About 2 pm, my free and random thoughts were interrupted by my cell phone musically entertaining me with a call just a few miles shy of the Wisconsin-Minnesota border and La Crosse.
It was Dr. Getz, calling to reaffirm what Katie had told me. They had run the testing on the surgery tissue and I am considered HER2 negative. That was more common with my type of invasive lobular carcinoma and should also reduce the chance of reoccurance as well. There is no need for Herceptin at all so I no longer had to concern myself with the TCH protocol.
He went on to discuss the oncotype testing I had asked about and that is something I can talk with Dr. Alguire about when I see her next week. He also said I could take Tamoxifen but he was still encouraging me to consider one of the Aromatase Inhibitors that has been found more effective for postmenopausal women like myself. The type he recommended was Letrozol, trade name Femara. (That will have to be discussed with my insurance company as I know Tamoxifen is a covered prescription but not sure about the AI's and at $321.00 per month, we'll have to check this out)
He clarified a couple other things for me and was much more relaxed as I was. We had a really helpful discussion in regards to questions I had for him. But I knew my last question was going to be the one that made my treatment decision for me.
"Dr. Getz, I know that HER2 has various levels. From my biopsy, I was believed to be a 3+. Did I have a number this time too?"
"You are a 1+", he responded. I thanked him for his honesty, discussing things with me, and helping me towards getting my treatment started. For a moment, he seemed rather surprised, and then just said "You are welcome. I enjoyed meeting you and wish you good luck. I'll send the paperwork to your team and copies to you as well. Feel free to call me if you have any other questions or concerns." We were done.
I may or may not have gone full circle back to Dr. Batts' original recommendation: 4 hits of chemo or not, radiation, Tamoxifen for 5 years.
Chemotherapy kills the cancer cells. Dr. G had told me he had no doubt I could deal with it easily. Doing so would give me peace of mind knowing that I hit this little pesky tumor as aggressively as I could as well as any that may have just decided to vacation somewhere else unseen.
"0" HER2 level, means you do not have any cells showing any evidence of HER2.
"1+" means more than 10% of the tissue cells show partial evidence of HER2.
"2+" is the blasted gray area where the oncologist decides whether or not you have Herceptin and Chemo.
"3+", you have no choice, you do TCH...but not me, not now!
But you see, HER2 is a ghostly presence now, not a powerful force. Herceptin is not recommended for "0" or "1+" and that is well documented. That was the part I needed to have addressed and FINALLY, thanks to the pathologists at Mayo Clinic, it has been put to rest.
I left the weight of that "issue with the tissue" along the road somewhere in Minnesota. It's time to enjoy the scenery and focus on getting back home. Within a week or so, I will FINALLY have a treatment plan too!
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