About a month ago, my sister Tracy called me on my cell phone — I was at a dinner party with John — and she asked me if had taken the drug Herceptin for my breast cancer. She said there was going to be some big announcement on the news about this drug and she wanted to know where I fit into the puzzle before she watched it. I told her I had not taken it. My oncologist did not recommend it due to heart toxicity and unknown benefits. I fit the profile for taking the drug — I am HER 2 positive which means my tumor over-expressed a certain protein that makes it aggressive. Herceptin is designed to combat this over-expression and reduce recurrence from an aggressive tumor. But like other drugs, the potential long-term side effect (heart damage) outweighed the benefit. At the time anyway. Now things have changed.
Today I saw my oncologist for a check-up. He told me his opinion on Herceptin has changed. That big announcement Tracy saw revealed a new study reporting a significant reduction in recurrence for patients like me. My oncologist said the new report on this drug is the most impressive he’s seen in a long time — and he thinks I should now consider taking Herceptin. He is not completely sold on it because of the heart toxicity — there is no way to predict what the long-term affect could be for me when I am much older because the drug has not been around very long. But he seems to think the benefit might just outweigh the gamble of what the drug may do to my heart. It was reported on one website that:
“Data showed that Herceptin given in the adjuvant setting with chemotherapy to Her2-positive breast cancer patients significantly reduces the rate of recurrence compared to chemotherapy alone … Herceptin’s cardio toxicity data was also presented and it was found that although there is some risk, Herceptin given with chemotherapy was found to have acceptable cardio toxicity and that the benefits of the protocol outweighed the risk. It was stressed that these risks must be discussed by doctor and patients and that patients must be carefully monitored.”
So I have three weeks to make a decision. If I decide to proceed with this therapy — which in the broad sense is considered chemotherapy but is more specifically called immunotherapy — I would have a sonogram of my heart for a baseline reading so I could be closely monitored through therapy. Therapy would be administered via infusion which means the drug would enter through my port over the course of 90 minutes. I would go every three weeks for one year.
My gut — which seems to have guided me well so far — tells me to accept the therapy. The benefit seems to be clear and while the long-term affect on my heart is unknown, there are no significant short-term side effects (like nausea, vomiting, hair loss). After two hospitalizations, I won’t rule out the possibility that my body may suffer from the therapy, but my oncologist is not worried about side effects that would affect my normal functioning.
So I thought my treatment was complete. And perhaps it will go on for another year. I am not overly anxious about this — it may be the Zoloft that cuts down on my anxiety or it may be my weekly counseling sessions that are helping me process overwhelming information. Regardless, I plan to keep tossing this new dilemma around in my head until I feel a definite sense of direction.