Tag: Triple-positive

Five Years Down and Moving Along

I had another oncologist appointment last week. This one was a milestone, since it officially marks five years since my breast cancer diagnosis.

Five years ago, I was told that with triple-positive breast cancer I had an 85% chance of survival…but there in the fine print was added “five-year survival”.

Delays in routine care due to the pandemic have resulted in more late-stage diagnoses.

With advances in treatment for HER2-receptor-positive tumors (HER2 being the third marker in “triple-positive”), that percentage has improving. But it’s still interesting to note that there’s a finite end to what reliable survival info your doctor can give you, since it’s hard to run longitudinal studies with a large group of participants.

In any case, my oncologist was happy to see me alive and kicking. With the pandemic, women voluntarily and/or involuntarily delayed preventative care, and as a result, there has been an increase in the percentage of women presenting with advanced-stage breast cancer (from UC San Diego Health). Given how far treatment itself has come, this is a distressing statistic because it means that we have effective treatments but patients are not getting them soon enough. So perhaps, for him, I was a five-year treatment success in the midst of all of this.

My oncologist’s concern now is less that my tumor will recur and more that whatever conditions were responsible for the first tumor might result in a brand new one. He still checked me over carefully. My bloodwork looked good with only a lower white blood cell count (“that may never recover,” he’s said in the past). I have no headaches, my bone pain has significantly decreased and other long term physical side effects from endocrine therapy have just about Sudisappeared.

Five years post-diagnosis I’m turning down another path, one that I would have never explored had it not been for what cancer made me face.

I’m still dealing with things like distractability issues, but that could also be due to menopause and the pandemic situation and maybe just the march of age in general. I’ve noted before that it’s hard to pull apart all the factors to identify a single culprit.

My oncologoist remarked that I looked like I was doing well, that I exuded a positive “aura”, and while I’m sure he didn’t mean that metaphysically, the truth is, I feel like I’m finally moving forward in my life again. This coming weekend I start a three-month yoga teacher training course that will move me down a new path for the future.

I still plan to keep posting weekly during this time. We’ll see how it goes!

Targeted Therapy? Yes, Please!

You cannot say that there is a “good” cancer to have. Because the only thing that would make the cancer that you have “good” is not having it in the first place.

But if that’s not the case, the next best thing is having a cancer with characteristics that serve as targets for drugs, enabling the use of “targeted therapy”. As described by the American Cancer Society, “Targeted therapy is a type of cancer treatment that uses drugs designed to ‘target’ cancer cells without affecting normal cells. …Targeted drugs can block or turn off signals that make cancer cells grow, or can signal the cancer cells to destroy themselves.”

Cancer treatment often means chemotherapy, but there are some targeted therapies available that are highly effective.

When talking about breast cancer, currently there are several targets possible: estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (or HER2 [also HER-2/neu or ErbB2]). These three are the ones that your oncologist will use to characterize your tumor.

The estrogen and progesterone receptor positive (ER+ and PR+, respectively) tumors are the most common ones. According to WebMD, about 80% of breast cancer tumors are ER+ and 65% are PR+, and these tumors are treated with hormone therapy, generally tamoxifen and aromatase inhibitors (depending on the patient’s menopausal status).

HER2+ is an interesting case. HER2+ tumors contain extra copies of the gene that makes the HER2, which is thought to make cancer cells grow faster. Historically, the prognosis for HER2+ tumors has been worse than for HER2- tumors, with a greater chance of recurrence and metastasis.

At least, that was the case before the development of targeted drugs specifically for HER2, such as trastuzumab (Herceptin), pertuzumab (Perjeta) and others. These drugs don’t come without risks and are known for being potentially cardiotoxic, but they are very effective.

This is the irony. Triple-positive breast cancer went from being one of the more aggressive breast cancers to being almost “curable”. All due to targets.

This is also what makes triple-negative breast cancer (TNBC) more complex. Without specific targets to aim for, treatment of TNBC relies on aggressive chemotherapy, which can be quite effective. But without targeted therapies, TNBC still has the highest rate of recurrence and worst prognosis of all breast cancers. Researchers are furiously searching for new ways to characterize TNBC tumors for this very reason.

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We are all looking forward to the day when we can say there is a definitive cure for cancer.

But what brought on this post? I was searching on the internet for breast cancer info on HER2+ tumors and came across a provocative headline from MedicineNet.com that read, “Can HER2-Positive Breast Cancer Be Cured?” The answer to this, I assumed, would be “no” because we’re not at the point where we can say that we’re definitively “curing” breast cancer.

In addition, I’d been conditioned by my oncologist to think of cancer in terms of years of survival rather than cure.

But according to this MedicineNet article, “With recent advances in medicine, it is considered that HER2-positive breast cancer is curable.” A bold statement indeed. And one that I hope we will be making more and more.

For an article from the American Cancer Society describing available targeted therapies for breast cancer, go here.