HER2+

AA wrote:

"What is interesting about that is that trials done by reputably scientific institutions and researchers in other countries DID show 10 years ago that ovarian ablation plus tamoxifen IS equal to the use of CAFx6 plus tamoxifen for patients with + node (HER2 was not considered at that time but would be of similar risk). "

AA similar risk does not equal similar response to treatment.  Her2+ BC is know to respond well to chemo, her2- BC generally responds less well to chemo.  So making the leap that treatment with tamox + OA may be equivalent to chemo in Her 2+ BC is not logical.

Also, there are studies that have shown chemo to decrease recurrence in ER+, Her2- BC.  Not always.  Researchers are trying to figure out which ER+ cancers are likely to respond to chemo and have had some sucess - hence the Oncotype test. 

Also, I think the Oncotype Dx is based on patients who used tamoxifen (right?), so without tamoxifen....?

Evebarry, I found this:

Herceptin Heart Risks Clarified for Older Patients 

A limitation of many clinical trials in oncology is the inclusion of few older patients. With respect to trastuzumab, clinical trials in breast cancer generally limited participation to women 65 or younger and with good performance status. Therefore, extrapolation of results to older or sicker patients requires caution, the authors wrote.

Given the benefits of trastuzumab and the lack information about cardiotoxicity in older patients, Serrano and coauthors reviewed their own clinical experience with the agent.

Examination of medical records revealed 45 breast cancer patients age 70 or older treated with trastuzumab. The patients' median age at the start of trastuzumab was 75.9, and 11 patients were older than 80. About 90% of the patients had performance status 0-1, 56% received neoadjuvant or adjuvant trastuzumab, and the remaining 44% received the drug for metastatic disease.

The authors found that 12 (26.7%) patients had a cardiac event that had a time to onset ranging from three to 132 weeks after the start of trastuzumab-based therapy. Every patient had at least one risk factor for cardiac disease and eight had two or more risk factors." 

http://annonc.oxfordjournals.org/content/early/2011/08/08/annonc.mdr348.full

Thanks, VR. It sounds so promising!

Most docs are not deliberately obstructive. They just are part of a bureaucracy and trying to make it work for as many people as possible. My personal situation with my onc is just one example of the failure to offer quality care, the individual practitioner bias interfering with best care, and the truly difficult situation it creates for the newly diagosed patient who is not sure what to trust and what not to.

A.A.

I was not scared into anything. With all treatment for cancer: alternative, chemo, hormone therapy or targeted therapy like Herceptin they don't know for sure if it will work on any specific individual, unless it doesn't. Really the same thing can be said about alternative medicine.

I asked my onc "How do we know if this will work." She honestly answered "we don't. There are are some women that don't even need further treatment past surgery. The problem is we don't know who they are. If we did we wouldn't be giving them chemo."

There is no known cure, alternative or otherwise. Tucker you want to support alternative that's fine but saying chemo/herceptin is a scam and doesn't work is just inaccurate.

They do have stats on how many women survived without chemo that were HER2+. A woman with my stats had a 40 our of 100 women not needing additional treatment. Chemo,Herceptin and hormone therapy brought my states up to 84 women of being alive and NED in 10 years. (2 die of other causes). 

Herceptin can only increase those numbers. The reason why they don't have stats out for Herceptin is it hasn't been used for early breast cancer for 10 years yet. It was only approved as standard treatment 6 years ago.

Read up on the studies for Hereceptin. It has been a real life saver for many of us HER2+ gals. It also works more effectively with chemo. This is not an insurance scam. I highly recommend you read the book "The making of Hercepin, a Revolutionary Treatment" by Robert Bazell. The drug company actually didn't want to continue making the drug. Towards the end of the book this onc talks about how her patient was dying and she broke the double blind testing by checking to see if she was on Herceptin. She wasn't. The onc got the company to give her the drug. The tumors shrunk before their eyes.

Barbie remember Tucker had had the treatment. You might also consider complimentary. Doing both natural and traditional.

Hi lago,

I have been reading about herceptin since I was dx in 2008. I didn't say it was a scam. Unfortunately it does not work with everyone and there is no way to tell who will benefit and who will not. That was my point.

My other point is that women who are dx with breast cancer are not even TOLD about what is available in the natural, alternative world. Were you? Doctors don't lay it out in front of you and say, 'well, here's the chemo/herceptin route, and here is the alternative route'. Women should be told, and told clearly, that CAM is available. I had not even heard about it before I was dx. Suddenly, we are experts on a very complicated topic. I am not saying that herceptin should be ignored, just that it needs more study and I don't want to be a lab rat. The article I cut and pasted, above, explains the synergy between herceptin and some natural alternatives. I would have gone this route but didn't know until AFTER the conventional treatment. Also, chemo isn't quite a scam, but the statistical benefit is not high compared to the risks. The stats are only 1.2% or so benefit of chemo. I cannot say alternatives would not do better because Big Pharma does not do studies on these alternatives, natural products.

I have also seen the movie "Living Proof" about Dr. Slamon who created herceptin. While it can work for SOME women there is no test to see who would benefit. I know of no other product that is given to humans w/o some type of track record, especially at $80,000 a tx.

tucker

Not sure where you got your stat of 1.2% but in my case women with my particular diagnosis (biology, tumor size, age etc.) the number my onc gave me was much much higher.

Pharmacies shouldn't be expected to fund alternatives. The funding should be coming from somewhere else. You're right, pharmacies are for profit and therefor have no interest. This is why governmental research would make more sense.

There is no reliable test to see if chemo, AIs or Tamoxifen works either. The reason why there is not test is there is no reliable test to see if your cured from cancer so how can they test if Herceptin is working… but in women that have chemo/Herceptin before surgery they can see if it's working. That's how they know the drug works in the first place.

Everything is still in the experimental stage. You pick what experiment you want to be in.

lucy,

I was an experiment before I was born, since my mom was given DES, a synthetic estrogen, in the 1950's, which has subsequently caused many reproductive problems and now breast cancer. All the studies said it was safe. What a joke.

I'm done with being a lab rat.  

tucker

I hear ya, Tucker.

I'm so sorry to hear about your Mom being given DES. Was it even tested on rats by our pals at the FDA? I remember the thalidamide disaster too.

You see all these studies talking about "benefit" but they don't explain that benefit may mean less recurrences not living longer from all causes. Herceptin is one of those that hasn't been followed long enough to know if it is significantly better for OVERALL SURVIVAL than no Herceptin at ten years out.

I don't think they even did placebo studies on Herceptin. Maybe somebody could check?

Good, let's see the documentation. Source, please?

Thanks lucy. It's been an interesting "journey" to say the least!

Here's another study from Australia that is interesing re: stats.

http://www.curenaturalicancro.com/oncologists-criticize-chemotherapy.html

If the pro chemo folks can find a study that says chemo confers a huge benefit, like 50% from taking chemo, please let me know. I'll accept lower %, but I'm not seeing anything more than 1-5%.  Also 75% of oncs in Canada would not give chemo to their family, nor would they take it. That study is available online but I don't have time to google it. I will find and post it later today.

tucker

Lago, then maybe you could find the actual citation for us in Bazell's book. Thanks so much. Fact-checking is so helpful, isn't it?

tucker, as Lago said, that 1% benefit was what the patients were willing to do chemo for.  The study looked at patient's attitude toward chemo, not the actual benefit of chemo.

If you read the study further on, you will see it says the following:

On average, 94% of patients indicated a willingness to accept
adjuvant chemotherapy for a 15% (or less) improvement in 5-year
disease-free survival, which is the mean benefit in 5-year disease-free
survival for early-stage breast cancer patients under the age of 50
with positive lymph nodes according to a recent overview of
randomized trials (EBCTCG, 1998). 

So, there you go - some stats from 1998 saying the mean benefit of chemo is 15% improvement in 5 year disease-free survival for patients under 50 with positive lymph nodes.  I believe that would be the absolute benefit conferred, not relative, but I'm not 100% sure (I'd have to see the 1998 study to be sure).  There is a big difference in these numbers.  If my 5 year recurrence risk is say 30%, and chemo drops it down to 15%, that is a 15% absolute improvement, but a 50% relative improvement.  

I'm sure there are newer studies, but since I just read that in the study you presented, I wanted to share it with you.  Here is the link to the full study:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2363690/pdf/84-6691836a.pdf