Tuesday, March 10, 2009

what if?


"We have all the tools to eliminate mortality from Her2 positive breast cancers in the next 10 years."
-Dr. Eric Winer, Director, Breast Oncology Centre, Dana-Farber Cancer Institute (February 28, 2009, 9th Annual Conference For Young Women Affected By Breast Cancer).

Her2 is a protein. And it fuels cancer cells. Her2+ breast cancers are always very aggressive and, had I been diagnosed before Herceptin was widely available, I am sure that I would not be alive today. Now, a whole host of new drugs are being developed to attack this breast cancer that affects primarily younger women.

Dr. Winer's words are among the most hopeful that I have heard in a long time.

And then today, I heard a story on the CBC about a man who is being forced to choose between taking an oral chemotherapy drug for his brain cancer or feeding his kids. It's heart-breaking.

And, I can't help but wonder, what if, when the Herceptin stops working, neither my government or my insurance company will pay for the next course of treatment? What happens then?

Dr. Winer also noted that 30-40% of all women with breast cancer metastases will eventually have the cancer spread to the brain. He told us that Herceptin doesn't pass through the brain and suggested that all women with metastatic her2 positive breast cancers have brain scans done every 6 to 12 months. Guess what I am going to be talking to my oncologist about during my next appointment? (Although, vinorelbine, the chemo drug I'm taking is sometimes used to treat brain mets. That's reassuring).

I hope this is making at least a little bit of sense. I have a raging head cold and am feeling pretty muddled. My spouse was laughing at me this evening, reminding me that I am always very stoic about the big things (like, say, having a liver the size of a watermelon) but a garden variety head cold turns me into a whimpering puddle of goo.

I guess I am reminded that, generally speaking, I am very healthy these days. And that, in itself, is very hopeful.

This brings me to my second favourite quote from the conference:

"The best predictor of doing well is doing well."
-Dr. Winer.

Cross-posted to Mothers With Cancer.

7 comments:

Dee said...

Laurie,
Tykerb is an oral targeted therapy that also attacks Her-2 positive breast cancers. The great thing about Tykerb is that they say it does pass the blood-brain barrier.

Also, whereas Herceptin only blocks that growth protein from one receptor site on the outside of a cancer cell (thereby blocking access that allows the cell to grow), Tykerb works from inside the cell and blocks TWO different receptor sites. At least, that's how I understand it.

I don't really have many side effects from Tykerb - perhaps more dryness and definitely face break-outs.

So, there are other avenues to explore . . . hopefully, though, you won't have to consider them because you'll remain cancer-free!

nonlineargirl said...

You know, research has shown that people living with serious long-term or chronic illness often report their biggest health concern as something like "I broke my foot" or "I got bronchitis" instead of the "big" thing like cancer or advanced diabetes. (So, you are not alone in your alternately stoic and crabby responses.)

Rebecca said...

Laurie,
Let me tell you about Tykreb (aka Lapatnib). You do break out, and it's rather odd because it's your entire head (scalp and face). The other big side effect (affect?) is diarrhea. Easy to manage with Imodium, easy to get out of control if you don't. Other then that the only annoying side effect is the fasting before and after. You need to have a three hour block of time (2 hours before and 1 hour after) with no food. I never realized how much I ate all day until I had to find the time to not eat.

I worry about insurance too. With my HMO everything has to be pre-approved. What if they say enough is enough? I'm lucky that Massachusetts requires insurance to cover clinical trials. I may be heading for my third one soon trying to find SOMETHING to beat back my HER2.

And for all my trips to Dana Farber, I've never run into Dr Winer!

JuliaR said...

I like the last quote "the best predictor of doing well is doing well". Now that I have just finished chemo and am tired and not feeling well, I look forward to feeling better and better as a sign that I am doing better.

Nat said...

I hope the man with brain cancer didn't live in the Ottawa area...

I feel out of place commenting...But if it's a new unfunded cancer drugs there are many places that can help you with those. I'd make sure you tell your doctor and your nurse what's going on financially, they know about resources and they know how to work the system.

~*Jobthingy*~ said...

oh that poor poor man.

i hope that he speaks to someone.

most drug companies would subsidize.

feel better! stupid head colds i hate them

viagra online said...

I really hope we can get it this year or the next, goverments spend more money and time killing someelse than helping he's own country, I hope we can get the cure this year of next, tomorrow :s
Thanks