The good, the good, the one bad.

No more chemo. That is the biggest good. The Topo II alpha gene was not amplified, also was not deleted (which from my readings is a bad thing but, I didn't read why) it was just normal. What does this mean? I don't need chemo. The more good is that Topo II alpha when amplified usually makes the cancer resistant to herceptin they don't know why but, it does. So mine is not, this is another good.

Also more good is that there are two things inside the cancer cell that when mutated makes the cancer a run away train. Mine are not mutated and are still strongly intact. Whew. This is very good news.

I was worried about being ER+ and HER+ because from what I have read, it's rare and they don't feel it's a good combo because it seems you don't respond to hormone blockers. Dr. Barth said no. His experience is that it is better to have both. He is glad I have both. He doesn't just study this thing he works with it. I trust him. The ER+ being resistant to the hormone blocker has to do with something else and here come the one bad.

I have a pathway activated called PI3K. It somehow gets around the ER+ receptor blocker by being able to also use insulin. So it will receive signals from estrogen but also insulin. SO, Dr. Barth wants be to drop 5 pound but only one no more than two per month. So slowly. He wants me to not eat starches. I got to read. It was very vague. No bread, rice, white potatoes or pasta. He said simply don't eat anything white. Brown was OK. Brown rice. Whole wheat. Yea well, research I go and I know many of you already on dietary restrictions can probably help me with that.

But, what is promising is that in December there is a conference in San Antonio and Dr. Barth said they have done new clinical studies on this very thing the PI3K and they would be releasing findings and he knows they have found ways to deal with it. So he said in the mean time the herceptin would be keeping things covered. Once I'm done with radiation I will go on the hormone blockers. And in the mean time I will be changing my diet.

The other good and this is probably the best good is he said he has to remind himself and me as well that this is a stage 2a and negative lymph node status. He said because there was residual cancer in the breast after chemo that if there had been cancer in the lymph node there would been residual there as well. Since none was found we can be assured that none was there to start with.

I will be starting herceptin tomorrow. Then I will get another dose next week. They load dose you start with then it will be every three weeks after that. The hormone blocker when I start that is pill form.

Off to see Dr. Guerra.