Hello, my mother was recently diagnosed with invasive ductal carcinoma grade 3 HER 2 NEU positive. I want to know what are the most advanced treatments out there for this type of cancer and what are the side effects? Now that the pathologist report is complete, what should she expect as the next step? Thank you for your help.
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Q: idc grade 3 her2neu positive
Answers (1)
11/ 7/09 8:35pm
Hi - The usual treatment for this would be surgery to remove the tumor (if she hasn't already had that, though it sounds like she has); radiation if necessary (for instance, if the tumor had invaded her chest wall, or the skin of her breast); probably chemo; and a year of Herceptin, a targeted therapy for HER2-neu positive breast cancer.
Chemo side effecs would vary according to what combination of drugs she receives; once she knows, visit here again and search for the specific drug combo, as we have FAQS on all the common chemo regimens. For information about radiation, please read our radiation FAQS. Our Herceptin FAQS should prove helpful, too.
Her next step will be to meet with her oncologist, who will have created a treatment plan based on her pathology report. It will help for someone to go with her to take notes - she'll have a lot of information coming at her quickly... Hope things go well, for both of you. Good luck - PJH
11/ 8/09 5:57am
Hi - Cancer is indeed a terribly scary thing; it's such a shock, getting the diagnosis. But these days, it's simply not the death sentence it used to be. Sounds like you're saying the cancer is in her lymph nodes, which means she'll definitely have chemo. If it's in her lungs - for sure, and those spots aren't something else, which still remains to be determined? - then that changes evrything, pretty much. It means she'll be in stage IV (metastasized) cancer, and will need to continue chemo, in order to treat the lung cancer, for as long as it takes to get it under control. I don't really know the protocol for lung cancer, surgery vs. no surgery; that'll be a key question to ask her medical oncologist, who'll be the doctor designing, leading, and coordinating her treatment. Which means it's imperative both of you like and trust this person as you'll have a long relationship with him/her. If there are any issues with the oncologist, get thems solved right up front - either by getting a new oncologist, or by working things out with the current one.
In laymen's terms - if she has lung cancer, it's clearly a lot more serious than simply having breast cancer. That said, many women with metastasized cancer - breast cancer that's spread to lungs, bones, brain, or liver, which is where BC spreads to - live for years with it, some staying under treatment all the time, some having a remission where they can go off treatment. There's no telling ahead of time what part of the spectrum your mom will fall into... But clearly she'll need aggressive treatment. Is she being treated at a good cancer hospital? It makes a difference where you're treated. Here's a list of Comprehensive Cancer Centers, which are government-designated as being the top facilities in the country. HOpefully she can access one of them.
I wish you both safe travels... PJH
11/ 8/09 10:55am
Dear PJ, Thanks for your help and taking the time to explain things. What is in her lungs has not been officially determined to be cancerous but it is more than likely that it is since it is the lung that is behind the breast with the tumor. I thank you for your frankness and I will talk to her about checking out the centers that are on the link you gave me. How does one know if a hospital is a good cancer hospital? Are the hospitals that are considered good cancer hospitals only the ones that appear on the comprehensive cancer centers list? Thanks again. The stage iv possiblity is a definite shock but it is also helpful to know.
11/ 8/09 11:09am
Other than the hospitals on the Comprehensive Cancer Center list, I don't know how you can tell how competent a cancer hospital is. Not being on the list doesn't mean a hospital is incompetent; it just means it's not AS good as the ones on the list. Also, different cancer centers are better at different types of cancer. Your best bet would definitely be one of the centers on the list - so hopefully she's somewhere where she can access one of them. I'm sorry you're (both) having to go through this... PJH
11/ 8/09 1:54pm
If you live near a comprehensive cancer center, that would be a good direction to go, but smaller hospitals can have strong oncology programs as well. See what you think about the oncologist when you go for the appointment next week. If this doctor seems like a good match, you may not need to go further. When you go to a hospital's home page, they will usually brag on their certifications and ratings if they are strong.
An important piece of information will be what those lung spots are. If they are lung cancer that has started independently of her breast cancer, that will require a different approach than if they are bits of breast cancer that has spread to her lungs--often called lung mets for short. Either way, they will probably start with chemo rather than surgery if the lung spots are indeed cancer because cancer in the lungs is more dangerous than cancer in the breast. Since her cancer is Her2 positive Herceptin will probably be part of her treatment plan too.
People can live a long time with Stage IV breast cancer. In many cases chemo can shrink or stabilize the tumors.
11/ 8/09 4:28pm
To PJ and Phyllis, Thank you very much. I am not sure if the two of you really see the importance of what you do but for those of us who are extremely worried, anxious and so scared that we are about to lose our minds, thank you for everything. Please know that you are truly sharing the gifts of your wisdom and experience and it is appreciated.
11/ 8/09 5:42pm
Once you have cancer, it seems you just want to give back - you want to help other women through it. I think it's just our nature as women, to want to mother, to help, to collaborate. I think of a long, long line of women, each reaching out her hand to the one behind, holding the hand of the one in front. Together, we face this. Together, we're strong. And together, we survive. Stay in touch - we'r ehere for you. PJH
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PJ, thanks for your prompt response. She has not had surgery yet. We just found out that she had cancer (officially) on Thursday. She has had her scans and everything else is negative in terms of metastasis except her lymph nodes and her lung which has about 10 to 15 1cm diameter nodules on it. We have not yet spoken to her Medical Oncologist that will be the first thing we do next week. When asked about her lung, the Surgical Oncologist stated that surgery won't be performed on the lung. Is this the standard as far as metestatic movement toward the lung? I don't want to ask this but I'm compelled. How survivable is this? She is terrified and trying not to show it and I am trying to be her support but I need to understand in laymens terms what we are up against. Again, thank you and I really appreciate your positivity even in the midst of difficult questions/situations.