My latest panic about HER2+
It's my 25-year-old daughter that has bc, not me. Her tumor is 3 X 3 X 1.8 cm, Grade III, ER+ PR-, HER2+. We don't know what stage yet.
I was reading an article last night that suggested that the HER2+ gene mutation predisposed the carrier to breast and ovarian cancer. Kiri did have an ovarian cyst burst some years ago and she has had ongoing digestive problems (constipation) for which she has been treated and takes OTC meds.
She's being treated at Dana-Farber in Boston and plans to have her ovaries stimulated to harvest her eggs in the next couple of weeks before she starts Chemo (with Herceptian and possibly Lapatinib--she'll be in a clinical trial) for 16 weeks.
Should her ovaries be investigated, or possibly removed? Should I call the oncologist and ask about this? Do any of you know of any possible link between HER2+ bc and a predisposition to develop ovarian cancer?
I thought I was scared before...:-(
Comments
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Calm down, Mom. One good way to tell if she has a higher risk of ovarian cancer is to have the genetic BRCA test. That test really helps women who are carrying the gene(s) to know how to proceed. I am sure one of our scholars will come along and point you to some studies that will help you understand her risks. Deep calming breaths. (((HUGS)))
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Thanks, Barbara. Yes, they did recommend she have the BRCA test, but a little down the line, as it's apparently unusual (not impossible) to have HER2+ and be BRCA1 or BRCA2 and there's a lot else going on now she has to deal with--body and bone scans, egg harvesting, sentinel node removal, then the chemo/surgry/chemo/radiation/tamoxifen. D-F is nothing if not thorough! So I'm sure all my questions and concerns will be superfluous, but I am still in roller coaster panic mode. Breathing helps. Thanks.
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Hang in there KirisMum. They will address the issue. I had an ovarian cyst years ago but it went away on it's own. I also had the BRCA test and was negative. Good chance she will be too if there is no history of breast cancer in your family. Since I was negative and no history of ovarian cancer in my family there was no further discussion regarding my ovaries.
Get ready. They will be doing lots of tests. I remember the bone scan, CT test. They check these things just to be thorough but it doesn't mean your daughter will have issues. Dana Farber is one of the best. -
KirisMum - Sorry to hear about your daughter! Try not to look too far ahead. Take each phase as it comes and then move to the next. There is so much to breast cancer treatment that it is overwhelming. Maybe keep a journal of your concerns and when the time seems right bring up your questions. Are you going with your daughter to her appointments? Big hug for you!
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KirisMum - I forgot to say, when I had the BRCA test they draw blood and send it off to the lab. BRCA positive women are at an increased risk of ovarian cancer I think. Given your daughters young age I would think the medical team would want to test her cells for the BRCA mutation. One more thing, I think the BRCA mutation is something you are born with and the HER2 genetic problem is different and developes over time after you are born.
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I had blood drawn for my BRCA test.
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Lago - you are right!! I was confusing with another thing! chemo-brain - I'll edit my post.
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Hey Kirismom (aka MollysMom on the booger board)! This is Booger Bop (mthomp2020 here). I'm glad you found this board. I forgot to tell you about it when I PM'd you. The women here have tons of useful information, and they're always willing to answer questions and recommend resources.
I've never heard of any connection between HER2+ breast cancer and ovarian cancer, as others have said. BRCA bc does increase the risk of ovarian cancer.
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Hi mom,
My cancer is exactly the same as your daughters. (Except, once I had my mast they found two more invasive cancers and a large area of DCIS). Here I am alive and well. Granted, I'm not 25, I was 51 when dx'd but there are great treatments now for all of us. It's not a death sentence by ANY means.
As a mom of a 24 year old son, I totally get what you are going through though - I know you wish it was you and not her.
I know it's scary but I just want to say (for the 2nd time today) that sometimes a cigar is just a cigar. Her ovarian cyst is very likely to be unrelated. However, the tests will be done to rule it out.
Frankly, I would not remove the ovaries unless you are given an overwhelming reason. She will be on tamoxifen for five years, but she could regain her fertility afterwards. And, the SEs of tamoxifen are not pretty and are way more difficult (for me, at least) then chemo. I was premenopausal and chugging along as normal before chemo. Removing her ovaries will make those SEs permanent so unless her doctors really show you a large benefit, I wouldn't do it. A lifetime sentence of tamoxifen like side effects is really a horrible picture in a woman her age.
That's my only advice about her medical situation. Stay calm for her, help her cook and clean and for god's sake, don't shave your head in support :-) She will look beautiful bald - we older women - not so much.
Chemo is not nearly as bad as you are imagining for most of us. Please read the tips and tricks for getting through it here on the forum. Lots of water and a high fiber diet are key.
Good luck!
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I also wonder about removing ovaries in such a young woman… how does this affect her bone, heart, skin over the long term. Long term is much longer for a 24 YO than it is for us middle aged women and older.
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Hi Bop!! Great to see you here! Yes, this board has been my lifesaver. All you ladies are so sane and encouraging, I can't thank you enough.
I've decided I have to accept the fact that just maaaybe, the docs at Dana-Farber can actually look after Kiri and best advise her on things like this, not the panicky mother with the overactive imagination. NO ONE has suggested she remove her ovaries except me.
CoolBreeze, how did you know I was thinking of shaving my head in support???
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Hi, KirisMum. I'm not sure what the link might be, but I was Her2+ (a triple positive) and BRCA negative. However, both my oncologist and gyne-onc-surgeon were in a big hurry to remove my ovaries and everything else asap (of course I am 59). My sister has Lynch Syndrome, which predisposes for breast, ovarian, colon, melanoma, stomach, and endometrial cancers. And, I am a DES daughter, meaning I was exposed to an abundance of estrogen in utero, as were my brothers and sisters. I have a niece slightly younger than your daughter and my sister's treating docs have said that she is potentially exposed on both counts--Lynch and DES. The niece is my brother's daughter--but the theory goes that any one of us has a fifty-fifty chance of having Lynch.
It isn't known how DES affects generations following the first exposed woman and her direct descendants.
On the Lynch front, there are several genetic mutation theories and a couple of varieties. The list of Lynch related "types" is a work in progress, and there is a test for Lynch Syndrome, although it is expensive and insurance doesn't pay for it.
The very good news of course is that the list of cancer-fighting tools is also growing, and they work better all the time. It's wonderful that your daughter is getting great care at such a well-respected institution.
Warmly,
Cathy
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NO NO NO to shaving heads in support - for ANYBODY. (In my opinion!)
I found that I didn't mind THAT much being bald, BUT I definitely stayed away from mirrors as much as possible. So if a loved one had done it, I would have been reminded every moment when I looked at THEM. Definitely would not have been AT ALL helpful to me.
In general, outside of actual treatment days, I found it very helpful to maintain as much normalcy as possible. You HAVE to take mental vacations from cancerland or it can consume your life and really affect your state of mind and emotional health. I mean, it affects both of those no matter what, but it helps to keep it as little as possible.
For example, during treatment week (during the chemo phase), I definitely thought about/dealt with chemo/SEs/cancer almost every moment. But the 2nd week, it started to fade, and the third week I felt/acted totally (almost) normal. That third week was what got me through the other weeks, if that makes sense. And then as chemo ended, and it was herceptin-only, the non-cancer part of my life expanded and the cancer-part shrunk down to just the few days around the herceptin treatment. And now that all of that is over, the cancer stuff takes up a smaller and smaller piece. Think of it like a pie chart where, as time goes on, cancer (and all its related medical stuff) takes an ever-smaller slice. Right now ,of course, it is just about the whole pie (which sucks, I know).
But as Kiri starts actual surgery/treatment, it will not be that way. And while you may want to discuss and rehash the details and plans over & over (I know as a mom, I do this with my daughters), I really want to encourage you to take your cues from her. She may just want to talk about or do something totally unrelated to the medical stuff - do some crafts, take a walk, watch a movie, GO SHOPPING, etc. If you have questions or worries that pop into your mind during those time, try to shelve them and bring them up when she is in 'cancer mode' anyway, so you aren't bringing her mind back to the situation when she is trying to take a break from it.That being said, if she can't stop thinking about/dwelling on it, sometimes it's good to have someone distract you. I signed up for Netflix (i'm not at all a movie watcher normally) and always had a few funny/light movies on hand, an easy-reading book by the bedside, people to stop by to talk about OTHER things, etc. You get the idea.
I can sense your deep passionate mama grizzly-type protective love for Kiri in all your posts. This is a very hard and painful thing for you to go through. But you have such an important role here, you just have to be strategic as to how you can help her the best way and be intentional about channeling your energies into those things, not the hovering/worrying stuff that could upset her.
Hope this helps. Keep us posted please.
Kiri has a whole team of women behind her now -and so do you!
Amy
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But as Kiri starts actual surgery/treatment, it will not be that way. And while you may want to discuss and rehash the details and plans over & over (I know as a mom, I do this with my daughters), I really want to encourage you to take your cues from her. She may just want to talk about or do something totally unrelated to the medical stuff - do some crafts, take a walk, watch a movie, GO SHOPPING, etc. If you have questions or worries that pop into your mind during those time, try to shelve them and bring them up when she is in 'cancer mode' anyway, so you aren't bringing her mind back to the situation when she is trying to take a break from it.
Amy you are so totally right about this. Kiri has NO problem leaving cancerland--she's very active with her schoolwork, her horses, and her social life. She is the best possible person to take cues from, for all of us, these days. After our long day with the docs last Tuesday, she shepherded us straight to the mall for some retail therapy, and we hit Target, Filene's Basement and Old Navy over several hours (and $$$$) replenishing her wardrobe--then it was off to a sushi dinner. I spent most of several days with her and her boyfriend, and you would never guess she had just been diagnosed with cancer outside of the time we spent at the hospital and some very frank, matter-of-fact discussions with her in the car on the way to the riding stable. She seems to have no fear and is tackling this as if it were a school exam she had to prepare for. I decided early on to take my cue from her and not bring up any cancer-related topics unless she brought up the subject herself. That seemed to work well and that is what I'm trying to continue to do. I do email her stuff that I think would interest her, but only practical stuff about treatment, help available, etc, not metaphysical discussions about cancer.She is light years ahead of me in her wisdom about this.
What a learning curve! I remember reading a long time ago something a cancer survivor had written along the lines of "Cancer was the best thing that ever happened to me." I thought that person must be insane. I would still never put it that way, but I can truthfully say that I'll probably look back and think, "Kiri's cancer was probably one of the things that opened my eyes--and my life--most fully and taught me the most." Talk about being forced out of your cozy, mindless little daily cocoon.
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