BRCA positive in a 76 year old woman

Hello Karlalynn,

First, let me say that I'm sorry that your mom was diagnosed with bc. Second, as  BRCA+ diagnosed myself, I don't know anything about "gene therapy." My oncologist hasn't mentioned it and I've not read about any type of treatment while researching. I couldn't have radiation because I have autoimmune disease as well as bc, However, I was offered chemo (8 treatments), radiation (before discussing in detail the effects of rads on autoimmune illnesses), and surgery (first lumpectomy then bilateral mastectomy.)

The chemo may last a year because the treatments are spread out once every 3 weeks. I think you should talk your mom into having a second opinion. It's always good to do that.

Prayers to you and your mom...

Hi Karlalynn,



I think your mother is wanted for a trial or study. please get a second opinion. Different hospital, different Dr. Office, different everything. Take a pen, paper or recorder if necessary. Your mom probably was unaware of what was involved with gene testing. I refused. Please go with your mom to every appointment if possible. When I was first dx, I could not hear a lot of what the docs were saying, I think my mind and body kicked into survival mode to keep me from going into shock.

Hi Karlalynn,

I'm just joining in the recommendation to get a second opinion -- what I see online about gene therapy for BRCA+ all dates from 1998, 1999, 2000 -- there were clinical trials at that time of gene therapy for BRCA+ ovarian cancer, but it looks like it was something that was tried then and not since.  Of course, I could be completely missing something -- but in general, my understanding is that there is no gene therapy (for any condition)  that has gone beyond the clinical trial stage: see http://www.ornl.gov/sci/techresources/Human_Genome/medicine/genetherapy.shtml

I think it will be really good that you go with your mother to her visits -- everything is so new and there's so much to take in -- even for younger women who are health professionals! -- it's always good to have another set of ears. 

I may be way off base here, but somehow I wonder if the doctor was actually saying your mother's tumor is Her2+, and the therapy that will "kill" the cancer cells is Herceptin?  Her2 is sometimes referred to as a "gene" -- but it is the result of genes of the cancer itself.  (BRCA is what we usually think of as a gene -- something inherited from our parents that increases our susceptibility.)  Testing a tumor for Her2 would be COMPLETELY standard of care (whereas, as Allison said, it would not be standard to do a genetic test for the BRCA gene in a 76-year old). Because Her2+ cancers are aggressive, Herceptin would be recommended for almost every Her2+ patient, if they pass a pre-therapy heart test called a MUGA scan.  And Herceptin really does bind to the Her2 "gene" on the cancer cell, killing the cell, and it is usually given once a month or every 3 weeks for a year (and sometimes weekly, although I think weekly is still being tested?). [See: http://www.breastcancer.org/questions/herceptin.jsp]

Herceptin IS an approved drug -- it's not what is usually meant by "gene therapy" because it's not the introduction of a different, "correct" gene into the body.  Instead, it's a "biological" "immune" therapy -- it's an antibody that attaches to the Her2 protein on the surface of the cancer cell (a protein that is there on the surface because the cancer cell has an "abnormal Her2 gene" in the cancer cell itself).

Anyway, I think it will be good to go with your mom to appointments, and I think a second opinion is a really good idea, and I wish you both the best.

Ann

Something may be "lost in translation" there, perhaps the physician was doing everything by the book but the doc's words were misunderstood? Like not some "gene therapy" (there really isn't any, not even trials) but perhaps "a therapy suggested based on a result of a genetic test"? And possibly not BRCA but some "other" gene-related test like for Herceptin or maybe the Genetic Health tumor test? Before rushing for the 2nd opinion, it may be good to figure out exactly what has been been tested and what is the suggested regimen.

Karlalynn, we are all happy this is working out for  you and your mother

Karlalynn, thank you for posting this update!  It sounds like your mom is indeed in good hands, which is great so she won't have to travel far for treatment.  Make sure you take care of yourself, too!  (You know, like in the airplane safety lecture, how they tell you to put on your own oxygen mask before you help someone who can't do it for themselves!)  I second Allison in saying "tell your mom we're all thinking about her" -- and you, too!

Hugs,

Ann

Good luck to your Mom, and you, Karlalynn!

There's also a forum for HER2/neu positive (where you'll find others taking Herceptin):
http://community.breastcancer.org/forum/80

and forum about chemo: http://community.breastcancer.org/forum/69

with a really great thread called "Tips for Getting Through Chemo":
http://community.breastcancer.org/forum/69/topic/478386?page=1 

and there's usually a new thread every month for those who start chemo at the same time, kind of a "buddy" thread -- here's one for those starting chemo in June 2011:
http://community.breastcancer.org/forum/69/topic/769067

Beacon800, Karlalynn confirmed yesterday that your guess is correct -- her mom is HER2neu+ rather than BRCA positive, and the treatment regimen includes herceptin.

You're right, there is no "gene therapy" for BRCA+ people in the usual sense of "gene therapy" -- using a vector (usually a virus) to insert a "good gene" into every body cell the vector penetrates.