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Radiation did not work, options now?

Posted by asapienlessordinary @asapienlessordinary, Jul 14 7:51am

Hi, here's a brief summary of my case:

- On dialysis for the last 28 years
- Early Liver Cirrhosis from Hepatitis C infection (treated successfully a few years back), liver function normal
- Diagnosed in January 2025 with well-differentiated adenocarcinoma of the GE Junction Stage 1-2, not present anywhere else, no symptoms, discovered by accident while doing an endoscopy
- HER2 FISH Positive
- Resection attempted but unsuccessful due to severe bleeding
- 28 sessions of Radiation ended April 30
- PET CT after 2 months of last radiation treatment showed "moderate response" only. Tumour is about 44% in size and 38% activity (Vmax) comapred to before treatment.
- Biopsy taken during endoscopy shows that cels are malignant

So, now that the radiation did not work fully, what are the other options? Resection is ruled out, chemo is also not an option as per the oncologist. With a positive HER2 FISH, I believe they will try targeted therapy with Trastuzumab or an equivalent.

Does anyone have experience with this drug? Can I hope for complete remission? Or will it only be palliative? Any thoughts or suggestions would be helpful. Thanks!

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Moderator
Colleen Young, Connect Director | @colleenyoung | Jul 14 11:11am

Welcome, @asapienlessordinary. I'm sorry to read that neither surgery nor radiation were options that worked for you. But glad to hear that the cancer has not spread and you were staged at stage 1 or 2.

Thanks goodness immunotherapy offers potential options. You might be interested in this related discussion:
- FLOT plus Trastuzumab Immunotherapy https://connect.mayoclinic.org/discussion/flot-plus-trastuzumab-immunotherapy/

I'm also tagging members like @mrmac1234 @jane59 @mrmac1234 @jeh10 @charliecr, who have had experience with immunotherapy, specifically trastuzumab (Herceptin) for esophageal cancer. Some also have the HER2 mutation.

@asapienlessordinary, when do you start treatment? How are you managing with side effects from radiation?

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asapienlessordinary | @asapienlessordinary | Jul 15 12:21am

Hello Colleen. I am meeting the oncologist to discuss next steps. So, no date yet on starting treatment. I had very few side effects from radiaton that were controlled with Pantoprazole and Sucralfate with Oxetacaine.

Thanks for your your response.

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mrgvw | @mrgvw | Jul 15 10:53am

Pop on any of our twice-weekly Zoom calls. You are certainly unique. Herceptin (and not Enhertu at this point) should have been used immediately with your dx... no need to save it for a rainy day. We do have a stage 4 on our Zoom calls who was given 3 months to live about 6 years ago. For some reason Herceptin seems to be doing it for him (he is Her2 positive at the +3 level)... he's still on it to this day. I think he's done maybe 106 Herceptin infusions! Crazy! We have another stage 4 who's done over 100 Keytruda infusions... and still going!
Our Zoom calls are as follows:

Wednesdays, 6pm Eastern
Sundays, 9am Eastern

Here's the one-touch Zoom link:
https://us06web.zoom.us/j/4550284795?pwd=UjBHQ0J2V1pOc21SOExTR2N1UXNpQT09

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asapienlessordinary | @asapienlessordinary | Jul 16 12:49am
In reply to @mrgvw "Pop on any of our twice-weekly Zoom calls. You are certainly unique. Herceptin (and not Enhertu..." + (show)
Profile picture for mrgvw @mrgvw

Pop on any of our twice-weekly Zoom calls. You are certainly unique. Herceptin (and not Enhertu at this point) should have been used immediately with your dx... no need to save it for a rainy day. We do have a stage 4 on our Zoom calls who was given 3 months to live about 6 years ago. For some reason Herceptin seems to be doing it for him (he is Her2 positive at the +3 level)... he's still on it to this day. I think he's done maybe 106 Herceptin infusions! Crazy! We have another stage 4 who's done over 100 Keytruda infusions... and still going!
Our Zoom calls are as follows:

Wednesdays, 6pm Eastern
Sundays, 9am Eastern

Here's the one-touch Zoom link:
https://us06web.zoom.us/j/4550284795?pwd=UjBHQ0J2V1pOc21SOExTR2N1UXNpQT09

Jump to this post

Thanks so much. I will join on Sunday as I stay in India. Wednesday will be be 3:30 AM for me.

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