We met today with the oncologist, who had a tumor board meeting this morning. There wasn’t much new to report, except to say that the chemotherapy has been 95% effective thus far. With regard to the liver mets (cancer speak for “metastases”), he has ordered a test on the biopsy sample at UCSF. The test will look for an expression of the HER2/neu protein.
HER2/neu is mostly associated with breast cancer, but it has been found in other cancers, as well. If her cancer is positive for HER2/neu, then the doctor will add a monoclonal antibody (likely Herceptin, made by Genentech) to the mix. Not sure of the plan if she is negative, except that we will stay the course with her current regimen.
With regard to the pain, he doesn’t believe it comes from the liver since the liver doesn’t have nerves that would send pain signals. The pain is likely coming from whatever tumor activity is left in her peritoneum, which is the membrane that lines the abdominal cavity. He told my mom to be sure to take her pain meds, since they seem to help.
A study published in 2005 showed that up to 39% of urothelial bladder cancers are positive for HER2. I’m not sure why they didn’t just run this test when she was first diagnosed.
For now she’ll return to her regularly-scheduled chemotherapy sessions. She’s lost most of her hair, and now has a little collection of caps and scarves. She’s gained a couple pounds, and seems to have a reasonable amount of energy even if she tires easily. We ran a couple errands and went out for lunch today, and she is in good spirits.
So far, so good.