- Question from Mary: I have metastatic breast cancer that presented itself in the lungs and liver. I do not qualify for Herceptin. I am currently receiving Taxol and Carboplatin, and I am wondering if they are working on any other antibody-type drugs. I feel that if I can make this a chronic illness and hang on, that I'm on the cusp of a cure. Do you agree?
Eric Winer, M.D.
As we were talking about, there are many new treatments, both antibodies and other types of treatments, that are in various stages of development, and many of which are in clinical trials. For the moment, it probably makes sense for you to continue your present treatment as long as it's working and as long as you're tolerating it reasonably well.
The time to look for a new treatment approach would be when you're ready to stop this treatment, and that would be a time to ask your doctor about clinical trials and what might be available either at the center where you're being treated or at other locations.
- Musa Mayer One way that people find out about new treatments and ongoing research is that they help one another discover what's available. One thing you might think of is joining a mailing list called BCMETS, a large international discussion list on which women and their partners discuss treatment and offer support. You can find out about this at www.bcmets.org.
- Marisa Weiss, M.D. Each month at Breastcancer.org, we have research news that features important new treatment advances. We also report on all of the major breast cancer conferences throughout the year. You can sign up for the Breastcancer.org free email updates on the homepage. There are also many forums within the Breastcancer.org discussion boards where women with advanced breast cancer share this important information, as well as encouragement.
Eric Winer, M.D.
I would agree that the name of the game for you at the moment is hanging in there and being hopeful that some of the new therapies that are being developed will be helpful for you. As a general rule, my own preference, in terms of using chemotherapy, is to use one drug at a time. Combinations like Carboplatin and Taxol are certainly fine regimens, but one of the problems we run into when they work is that we don't know whether it's the Taxol, Carboplatin, or both. Since these drugs all have side effects, it can mean that we're giving a drug that isn't effective but is still causing a number of side effects.
Studies have shown that when we give 2-3 drugs together, we can shrink tumors a little bit more often, but that the long-term results aren't different than giving one drug followed by another, and that either approach leads to the same number of women who are alive at various points down the road. Again, giving 2-3 drugs together is not wrong, but it's usually not the approach that I personally like to take. I would also say that the same is true in terms of combining hormonal therapy and chemotherapy. It's something I'll do rarely if I feel that there isn't going to be an opportunity to come in with another treatment in the future because a woman is so very sick.
Most of the time, my strong preference would be to first use a hormonal therapy and then a chemotherapy drug, or sometimes rarely in the other order, or use them in such a way so as to tell what's working and what's not working in an effort to individualize treatment for each patient, to maximize the benefits and minimize side effects.
On Wednesday, September 17, 2003, our Ask-the-Expert Online Conference was called Metastatic Breast Cancer. Musa Mayer, Eric P. Winer, M.D., and Marisa Weiss, M.D. answered your questions about treatment and quality of life issues related to advanced (metastatic) breast cancer.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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