Thursday, March 1, 2007

Thursday, 3/1/07

The amount of information available about breast cancer is a bit overwhelming. It is like drinking from a fire hose. So the following is as I understand it at this time...

I went to see the Radiologist this morning. Apparently the NCI (National Cancer Institute) is conducting a "randomized phase III study of conventional whole breast irradiation (WBI) versus partial breast irradiation (PBI) for women with stage 0, I or II breast cancer". I have applied to be part of this study. For more information kick it here:

What does this mean? (Excellent question....)

WBI is the conventional radiation therapy. It involves 6 1/2 weeks of radiation - every day for approximately 15 minutes a day. If chemo is indicated, radiation will be AFTER the WBI.

PBI is given twice a day, about 6 hours apart, for 5 days. If chemo is indicated, the radiation will be done BEFORE the chemo.

This study is the first multi-institution study of PBI/WBI done in the US. There have been three single site studies done - one of which was Ochsner's in New Orleans. Ochsner's study began in 1991, so they have 16 years of data. Also, this treatment is standard in both France and Hungary.

According to Dr. Boyer, the Radiologist, the long term prognosis is the same for both the WBI and the PBI.

Remember I said randomized? Even though I've signed up for the study, I still need to be accepted by NCI (National Cancer Institute) Dr. Boyer didn't think this would be an issue. More importantly, the computer randomly will assign me to one of the two treatment options. So I may still get the WBI (6 week) treatment option. I should know early next week if I was accepted in the study and which option the computer assigned me.

More about the HER-2 status(also called HER-2/neu) The following is from

"HER-2 is a gene that helps control how cells grow, divide, and repair themselves. About one out of four breast cancers has too many copies of the HER-2 gene. The HER-2 gene directs the production of special proteins, called HER-2 receptors, in cancer cells.

"Cancers with too many copies of the HER-2 gene or too many HER-2 receptors tend to grow fast. They are also associated with an increased risk of spread. But they do respond very well to treatment that works against HER-2. This treatment is called anti-HER-2 antibody therapy.
There are two tests for HER-2:

  • IHC test (IHC stands for ImmunoHistoChemistry)
    The IHC test shows if there is too much HER-2 receptor protein in the cancer cells.
    The results of the IHC test can be 0 (negative), 1+ (negative), 2+ (borderline), or 3+ (positive). (My IHC test was a 2+)
  • FISH test (FISH stands for Fluorescence In Situ Hybridization)
    The FISH test shows if there are too many copies of the HER-2 gene in the cancer cells.
    The results of the FISH test can be "positive" (extra copies) or "negative" (normal number of copies). (I am still waiting on the results of the FISH test.)

There is an additional test, Oncotype DX. This test helps make chemo decisions for women with ER-Positive cancer. (Me!) Dr. Boyer is going to discuss ordering this test with Dr. Christian. The results typically come back in 10 - 14 days.

SO, I'm still in the hurry up and wait mode.

Many of you are asking how I'm doing emotionally. I'm sure this will come as a shock to most of you, but I'm a very pragmatic person. Crying, carrying on and wringing my hands will not change the fact that I have breast cancer. Am I happy that I have cancer? No, of course not. But I do and nothing will change that. However, I am very grateful that it was found early and I'm confident that by following the recommendations of my doctors, I will live a long and fruitful life. And having the support of such wonderful friends and family can't hurt either!

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