Info--maybe more than you want to know....Decisions--still unmade.. Hurry Up--and Wait....

Saturday, November 23, 2013

Hi All...

Well I had my first appointment with my new oncologist yesterday and it was interesting to say the least.  First off, I like her a lot.  She seems very knowledgeable, almost speaks in terms I can understand and does translate when I have that "what the heck did you just say" look on my face.
                                                                                                                                                   

The decision about my having chemo as part of my treatment is still up in the air because we are waiting for a couple of reports to come back.  One of them is a retest of the HER2/nau.  So what does that mean.....the easiest way I know to explain it, because I'm not a medical person, is to cut and paste info I found on it (I just cut and pasted the highlights....the info I found was lengthy).  This may be way more than you want to know about test that are done with cancer, but for those "sister" readers of this blog, it might be informative.

HER-2/neu Test

How is it used?

After a diagnosis of breast cancer has been made, Her-2/neu testing may be used as a prognostic marker to help determine how aggressive the breast cancer tumor is likely to be. It is usually ordered along with estrogen and progesteron hormoe recepter status tests (ER & PR) both of which were positive in this cancer and in the breast cancer I had in 2002.  The results of these three tests give the doctor information about the person's likely prognosis and response to specific therapies such as hormone therapy and chemotherapy.

When is it ordered?

Her-2/neu tissue testing is recommended along with ER & PR status testing as part of an initial workup of invasivev breast cancer and is sometimes performed with recurrent breast cancer. It is not diagnostic but helps the doctor determine treatment options and understand more about the tumor's characteristics.

What does the test result mean?

If an IHC Her-2/neu test is positive, it means that the Her-2/neu gene is over-expressing the Her-2/neu protein. If a FISH test is done, then amplification of the Her-2/neu gene can be detected. If either of these is positive, then the person is likely to have a tumor that is aggressive, that will respond poorly to endocrine treatment, and that will be resistant to chemotherapy. These people may be considered candidates for trastuzumab (Herceptin®) therapy, a drug that was created to target Her-2/neu protein.

My cancer in 2002 HER-2/neu test was negative.  But the test that was initially done in the biopsy for this current cancer was "equivocal" (or not firmly positive or negative)...so they are redoing that test to see if they can get a more definitive result.

The second report we are waiting on and that takes the longest (at least 2 weeks) is the 

ONCOTYPE  DX Test

It is a relatively new test that is done in a single lab (only one in the US)....again I've cut and pasted information:

 The Oncotype DX test is a genomic test that analyzes the activity of a group of genes that can affect how a cancer is likely to behave and respond to treatment. The Oncotype DX is used in two ways:

• To help doctors figure out a woman’s risk of early-stage, estrogen-receptor-positive breast cancer coming back (recurrence), as well as how likely she is to benefit from chemotherapy after breast cancer surgery.
• To help doctors figure out a woman’s risk of DCIS (ductal carcinoma in situ) coming back (recurrence) and/or the risk of a new invasive cancer developing in the same breast, as well as how likely she is to benefit from radiation therapy after DCIS surgery.

The results of the Oncotype DX test, combined with other features of the cancer, can help you make a more informed decision about whether or not to have chemotherapy to treat early-stage hormone-receptor-positive breast cancer or radiation therapy to treat DCIS.

Who is eligible for the Oncotype DX test?

You may be a candidate for the Oncotype DX test if:

• you’ve recently been diagnosed with stage I or II invasive breast cancer
• the cancer is estrogen-receptor-positive
• there is no cancer in your lymph nodes (lymph node-negative breast cancer)
• you and your doctor are making decisions about chemotherapy.
• That would be me!

I am glad they now have these tests because enough advancement has been made in cancer treatment to allow for some educated (test result) decisions to be made.  The medical field is finally admitting that chemo is not always best for their patients and sometimes the nasty side effects far outweigh any good the chemo does.....but on the other hand these tests are proof positive that the patient most definitely would benefit from chemo.  I'm not crazy about the thought of doing chemo, but I will do it if the test show it will benefit me in the long run....and ward off recurrence.

I found it interesting to hear the oncologist ask me which kind of chemo I had in my 2002 cancer treatment...........and her response when I told her (Adriamycin and Cytoxan) that if I had to do chemo again, they would not use those two meds.....that the body can only have them once in a lifetime.....now I know this will  throw red flags up to my naysayer friends (that I love dearly and that I know loves me dearly and are looking out for my best interest) and it certainly gave me 'pause' to think that a medicine could be so strong and so destructive to your immune system that it could only be used for one grouped session of treatment (my session was 4 treatments in 2002).

So now I play the waiting game....I was told as soon as both tests are back I will be called in to have  further discussion....and make decisions.  More than likely if I have to have chemo it will begin the week before Christmas.....and if I don't have to have chemo, I am assuming that is when I will begin the 6 weeks (every day) of radiation. 

Well now that I've bored you to tears.....I'll close with samples of thoughts that get me through this bend in my road.....


and this one....... because I hope that is what this blog is to someone......