Neoadjuvant chemo

melza89
melza89 Member Posts: 64
edited May 2019 in HER2+ (Positive) Breast Cancer

My friend has been Googling my cancer and is telling me neoadjuvant chemo can cause metastasis so I should consider getting a mastectomy first on my 8cm+ tumor and at least 1 affected lymph node...any thoughts? I honestly don't know how to respond. I thought neoadjuvant TCHP was pretty standard for cases like mine (and according to MO & BS)?

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  • kber
    kber Member Posts: 394
    edited May 2019

    I’d ask your oncologist. To be honest, that’s not one I’ve heard. I’d be skeptical.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited May 2019

    Yes, neoadjuvant TCHP is fairly standard for large HER2+ tumors. Why are you listening to your friend when your medical professionals have given you their far-better informed opinion? There's a reason they are medical professionals and not amateur Googlers.

    Of course, that is not to say that you cannot seek a second opinion from other medical professionals because they don't always agree on the best treatment plans. For example, I also had a large HER2+ tumor, but my MO preferred Adriamycin + Cytoxan and then Taxol + Herceptin + Perjeta. That's another fairly standard treatment.

    You may want to ask your doctors as to why they prefer TCHP over AC + THP, if you're interested in having options.

    By the way, neoadjuvant chemo destroyed my lump and I was able to get a lumpectomy. Best wishes!

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  • melza89
    melza89 Member Posts: 64
    edited May 2019

    kber - I too was just surprised. I know she isn't an expert, I just wasn't expecting that person to Google stuff then react so negatively about a standard protocol. I am pretty comfortable with my doctors and treatment plan right now.

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  • Newfromny
    Newfromny Member Posts: 139
    edited May 2019

    Had TCHP a large tumor and at least one positive node also clinical IBC had a total response. Still needed mastectomy but the chemo worked

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  • WC3
    WC3 Member Posts: 1,540
    edited May 2019

    melza89:

    I believe the study that your friend is referencing is the one that found an increase in TMEMs in neoadjuvant chemotherapy. TMEM stands for tumor microenvironment of metastasis and are groups of cells of cells that can serve as gateways that allow the tumor cells to enter the blood stream.

    This study has sparked a lot of conversation in the oncology world. Most existing studies have not found much of a difference in recurrence and survival rates between those who have had neoadjuvant and adjuvant chemotherapy.

    Tumor cells don't survive well in the blood stream. They have to get out of it within 3 days or they will die, and your blood stream will be full of chemotherapy and herceptin.

    What has been shown is that people who have a pathologically complete response to neoadjuvant chemotherapy and herceptin have longer times to recurrance and better over all survival rates than those who did not.

    Neoadjuvant chemotherapy was originally done when treatment with herceptin was indicated due to licensing rules, which have since changed, allowing patients with triple positive breast cancer a choice between neoadjuvent and adjuvent chemotherapy.

    Many facilities prefer to do neoadjuvant chemotherapy because it helps them determine if the cancer is responding to the treatment, and for them to change the treatment plan accordingly. Neoadjuvant chemotherapy also can help to make some non operable tumors operable, or large tumors, possibly such as yours, easier to excise.

    My doctors gave me a choice between adjuvant and neoadjuvant chemotherapy. I went with their preference, which was the neoadjuvant chemotherapy and my tumor did respond to it by softening dramatically, but I found it very difficult to live with cancer in me for four months.

    ElaineTherese:

    Some facilities prefer TCHP over using adriamycin and cytoxane along with herceptin because the combination of adriamycin and herceptin is associated with a greater risk of heart damage.

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  • melza89
    melza89 Member Posts: 64
    edited May 2019

    WC3 - I did come across that study, but I didn't understand much of it. So thank you so much for explaining!

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