Dear OncoLink "Ask The Experts,"
How do you know if Herceptin is working? I have stage III, HER2+, ER/PR- breast cancer. I had neoadjuvant chemotherapy with 4 cycles of Adriamycin/Cytoxan and 4 of Taxotere, then bilateral mastectomy.
I've been receiving Herceptin alone since June 2006 and wonder how I can tell if it is working.
Suzanne M. McGettigan, MSN, CRNP, AOCN, Board Certified Adult Nurse Practitioner and a Certified Oncology Advanced Practice Nurse, responds:
I want to first give you a little bit more information about the reasons you are getting Herceptin right now, as well as the other settings in which a person would receive Herceptin. This way you can better understand the use of Herceptin as one aspect of breast cancer therapy.
There are two general time frames during which chemotherapy is given. In the first setting, a person has measurable breast cancer that is then monitored for a response to the chemotherapy. In the second setting, a person has no evidence of breast cancer anywhere in the body. However, our experience and our research teaches us that even when we can't see breast cancer on any scans or in lab work, it sometimes is still able to come back. Therefore, in this second setting, we give chemotherapy to people even though we have no measurable way to tell whether it is actively working or not, other than by following patients over time and checking if the breast cancer comes back.
When you received neoadjuvant chemotherapy with Adriamycin, Cytoxan, and Taxotere, your providers were able to measure the amount of breast cancer that you had at that time and then measure its response to the chemotherapy. You then had surgery to remove all traces of breast cancer and were rendered cancer-free. You are now receiving Herceptin as in the second setting described above. You have no further cancer as far as we can tell, but you are receiving Herceptin to address any possible microscopic disease left behind, and thus help prevent the breast cancer from coming back. Generally, Herceptin is given for about a year in the adjuvant setting, but could be given for more or less time based on the decisions made by your healthcare providers.