Herceptin Only?

A friend of mine, who is in her mid-60s with a Stage 1 tumor, did Herceptin only. Herceptin was the 'big gun' for her. Adding chemo only raised her chances of non-reoccurence by another 2%. Both she and her oncologist felt that the possible risks did not outweigh the benefits at her age/stage/grade. (She is, however, ER positive and on an anti-hormonal). Talk to the oncologist about how much benefit the chemo would add before she makes her decisions.

There are no studies on Herceptin alone in early stage cancer, but there are very few studies done on stage Ia anyway and very few done on treatment for someone in their 70s. It was only recently that there was a retrospective study showing how high the recurrence is for HER2+ in stage Ia and Ib. Herceptin does pretty well in stopping the progression of Stage IV cancer so there is probably some benefit from using it alone when chemo would be too hard to tolerate.

Herceptin by itself is pretty easy to tolerate. The side effects are very low but the heart has to be monitored because it can occasionally lower LVEF. 

Treatment for someone in your mothers age group is a judgement call and I think that what her onc is suggesting is a reasonable course of action. A healthy 72 is young enough that the 5 year recurrence risk for HER2+ stage Ia or Ib is a concern (about 23% with about 15% distant recurrence) but chemo might be too hard to tolerate for someone that age. Herceptin alone is a compromise between the risks of doing nothing and doing chemo. 

When looking up something else for a friend, I stumbled across this:

http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=671276&version=HealthProfessional&protocolsearchid=8049743 

Apparently there is a clinical trial in Japan looking at Herceptin only for elderly women. The study started late 2009 so it won't have results for years. 

There is also a study of Herceptin only for women 65 and older that is based in Ohio that started in November 2008:

http://clinicaltrials.gov/show/NCT00796978 

Michelle, getting Herceptin alone isn't chemo and doesn't have anything like the side effects of chemo. I'm also skeptical about the calculations in Lifemath for early HER2+ tumors because the recurrence that MD Anderson found in their 2008 retrospective study of node negative <1cm HER2+ tumors was higher than previously estimated and metastatic recurrence was a really high proportion compared to HER2- hormone positive or tripple negative. Lifemath's calculations don't seem to have changed to take those results into account.

Bluedasher~Hope you can help me...I just was reading up on some of your info.  I'm a younger lady who is ER-/PR-,HER+ also and am on a current clinical trial of 12 wks (weekly) of Taxol/Herceptin.  I've had 6 treatments and the last 2wks I've had severe symptoms of neuropathy to the point that my Onc. Dr. called it quits on the Taxol today.  She said my toxicity levels were at their peak for my body and that whe was concerned at the damaged if we continued.  We are going to continue with Herceptin from here on out for the remainder of a  year.  My question is, I am less then 1cm and node neg. I also had a bmx in May.(clear margins) I just am concerned that I havent done enough chemo.  I know there are no guarantees, but being HER2+ makes me more concerned.