My tumor markers are up again, so my oncologist today at our regular meeting said it is time for another PET scan. Tests and meetings with your oncologist on progress and treatment failure are always nerve wracking, no matter how calm and collected you might appear or try to feel. My oncologist is always very encouraging though very careful about misleading me.
When they were testing my metastases at its discovery in early 2009, the tests indicated that my cancer had changed from hormonal positive to hormonal negative; that along with the negative HER2/neu made my cancer newly classed as triple negative. As I have written previously, triple negative breast cancer is both aggressive and responsive only to chemo, eliminating hormonals and other treatments as options. My doctor treated me with Faslodex on the hunch that since my initial bout with breast cancer went four years until progression, while I was taking Tamoxifen® and Arimidex®, perhaps the tests after metastasis were incorrect and my cancer was still hormone-receptor-positive.
Now that I have gotten a year’s worth of treatment without progression on the Faslodex, it is likely that my cancer is still hormone-receptor-positive, and her hunch was correct that the mets testing was invalid. This is an important point for us with bone mets as the testing for breast cancer markers for hormone and Her2/neu receptors is often unreliable. When I listened to one of Living Beyond Breast Cancer speakers Lidia Schapira, MD, from Massachusetts General Hospital, an affiliate of Harvard Medical School, she mentions the issues with receptor testing in bone metastases. I recommend taking a listen to Dr. Schapira’s talk; click on the link and scroll to the line toward the bottom about downloading the podcast.
For now I will wait for insurance approval of my PET scan, and we will see whether the increase in my tumor markers indicates progression or is just an aberrant reading. It is comforting to know that we can use more than chemo when we have to move on from Faslodex since it appears my MBC is hormone-receptor-positive instead of triple negative.5 6 7 8
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