An interesting day at the clinic today. We had come across an article on the Cancer Research UK site that indicated that Herceptin could be a viable treatment for my type of cancer, so I brought up the subject with the oncologist. It turns out that it isn’t straightforward, it might not be appropriate, and there will be some hoops to jump through, even if it is viable.
First, as a biological therapy — one that works at a genetic rather than at a chemical level — the cancer has to have the right genetic make-up. In the jargon, it must over-express the HER2 gene. If it does, then Herceptin can be a good way to attack the cancer. It turns out that only about 7–16% of gastric cancers over-express that gene, so the chances that the treatment is appropriate are quite small. But if it makes sense to use Herceptin, recent evidence showed that median life expectancy was increased by three months. That may not sound like a lot, but I only get one chance so I want to play for everything. A genetic test of a sample of the cancer will be needed to determine whether Herceptin is an appropriate treatment.
Second, Herceptin hasn’t (yet) been approved as a treatment for oesophageal cancer by NICE, so it isn’t possible to prescribe it within the NHS. If I want the treatment, I’ll have to find a way to pay for it myself. Fortunately I can do that. Even more fortunately, I only have to pay for the genetic test at the moment, which is a lot cheaper.
Third, it looks as though Herceptin isn’t compatible with Epirubicin, so a decision about changing the direction of my therapy would have be to taken. It’s too soon to be thinking about that now, as we don’t even know whether Herceptin would be an appropriate therapy, but if it comes to pass it will be an interesting decision to have to make.
The first step is to get my cancer tested for the HER2 gene. The oncologist found that the biopsy sample of my cancer was in Redditch, and we gave her the go-ahead to send it to Birmingham for testing. I hope there’s enough of it left to allow the test. If not, I’ll probably have to undergo another endoscopy, which is not my favourite medical procedure of all time, not by a long way!
What do I do next? I wait for the results of the genetic test. I’ll try to do it as calmly as I can, but calmness is not my strongest suit. Oh well…
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This is exciting news, Chris! Waiting isn’t so bad; there’s always something else to do in the meanwhile! 🙂
@Ryan: How true! I’m just about to start something fun right now. And this afternoon, I might even record something short for LV. That’ll be the first in a looonnnggg time.
Depending on how long/short a queue they have in the genetic testing line, it could be really quick. I’m guessing they do some sort of PCR-based test, which (1) is very fast, and (2) generally requires very little starting material.
Good luck!
(On a totally unrelated topic, I heard your voice for the first time yesterday while listening to chapters of She, by H. Rider Haggard. Nice to put voice to keyboard, as it were.)
@Catharine: There are two tests. From the PDF document I linked to in the post, they are “immunohistochemistry and fluorescence in situ hybridisation (FISH)”. I don’t know how long it will take either, but I shall put the wait into the back of my mind as far as possible. The probabilities are too small to count on, I think.
As for the chapter from She, that was my very first LV recording. What a coincidence. My recording gear is much nicer now, so I hope your listening experience wasn’t too bad.
Hi Chris, i’m still here reading every word of your blog and find it really interesting. Good luck with the test to see if Herceptin is a viable option for you. Is that the drug that they use for Breast Cancer?
Keep blogging
Love Jayne x
@Jayne, thank you. My fingers are crossed, but I’m not putting too much faith. I’m just not that much of a betting man to think that Herceptin is likely to be suitable for me.
You’re absolutely right about Herceptin for breast cancer. It only works for about one in five women, and a smaller proportion of men. And yes, men can and do get breast cancer!
Hi Chris, So pleased there might be another option and think it’s fab that you are highlighting all of the details for others. I’ve posted the link to your blog on twitter too so hopefully more people will find you :o)
Take care,
Frosty
Thanks Frosty. I have about 40 Twitter followers, so my posting it there didn’t get a great deal of traction. I bracing myself for the flood… 🙂
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[…] visit to see the oncologist, mostly because everything is going so well. We did discuss the Herceptin treatment possibility, though, which seemed to have excited him somewhat more than I have come to expect from his usual […]