On being sucked into a maelstrom

In 2006, a patient in the UK, who happened to be medically trained, found herself swept along by the Herceptin tide. She had been diagnosed with HER2 positive breast cancer the preceding year.

‘Prior to my diagnosis, I had little knowledge of modern management of breast cancer and, like many patients, used online resources. The Breast Cancer Care website was running a campaign to make Herceptin available to all HER2 positive women and I signed up as I simply could not understand, from the data presented on the website and in the media, why such an effective agent should be denied to women who, if they relapsed, would receive it anyway. . . . I began to feel that if I did not receive this drug then I would have very little chance of surviving my cancer! I was also contacted by the Sun newspaper who were championing the Herceptin campaign and were interested in my story, as a doctor and a “cancer victim”.

At the completion of chemotherapy, I discussed Herceptin treatment with my Oncologist. He expressed concerns regarding the long-tem cardiac [heart] effects which had emerged in studies but had received very little attention on the website and from the media, especially when one considered that the drug was being being given to otherwise healthy women. Also, more careful analysis of the “50% benefit” which had been widely quoted and fixed in my mind actually translated into a 4-5% benefit to me, which equally balanced the cardiac risk! So I elected not to receive the drug and will be happy with the decision even if my tumour recurs.

This story illustrates how (even) a medically trained and usually rational woman becomes vulnerable when diagnosed with a potentially life threatening illness. . . . much of the information surrounding the use of Herceptin in early breast cancer was hype generated artificially by the media and industry, fuelled by individual cases such as mine.’

Cooper J. Sucked into the Herceptin maelstrom. BMJ 2007;334:18