ImmunoAdvocates Ann Silberman Breast Cancer Ann’s Story Ann S is a metastatic breast cancer patient who is in remission due to Herceptin and Perjeta. In 2009, Ann Silberman was diagnosed with stage 2 HER2 positive breast cancer, and was treated with surgery, chemotherapy, and the monoclonal antibody Herceptin® (trastuzumab), a type of immunotherapy. When her cancer recurred in 2011, it was stage 4.She began a difficult course of treatment, which included surgery, radiation, and several types of chemotherapy, until finally beginning a combination of Herceptin and a second monoclonal antibody: Perjeta® (pertuzumab). The synergistic combination of these two immunotherapies slowed and then stopped the growth of her cancer, and Ann was NED (No Evidence of Disease) for over a year. She is currently receiving Kadcyla®, and antibody conjugate.Ann is a breast cancer advocate and blogs at Breast Cancer? But Doctor…I Hate Pink! She recently spoke at a SXSW conference about her experiences as a breast cancer patient. Questions and Answers How and when did you first learn you had cancer? I was diagnosed with breast cancer in 2009. I was 51 years old and my youngest son (I have two boys) was 12. Because I was HER2 positive, I did chemo and a year of Herceptin. I was finished with my treatment in December of 2010 and started on the hormonal therapy tamoxifen (Nolvadex). The following May, we discovered that cancer had returned, and was in my liver. I was Stage 4. Having a diagnosis that’s considered life-ending, I struggled to adjust, but amazingly, I did. You learn to see life in a different way when you know it is likely to be very short. Some of it is difficult. But some of it is beautiful, as you are able to make sure to say all the things you need to say to the people you love, and to really plan for your death. How did you learn about immunotherapy and why did you decide to do it? After about four years of chemo, I was not tolerating it well. My white cell count was always critically low. Yet, cancer was still only in my liver and never spread anywhere else, which was a hopeful sign. My oncologist thought we might try Stereotactic Body Radiation Therapy, or SBRT. At the same time, Perjeta was approved by the FDA, so he started me on that along with Herceptin and the chemotherapy Gemzar® (gemcitabine). What was treatment like? Did you have any side effects? For a year my cancer was stable on the immunotherapy combo. The second year, my scan showed that I was in full remission, due to what I call “The Wonder Drug,” Perjeta. It’s easy to take, has minimal side effects, and it has made my cancer disappear. How did immunotherapy compare to other treatments you may have received, if any? When I was diagnosed, Perjeta was not in existence. After years of treatment, I was becoming critically ill, sleeping days at a time, unable to leave the house, susceptible to infection. I could easily see that I didn’t have much time left. Then Perjeta became available and reopened a door had been closed. I am not special. I have no powers. I didn’t change any habits — I eat the same, exercise the same. Medical science has a few tricks up its sleeves, and it is possible you will be the beneficiary. Are there things that surprise you about the cancer experience? You never know what is being worked on and will be approved in time for you. Don’t give up hope until you have to. (I’m not one to tell somebody to never give up because there comes a time when many cancer patients must accept the inevitable.) What would you want another patient to know about immunotherapy or about participating in a clinical trial? My advice is to get a good doctor who is up on the latest, keep your appointments, stay on top of what is happening in the field of your type of cancer, try everything that is offered, and hope for the best. I never thought I’d not only be here today, but also be healthy. I am very grateful. When I was first diagnosed with metastatic breast cancer, my goal was to see my son graduate high school. I made that goal, and that was one of the most beautiful days of my life.
