I will fill in more details in my next post, but here is a quick recap of this morning’s meeting with Dr. Semien, the medical oncologist at Kaiser Redwood City.

1)  As long as I understand the underlying benefit vs. risk associated with adjuvant therapy in my case for which there is not a clear official recommendation for further treatment, she is willing to treat me with adjuvant therapy.

2)  Because my invasive component is so small and because there is not a clear recommendation for treating me, she wants to use a lighter regimen, not TCH, but Taxol + Herceptin.  I will get weekly lower dosage infusions of Taxol and Herceptin for a total of 12 weeks.  After that, I will switch to Herceptin only treatment, administered every 3 weeks, for the remainder of a calendar year (I think this means 14 infusions of just Herceptin).  The theory is that more frequent but lower dose exposure of fewer drugs (Taxol instead of Taxotere + Carboplatin) will result in a reduction in overall side effects and long-term serious side effect risk.

3)  She wants me to have the re-excision (+plastic) surgery before I start chemo.  I will go ahead with my Sept. 19th surgery date, wait for the surgical drains to be removed and for the surgical wounds to heal, and then start the Taxol+Herceptin regimen.  She anticipates the adjuvant therapy would commence in early October.  If everything goes well, I should be done with the more difficult 1st part of the treatment by the end of the year or just after the new year. The Herceptin only infusions are expected to be considerably more tolerable.


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