but is much better now, becasue there is Herceptin, an IV antineoplastic drug (not chemo) that you will most likely be prescribed. Some people get their first doses with chemo, then subsequent doses without chemo, and usually every three weeks for a year. I have been getting it for 3 months now, and had it with my chemo first, now I just go in every 3 weeks and get my infusion. There are a few Herceptin threads on these boards. Much Love, Jessica
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Digid,
The fact that you are HER2+ qualifies you for the anti cancer drug Herceptin.
Please try to watch the movie "Living Proof". It is the story of Herceptin, the doctor who discovered it, and women with HER 2+ cancer who went through the drug trials to get it approved for cancer treatment. It is a wonderfully uplifting movie.
I too am HER2+ and I thank God for Herceptin, even though I was scared to death to have to take it due to the side effects that I read about. I had a panic attack about that! I am 2 weeks away from my last Herceptin infusion, all the side effects that I feared didn't come to pass. Sometimes we can be our own worst enemies.
I was like you, I looked everything up and it seemed like each time I did I came away with more worries and questions and anxieties than ever. My husband would be very unhappy that I would do the research only to get more and more discouraged. My advise to you is this; talk to your doctor about every doubt and question you have, take one day at a time, this time in your life will be easier to get through when taken one step at a time, be easy on yourself , and trust that you are stronger than you can ever know. You will amaze yourself!!!!
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With Herceptin and modern chemo drugs, the prognosis for HER2+ women is as good or better than HER2-. The first break through for HER2+ tumors was Adriamycin which is more effective against HER2+ than older chemo drugs. Next came the taxanes,Taxol or Taxotere, which are also more effective than the older drugs. Even more recently came Herceptin - they started testing it for adjuvant chemo (chemo after surgery for women who don't have mets) less than 10 years ago. Herceptin isn't chemo, it targets the receptors on HER2+ tumor cells. It works best when started along with chemo. In the US they usually continue it after chemo ends so you get it for 12 months.
One clinical trial for Herceptin tested two chemo combinations with Herceptin - AC-TH (4 cycles of Adriamycin and Cytoxin (a cycle in this case was 3 weeks with the drug given at the start of the cycle followed by 4 cycles Taxotere and Herceptin and then continuing the Herceptin until it had been given for a year) and TCH (6 cycles of Taxotere, Carboplatin and Herceptin and then continuing the Herceptin for the rest of a year).
After 4 years 83% who had AC-TH were recurrence free and 82% who had TCH (they say the difference between the two numbers was not large enough to be statistically significant). TCH has less side effects and a lower risk of heart issues.
Chemo was rough for me but its not that long (I had TCH) and taking the Herceptin was easy - and I'm so glad this was available to me.
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Stats don't yet include Herceptin, which is our Her2 positive miracle drug. Our prognosis is now as good as Her2-, if Herceptin works for you. Apparently it did for me. I am now 3 years out from dx, and they say for us the first 2 years are the most likely to see a recurrance.
People will tell you not to look at the stats. I think it's good to be informed, just remember the current stats are based on info that's up to 10 years old.
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The stats are all outdated and now many Onc's will say Her2 is the preferred dx. My onc states it has the most favorable outcome because of Herceptin.
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Digid, our docs sometimes put a positive "spin" on things for us, but they will not outright lie.
Trust your doc, not the out of context, out of date stuff you find on the Internet. Most of that information is so easy to misinterpret unless you have a medical degree yourself.
Herceptin is da bomb. And it is only 1 of a series now of drugs that are used against HER2 positive disease. Some of them are still in trials, though they are late stage trials.
HER2 USED to be a bad diagnosis. There is now an arsenal of great, effective drugs to fight it.
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Hi digid,
All of the ladies above are correct. The starts are outdated and don't reflect current tx.
(Herceptin was initially given to only her2 metastatic ladies, and only approved for non mets in late 2005)
I made the mistake of searching the web too, ( 4.5yrs ago), which put me in a tail spin.
I was dxed with stage IIIc and actually was reading the Newsweek article about Herceptin June 05)
while I was being reeled into the OR ( for my mastectomy post my " bad" path report from my lumpectomy )! I prayed I was her2 positive.
The amazing thing is they have identified the pathways of the HER2 mutation and replication, and Herceptin blocks it.
More research is currently being done, so there are new txs on the horizon.
You will be OK
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I'm also stage 2 ER-/PR-/Her2+, and although I have nothing to add to the wonderful advice above, I wanted to stop in and say, "Breathe." After my surgeon gave me the path report news, I remember turning to my poor husband on the way home and saying, "You realize she just gave me a death sentence?" OK, here I am almost two years later - feeling great and thanking God for Herceptin.
As Linda told you, you will be OK. And we'll be here for you every step of the way.
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Digiid
Oh you can definately breathe!! I was Stage IV right from the start with mets to my liver and bones. I had six cycles of TCH (Taxotere, Carboplatin and Herceptin). After three cycles, they scanned me and no sign of cancer at all. I have been taking Herceptin now for 18 months. I will take it for life and I am OK with that. It is an easy drug with few side effects. Her+ girls are getting more options than every. Besides Herceptin which is very effective there is also Tykerb which is an oral that acts alot like Herceptin except it attacks the proteins in a different way. Super Herceptin in in trials along with another HER2 drug. I have been cancer free now since June 2008 and living a very normal and good life. In my opinion, I would rather be Her+.
Jennifer
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I was Stage 4 from the get-go with liver mets. My liver had a 9cm tumor and numerous 2cm tumors throughout. I remember very well hearing at a BC conference in January 2004, that the chance of my living for 5 years with liver mets was 5%. I cried all of the way home.
But I went on a clinical trail of Gemzar and Herceptin and 9 months later my liver went into remission.
It has now been over 5 years remission for me, and I will be on Herceptin for life. It is a true miracle.
The stats are now totally wrong thanks to the new monoclonal antibodies, which, hopefully will soon replace chemos.
Denise
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Denise,
Thats fabulous!!! I love stories like yours!
My onc has always been optimistic with my Her2 diagnosis. I have to admit, when I was first diagnosed I searched the net and all the Her2 talk was negative.
Today, being Her2 + is not bad at all. All the ladies are right, some docs consider it to be the more favorable prognostic factor when it come to breast cancer.
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I remember being one of the first few patients with stage I, was given Herceptin in September 2005.
They really didn't know what to expect from me, in a long term. I'm still here and very grateful to my doctors and the hospital I received the treatment starting with my first dose of Taxol and continued for 52 weeks, once a week. (The Herceptin not the Taxol)
I see Linda was also DX the same time as I.
Good Night Ladies
Sheila
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Thanks guys. I am so paranoid about everything - random back of neck blemish and other bumps etc. You all really helped put my mind at ease about the HER2. It's weird, although I dread the side effects, I actually want the chemo etc. to get started FAST. Then I know that any rogue cells are being blasted to heck and back. All this waiting is terrible. It makes me wish I had less imagination :P.
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Digid...I agree with the others...my surgical oncologist said Thank God you are Her2+! After the things I had read, he had some 'splaining to do. My medical oncologist went one step further and said that with all of the success they are having with Herceptin and other new things in the pipeline, Her2+ is a good thing to be! I'd rather be none, thank you, but I do believe those negative stats are dated, numbers taken from before Herceptin was an option. They tried a couple of years ago to do a Herceptin/Non Herceptin study to get some comparative data, but stopped it because they saw such a benefit that they needed to give the non-Herceptin women the drug. So, stats stay dated, By the way, I think most people feel the same as you about the chemo. While we hate the idea, we like just getting it going. I think you'll find it is NOT as bad as what you are afraid of....and it DOES feel good to be doing something about the cancer, no matter how unpleasant that something is.
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I'm waiting on my FISH test to come back in (due on Tuesday). If it turns out that I am Her2- instead of postive, what does that mean for me?! Concerned since I've heard that Herceptin is like a miracle drug.
At first, they told me I was positive but when the oncologist got the report, she said it was not clear enough so she is waiting to start chemo on Thursday so that the test will come back. Apparently, FISH is ordered by the lab if you are within certain margins.
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Sherri, I had to have the fish test as well. It's more accurate the the reg IHC " Staining" test. They do the fish when the first test is borderline for overamplification.
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I love hearing from Her2+ survivors! Thanks ladies. Post treatment days are difficult to keep positive thoughts.
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Just wondering about Brenda R.'s comment with Herceptin, the first two years is the time most likely to see recurrence, when do you start counting the time is it from your last Herceptin infusion? I just finished my year of Herceptin in July
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Good question.
I think some studies have been from date of diagnosis & date of finishing chemo (ACT or TC). Correct me if Im wrong.
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hi.
I was dx HER2 3+ in Feb of /05. My oncologist said it was not a good thing. I read up on Herceptin and begged him to give it to me. But, he said he could not as it was still being studied. Then , May of /05, just 2 days before I was to start taxol, my onc said I would get Herceptin! So I did that every two weeks with taxol and then every 3 weeks. My onc. , however, did something with the infusion that affected my heart so they had to change the infusion to doing it slower and then I tolerated it. then , I found a Her2 cancer vaccine trial to be in and he discouraged me from doing it. ( I did it anyway.)
Anyhow, long story made short, Herceptin has made HER2 positive a "plus"-- but like others said, I'd rather not have had cancer at all! OH, yeah, I've since switched oncologists as I just didn't feel like the one I had was looking out for me-- he must have known Herceptin would be coming down the pike... and why give it differently than the trial and let it affect me adversely?
Sorry to vent..... just my advice is to do all your research!!!!!!! I was one of the first gals to get the drug after the trial .... so thankful!!!! The gals here can help you so much with answers to questions. Many have dones tons of research!!! I know they helped me so many times!!!!
blessings,
Wendy
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HES112 - in the MD Anderson retrospective study of women who didn't have chemo, they used time since diagnosis. In BCIRG 006 and I think most studies of chemo, they used start of chemo. I think treatment studies usually use start of treatment or the date of randomization which is usually about the same.
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Just wondering - is the HER2 vaccine still in trials or actually available? I live in Canada, if that makes a difference. Thanks.
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THANK YOU, THANK YOU HER2+ cancer ladies!! I had my first TCH chemo on Nov 4th and have since researched and felt like I was a dead girl walking. Very scary as I just turned 35 and have a 4yr old and 6 yr old I NEED to see grow up!! I feel much better knowing all of your stories and will rent that movie about the Herceptin doc. I feel much better and ready to breathe again. You are all very inspiring!!!
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jkwick74..that was such an amazing movie, my husband and I watched it and showed it to our families...so inspiring. THey should mention the movie to all of us as we start our Herceptin journey. I am also HER2 positive diagnosed in May 2008. Had 12 weeks of Taxol and Herceptin dose dense each week and then Herceptin every third week for a year. I finished in July and I had radiation as well. I am doing well and also find so many of these threads comforting at times as we all continue down this road. How did your first TCH go??? Hope
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HES112-
My first treatment was okay - had 3 days of bad stomach issues but mostly just felt like I was pregnant again. I now have a bad cold from my son but if I did not have this cold I would feel almost normal. I still have my hair and know my days with hair are numbered....I have 5 more chemo treatments to go. My next is on the 25th.
Just wondering about rads for you - no nodes and a small tumor and you still had rads?? I don't know yet if I will - need to see a rad oncologist.
I told my family about the movie as well and we plan to watch together.
Take care!!
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Yes I still had rads...wasnt even a question...they said I needed to go to a radiation oncologist after chemo. In the scheme of things it was fine more of a hassle to go back and forth every day for the radiation. I remember feeling the same way about my hair, I got a wig and was ready so that when it started to come out my husband shaved it. That day and the first day with the wig were difficult, then it just becomes part of your life....Thinking about you and sending you healthy healing thoughts...Hope
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Like some of the others, I was also dx as stage IV from the get go and herceptin has been very good to me!! It has kept my lung mets in check since last year. There is always hope and I want to let you know I have read many stories of women who are living long and wonderful lives despite being her2+. There are new drugs on the horizon so the future is indeed bright for us :>
I also have brain mets, but I had them zapped with SRS and I am clear. I take tykerb along with herceptin to help fight any future stuff up in there. Although I have lung and brain mets, I work full time and just got back from a vacation on the East Coast. I haven't missed a day of work, and get a little more fatigued that I used to but I live a full and wonderful life.....even with stage IV and stuff in my noggin!
As the others said, the statistics are all old and do NOT include us. I stay away from reading about the statistics for people like me and instead focus on the women who are still around 10 years later because that is what I plan to be....around in 10 years reading your posts! Best to you!! lisa
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i guess everything can be viewed as one wishes, but the best thing that happened during my chemo (which began with herceptin - am on short finnish program) was getting a dutch oncology nurse on first day who looked at me as he hooked me up and said something like ' arent you lucky to be her2+ -you get the golden bullet, a chance to reduce reoccurance that others dont get '. even if he was totally wrong it still makes me smile and you need every edge you can get in this lousy game.
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And now there are other drugs and trials for Her2+. I'm being screened to take part in a phase III clinical trial - the question is, Will adding nerantinib to treatment within 2 years of ending Herceptin help to prevent recurrence? Although our diagnosis of breast cancer really, really sucks, still, we're all relatively lucky to be diagnosed now with Herceptin and new treatment options coming.
Has anybody here done the vaccine trial? When will that be available?
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