Your thoughts on the way forward please

Anotherone
Anotherone Member Posts: 633
edited February 2020 in Stage IV/Metastatic Breast Cancer ONLY

I started abraxane herceptin pertuzumab mid September and continued on weekly chemo/3 weekly antibodies schedule til beginning of February due to widespread chest and lung metastasis diagnosis in July. With about 4 doses of chemo missing during this time for various reasons resulting in about 16 doses of chemo being done. Response after first 2 months (November scan) was 50 to 80% reduction in a number and activity of lesions. After second 2 and a half months there was further reduction in size and activity but far more modest - 20-30% reduction from the November scan. I tolerate chemo ok although I am concerned about its effects on my body and I would not miss some side effects of it. My line of work depends on fine manual dexterity and it just started to be impacted by neuropathy. I am a single parent of 15 yo.

A million dollar question is what to do - whether to continue with abraxane and if so till when... Is it better to treat the lesions until they stop responding with it. How likely are they to disappear altogether if I continue with it in view of much slower response.

I realise that the response to treatment is not linear - may be fast diving cells were already hit by chemo and now we are dealing with the core of the lesions where there are more dormant cells etc. Or may be there are no/few cancerous cells present in the lesions at present and they are just necrotic masses that my body did not have time to eliminate as yet?( wishful thinking). Will it make sense to discontinue chemo and see how I get on on antibodies only and then restart chemo if no further progress with antibodies is made?

Or should I make one more push with chemo for now before regrouping ?

I realise that my situation is quite specific and I may have no responses but as there is a lot at stake I thought asking will do no harm.

Of course it will be discussed with oncologist , travelling to the appointment now, just wanted as much input as possible.

My regards to you all and specially to those who may be in more difficult positions at this time- gumdoctor springs to mind first.

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Comments

  • pajim
    pajim Member Posts: 2,785
    edited February 2020

    Hello AnotherOne, I'm not HER2+ so not in your shoes but I have a friend who was.

    She did the chemo for a certain period of time (9 months?). They stopped and just continued with H&P. If the lesions started growing again they intended to restart the chemo drugs.

    This was at a good cancer center in Philadelphia and seemed a reasonable approach. I have no idea whether it was standard of care.

    In my friend's case she was fine for a year then developed brain mets. No way to know whether if she'd kept on with chemo they would have been prevented. Somehow I doubt it.

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  • Anotherone
    Anotherone Member Posts: 633
    edited February 2020

    thank you pajim.

    Oncologist asked me my opinion, I was not sure. I asked her about baseline SUV of lungs, she told me it was about 2. I tell myself those lesions may be just necrotic masses with inflammation that my body is trying to eliminate now ...

    She told me my response started to plato, I asked her what difference long term would it have made if we reduced the lesions a bit further and she said probably not much..

    So she decided to drop chemo after 4 and a half months and continue with antibodies only... I kind of was happy about this decision - shall update in 4 months after next scans barring some emergencies happening sooner ...

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2020

    We stopped Taxol after six months and continued the H&P but I am ER+ as well so at that point my doc started me on hormone therapy, which was attack from another angle since I had not had it before.

    If you're stable, might not be bad to take a break and see how you do? You can always go back on...but not sure what I would do in your somewhat different situation than mine.

    I have to admit I did feel a little afraid upon stopping the taxol even though that was our plan all along and even though I was continuing H/P and starting Arimidex.

    Maybe taking a break is better from a "you might need it later" standpoint?

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  • Anotherone
    Anotherone Member Posts: 633
    edited February 2020

    I asked about that , olma.

    Oncologist said resistance to chemo does not depend on whether it has been exhausted the first time or zripped and restarted- would develop anyway.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2020

    Have you decided yet, anotherone?

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  • Anotherone
    Anotherone Member Posts: 633
    edited February 2020

    oncologist decided with me not protesting .

    To be honest after diagnosis I was considering not having chemo at all and trying just antibodies first so I went with it quite happily.

    Well ' happily" is an ironic word in these circumstances ...


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  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2020

    Best of luck and enjoy your break from taxanes. I'm doing okay 20.5 months post-Taxol ... hope your results will be similar! xo

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