A functional symptom is a medical symptom with no known physical cause. In other words, there is no structural or pathologically defined disease to explain the symptom. The use of the term functional symptom does not assume psychogenesis, only that the body is not functioning as expected. Functional symptoms are increasingly viewed within a framework in which biological, psychological, interpersonal and healthcare factors should all be considered to be relevant for determining the aetiology and treatment plans.Historically, there has often been fierce debate about whether certain problems are predominantly related to an abnormality of structure (disease) or are psychosomatic in nature, and what are at one stage posited to be functional symptoms are sometimes later reclassified as organic, as investigative techniques improve. It is well established that psychosomatic symptoms are a real phenomenon, so this potential explanation is often plausible, however the commonality of a range of psychological symptoms and functional weakness does not imply that one causes the other. For example, symptoms associated with migraine, epilepsy, schizophrenia, multiple sclerosis, stomach ulcers, chronic fatigue syndrome, Lyme disease and many other conditions have all tended historically at first to be explained largely as physical manifestations of the patients psychological state of mind; until such time as new physiological knowledge is eventually gained. Another specific example is functional constipation, which may have psychological or psychiatric causes. However, one type of apparently functional constipation, anismus, may have a neurological (physical) basis.
It is also used in the same combination as a neoadjuvant (given to reduce the size of a tumor, prior to surgery or radiation) for HER2-positive early breast cancer; as of 2016 this use had not been shown to increase survival.As of 2016, pertuzumab has not been studied in people with a left ventricular ejection fraction value of ≤ 50% normal, a prior history of congestive heart failure, or conditions that could impair left ventricular function like uncontrolled hypertension, recent heart attacks, or serious cardiac arrhythmia. Caution should be used combining pertuzumab with an anthracycline. There is also no safety data available for use of pertuzumab in combination with doxorubicin.Women of child-bearing age should use contraception while taking pertuzumab; it may damage the fetus in pregnant women, and it may be secreted in breast milk. Adverse effects
In clinical trials of the three-agent combination therapy in metastatic breast cancer, adverse effects occurring in more than half the people taking it included diarrhea, hair loss, and loss of neutrophils; more than 10% of people experienced loss of neutrophils with fever, and loss of leukocytes.