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Goals of Treatment After Progression of HER2+ Metastatic Breast Cancer

Caitlin Flanagan, a patient with HER2+ metastatic breast cancer, shares her goals of treatment after progression of disease.

Sara A. Hurvitz, M.D.: What side effects were important to you when you were deciding this [treatment upon progression for breast cancer]? What were your goals at that time? Because now, fast forward to when this happened, your sons were much older. Talk me through that a bit: where you were in life and how your goals and thoughts about treatment might have differed based on where you were when we first met.

Caitlin Flanagan: My treatment had always just been about being a mom and being alive for my kids. Sometimes, when they were in college, I would think, “What am I still doing here?” When they had elementary school graduation, I thought, “Yes! I made it to that.” Then came high school and college. After losing my hair twice, which I really hated, I really hoped I wouldn’t have to lose my hair. Some women don’t mind it. I think with younger women, there’s more of a range of how you can look in the world. I hated it. I hated how slowly it came back and in such a weird way. I didn’t want to be so sick, because I had been really sick. The first chemotherapy was so sickening. I guess I wanted everything I could get. I wanted to not lose my hair. I wanted to have some energy to still go about my day. I didn’t want to be drugged out. But I wanted one that could work. I am always such a big talker about not losing my hair again. Sara, if you told me, “You’re going to die in a month unless you give a Hail Mary pass to this one that’s going to cause you to lose your hair,” I bet I would reconsider very quickly.

And now, the women have those cold caps I see in the infusion [center] so they can preserve some of their hair. I would do that, I think.

Sara A. Hurvitz, M.D.: Yes, absolutely. The supportive measures we have for patients have vastly improved since you were initially diagnosed. The treatment options we have available have improved as well, with a number of these agents not leading to hair loss. That’s a good thing.

Transcript edited for clarity.


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