She received a primary dignosis simultaneously with a diagnosis of “multiple” secondaries in both lungs last October and since then she has had three cycles of doxetaxel and Herceptin with (probably) pertuzumab as part of the CLEOPATRA study being carried out in Germany, where we live.
She got the results of her interim CT scan yesterday and the primary tumour has ashrunk by around 30%, which is of course a very positive result so early in her treatment. However, the lung secondaries (none bigger than a grain of rice) have not changed at all, neither bigger nor smaller.
I’d like to ask if it’s normal/within the bounds of possibility for a primary to shrink while the secondaries do not respond. Has anyone else had or do you know of a similar experience? Many thanks in advance for any help!
So sorry about your wife’s diagnosis - i don’t know about the specific treatment she is receiving but yes, secondaries in different places and breast primaries do seem to respond differently to the same treatment some times. They also don’t necessarily respond at the same rate, some times one tumour seems to lap up the chemo and shrivel whilst the others take more time to absorb it (well, that’s how i think of it).
Really hope she responds well and that the lung secs get completely hammered.
Many thanks for the reply and I would like to wish you all the best for 2010.
We’re still waiting for the doctors to discuss what, if anything, these results could mean. But we’re hoping against hope that this scan could mean that what have been taken to be metastases could actually be something else, given that they haven’t reacted at all the therapy. After all, my wife’s lungs have not been biopsied because it’s probably more dangerous to go poking around in the lungs than any benefits this might bring, so the only pathologically confirmed diagnosis is the primary tumour. The doctors will only go so far as to say that the scan shows what “are most likely to correspond to metastases”.
We’ll have to see what they say but it would be a great start to 2010 if my wife got “relegated” a stage or two!
hi charlie,
I’ve only just seen your post, but thought my experiences may help. I was diagnosed with primary and multiple lung mets in April 2007, and like your wife, my lung lesions don’t always respond in the same way to treatment as the breast primary does. I did have a lung biopsy at the beginning, but this was quite invasive surgery, meaning a weeks stay in hospital, but i needed to know there wasn’t an alternative diagnosis. The lung mets didn’t respond to Xeloda, but have responded well to herceptin and tamoxifen and arimidex , which have kept progression very slow. I am currently having Abraxane chemotherapy, and whilst i can feel its affects on the breast tumours, haven’t a clue whether its working for the lungs.
I hope your wife responds to her treatment, and give her all my best wishes.
nicky
My wife’s got her next therapy tomorrow so we went for the pre-treatment examination today. The oncologist told us that she has discussed the case with the gynacologist and the oncology consultant and they’re going to discuss my wife’s case again on Friday at their inter-disciplinary conference. The oncologist talked the chances down, which I think is reasonable and responsible, but she said they are going to assess whether a lung biopsy would make sense to find out exactly what is in the lungs. We’re viewing this positively because at least there are some doubts about the original diagnosis.
My wife has been asymptomatic so far and the only lymph node that was affected is no longer inflamed. Although a lung biopsy would be a difficult procedure, as nicky has explained, if it is practicable it would probably make sense to be certain what we’re dealing with. As the doctors explained at the start medicine is not always cut and dried and there can be differences in interpretations. We’ll see what they say on Friday!