This week, with the results of my biopsy, it has been clarified that my cancer is indeed Her2 positive still. When the cancer originally presented 8 years ago the biopsy came back showing triple positive.
What is triple positive?
It indicates that the my tumors grow in response to the hormones estrogen (as in as many as 75% of cases) and progesterone (as in as many as 65% of cases). The third + comes from being HER2/nue positive (as in 20-25% of cases). Her2/nue, often shortened to Her2, is a more aggressive type of cancer. This was definately the case with me.
When my cancer was discovered there was a very large and palpable mass. My Ongologist figured it was probably 10cm. Between my first and second chemo I could feel one or two additional lumps. So, in the course of a very short time I believe new masts were growing. Luckily it was also very responsive the the A/C, paclitaxel and Herceptin regimen I was given. I didn't have any heart health issues which are possible with these drugs other than HBP that was easily controlled and has since almost reversed completely.
When my cancer returned about 3 years ago it was found in my bones. While a biopsy was performed and extensive testing was done across the country, the results did not indicate the tumor was HER2+ any longer.
So, how did it go from + to - to +? Bone tumors are very difficult to biopsy - it's a solid matter versus soft tissue. So, it was probably HER2 positive all along. In fact, even the biopsy this week failed to indicate being HER2+ in the first test - an ImmunoHistoChemistry (IHC). Protocol would be to trust the results of the IHC. But, luckily Dr J requested that they move forward with the next test, a FISH test. (I say luckily not because I was lucky, but because if she hadn't I would have been angry and insistent that we go back and get the test done. I mean lucky for her since she didn't have to hassle with me.) It's a little funny to say, "Yeah, I had a FISH test." I feel like I could follow that up with, "they found out I am a mermaid."
Since I was probably always HER2+ and the treatment protocol is different when they aren't treating HER2 I did receive 3 years of treatments that weren't as custom tailored to my cancer as they could have been. It is easy to ask the question, what was the price I paid for not getting the HER2+ treatment for the last 3 years? And I will never know the answer. I don't have to know, because the treatment I received did a great job of keeping the cancer pretty controlled. I had results that far exceeded average experiences. I also was able to exhaust a long list of medications. Had I been treated with a HER2+ regimen for the last 3 years I would have already cycled through a number of chemo therapies that I am just starting now. Additionally, the drugs I have taken in the last 3 years, while not without side effects, have had side effects that were manageable and allowed me to work and raise my kiddies.
As I have gone through treatment it has often been my prayer that I would have peace when the choices about treatment I made were good choices that would offer me the best balance between being a druggy and a mommy. I have had a lot of peace over the last 3 years about the medical choices I have made. I have been so blessed to know the questions to ask and have felt guided in what I have done. Another case in point, after visiting with Dr J Thursday I talked to her about adding the bone treatments back into my protocol. Not that she would have forgotten or not done it, but I am so thankful to know what I need and be able to ensure that my medical team is giving the best of everything I need.
|from the Perjeta website homepage|
So I will probably become a hair-less cat. Yes, this is the 3rd time I am loosing my hair this year. I lost it right about Halloween last year, I remember thinking I should be a pirate. And, It will probably be gone before the first week of November ends again. This year I am considering something permanent to decorate my perpetually bald head. To keep from going on and on about how much I just want to grow long, dark, thick hair I am going to close now.