I went in today for a second opinion with a breast cancer specialist, who is also a leading MD in high dose chemo/stem cell transplants.
She was very straight forward with me. She said that she had reviewed my case, and indicated that she did not believe that a stem cell transplant was a good option for me. She indicated that she has done 200+ stem cell transplants on individuals with metastatic cancer over the last 9-10 years, and of those, 5 individuals were still living in 2004. She indicated that of those 5, all but one of them had had a recurrence during that time and required chemotherapy. She believes that the stem cell transplant did get them a longer period of time without any kind of treatment, but does not necessarily think that it was prolonging their life. She said that they likely could have all been placed on chemo again and been maintained on that type of treatment and had the same outcome. She said that since we can not expect a cure in my case, that to go through about 100 days of poor quality of life from the treatment would, in her opinion, not be a great option.
I asked her about whether or not she felt that a mastectomy was a good idea. She indicated that she did not necessary think that there was anything to gain from having the surgery, and also indicated that keeping the breast was going to help make recurrences more quickly identifiable, therefore allowing for treatment sooner.
I asked her about whether or not having my ovaries removed or radiated would be helpful, since my tumor is 26% Estrogen receptive. She said that I could do that, but felt that taking an oral agent to counter the hormones would be as effective. She said that she believes that the chemo will eventually put me into menopause anyway, so it will not really be an issue anyway.
I also asked her about experimental trials, and if I should look into them. She said that right now that would not be an option for me because I have no measurable disease, but that when I am in a recurrence I could look into that. She said that when the time comes, I should look at third stage trials because they were promising enough in the first two trials to actually make it to a third trial, and that is a good sign. She did not know of any exciting third stage trials going on at this time. She said that she would only look into the first and second stage trials if it comes to the point that I have exhausted all my other options.
She said that right now, Herceptin is very promising and that their are other drugs out there that I have not tried yet. She said that I still have good things available to me, and suggested that I continue down the path of treatment that I am already on. She said that if I feel like I have to have a stem cell transplant, that I could make another appointment to come in and talk to her about it, and she would consider doing it.
But for now, she feels like my doctor is doing very well by me, and that she respects him a lot, and that she would even go to him if she had cancer. She said that she knows that he is up on all the new drugs, testing and treatment options that are out there, but if at sometime I had a question(s) for her, I could call her and do a phone consult (to save on paying for a visit) or I could even have my doctor call her. She said that she would be happy to consult with us if we felt like we needed another opinion.
Well, there you have it. It was definite not fun to talk about the fact that my condition is not curable, and that I will have recurrences, and all of that, but I did get straight forward information and her honest and professional opinion (no matter how hard it was to hear) and that is what I was looking for.
What am I thankful for?!?! Herceptin.
