Scan after 9th chemo

Scan after 9th chemo

Attached Scan report of my mother after her 9th chemo. As per doctor she has made good progress

I still had few queries

- doctor recommended further 9 cycles of chemo- if she is doing well- are further 9 chemos required?

- spoke about a new drug yet to be launched in india -Perjeta - does anyone knows about it? Doc said- he will think of using this in future

- should we explore any alternate therapy also?

-can't this be fully cured?

5 Replies

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  • Dear Vineet, as per the earlier post i can assume, you mother has fourth stage cancer and in that case complete cure is really difficult..but as per the pet report your mother is responding very well to chemo. Perjeta is used for advance breast cancer for to increase the overall survival rate...Patients who received the drug — Perjeta, from the Swiss drug maker Roche — had a median survival time nearly 16 months longer than those in the control group.

    Regards,

    Manish

  • Vineet what's the stage of cancer? The PET is showing good progress as compared to last. Regarding further 9 chemos - let see what Dr Sumeet guides

  • I have not been following your blogs, but referring to my comment from one of your blogs :

    healthunlocked.com/breastca...

    I believe your mom is Her2+ve ( ER / PR ? ? )

    She has responded well to Herceptin + Abraxane.

    My personal recommendation was to understand the regimen properly.

    She will require life long Herceptin until evidence of progression along with regular scans every 4-6 months,

    Its important for you to understand the rationale of treatment which is not curative.

    Over 90% of patients are expected to respond this way when we offer them Herceptin based treatment. We hope this to work for at least 12 months ( on an average). With addition of Pertuzumab (this is expected to be 18 months on an average).

    ** Average means.... few patients do better than 12 months, whilst few do worse... their average by maths is around 12 months. Its impossible for any oncologist to predict which patients will be above or below average.

    So far so good... what Next ?

    Some oncologists may continue Herceptin + Abraxane , some may drop Abraxane and just continue with Herceptin.

    Abraxane is a chemo drug and sooner or letter you are bound to have toxicity of chemo. Herceptin is a wonder drug, you may go on this drug for years ( longest patient I ve treated is over 6.5 years on Herceptin). There is virtually very little toxicity from Herceptin.

    I would personally just continue with Herceptin. The cost of the doublet is quite a lot.

    And with treatment you have a long way to go, with many more drugs which will be used in 2nd line / 3rd line / 4 th line). Yeh toh sirf beginning hai....

    If she is ER/PR +ve, one may add Hormones ( Letrozole or Anastrazole) at this point.

    She needs maintenance treatment to keep her going.

    The moment you stop these wonder drug medication, all the places which mention of complete resolution of FDG activity will start having FDG activity and grow.

    We currently do not have access to Pertuzumab (Perjecta) as this is currently the std 1st line treatment option in the US / UK for women with Her+ve Mets Breast cancer.

    All the best for your moms further treatment.

    Dr Rohit Malde MD, DNB, FRCR (UK)

    Consultant Clinical & Radiation Oncologist

    BNH HCG Nanavati Hospital

    Vile Parle, Mumbai

  • Thanks Doctor. She is ER/PR -ve and HER2 +ve.

    Have read few blogs (on Google) where such patients have lived well for more than 10-15 years. What else can I do to ensure she has long and good life?

    She is doing well in terms of her day to day work, appetite etc.

    Is there any alternate treatment which we should try?

    Should I try to arrange Perjeta? Can that be introduced now?

  • Vineets, the pET report you have posted shows a wonderful response to chemotherapy. I would like to point here that, response to chemo does not down stage the cancer, meaning that, if all lesions have disappeared and PET does not show anything much, it would not mean that it is no more stage 4. The stage will always be same. But outcome of each patient is different. And we have always seen that when a patient responds well to chemo therapy even in stage 4, outcome is better than those who don't respond. So, at least the report is surely in your mother's favour, don worry.

    As for longevity, you see Vineet, cancer is a very untrustworthy disease and we just cant predict anything for any single patient, except give them what the average says, like roxboxfox has mentioned above. Some people may do better than average and some may do worse than average. It's not possible to test who stands where.

    Roxboxfox has already clarified about type of chemo and use of Perjeta, So, my suggestion is, be in touch with your Oncologist, and discuss with him about the same.

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