Taxotere, Carboplatin and Herceptin
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GAgirl - make sure you ask for Emend, dexamethasone and onadestron. I had to take the dexamethasone morning and night the day before, the day of and the day after chemo. The Emend was given an hour before treatment and I had 2 to take home for the following two days - one each morning. Also the onadestron was morning and night the 2 days after. These three will stop any nausea. I can honestly say I never felt like throwing up. I didn't feel good but removing tha chance of throwing up was SO good. Also make sure you DO NOT get constipated - I made that mistake only once and paid for it big time.
Unfortunately we can't have herceptin on it's own - they have found it works better given with the taxotere and carboplatin.
I didn't lose all of my hair. It still upsets me but it is growing back and it's not as important as doing everything you can to fight this beast.
Sue
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Gagirl - yesm i am in the boro. pm me if you need to talk, k? we are all here for you!
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gagirl - there have been trials on the weekly, but i did not qualify cause this is my 2nd bout of bc. I started the TCH every 3 weeks, but had bad te's and had to stop it after 2nd treatment. onc said no more carboplatin, and i said no more time off work, so we agreed on 8 weekly taxol only treatments, and i am getting the herceptin weekly while i am getting that, then will go back on every 3 weeks on herceptin.
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Hi DesignerMom and GaGirl01! Just another opinion here...I've been on TCH for four cycles now, and while I've had some side effects they've been pretty minor. Don't be too afraid- you might be surprised, as I was, that chemo isn't as bad as you expected.
TCH is the "gold standard" for her2+ bc, it doesn't have the risk of increased heart problems associated with the combination of herceptin and adriamycin. Also, there is a slight risk of developing leukemia years later from adriamycin. These are risks I wasn't willing to take.
As for the weekly vs. 3 weeks, I think you're thinking of weekly herceptin with TC every 3 weeks. A dose dense chemo would be TC every 2 weeks, but my onc wouldn't let me do this, even though I felt great and wanted to... I thought maybe I'd have less chance of recurrence if we just hit it hard! My onc says it doesn't make any difference whether you get herceptin weekly or every 3 weeks...it's just easier for me not to have to come in every week. The half life of H is 3 weeks, so I'm fine with that.
Oh, and we met with a rep from Genetech (my husband is a Dr) and they told us that herceptin works great on it's own (that's why we take it for a year after TC) but when given with TC it makes both drugs work even better- there's a synergistic relationship. Some women with mets take H indefinitely. We are SO lucky that this drug has become available for us!
Anyway, best of luck to both of you no matter what you decide. Blessings to ALL the sisters here! We all have so many tough choices to make, and since everyone has such a different experience it's hard to know exactly what you're in for. But I think worrying about the chemo is much worse than the actual chemo!
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Gin52, Wow, have there really been TC weekly trials? On a reduced weekly dose I guess? That's really interesting... this Her2 is such a beast... I wish they would find the perfect "magic formula" to knock it out permanently. I really wanted to do dose dense chemo- I'm so afraid of recurrence because all my biomarkers were so negative, plus I had EIC in addition to my tumor, which is just another poor prognostic indicator. How are you doing now that you're just on Taxol? Sorry you had trouble with carboplatin. Hang in there!
Chemo #5 of 6 for me tomorrow morning! Bring it on!!!
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Hello, everyone! This is my first post to this thread although I've been reading previous posts starting at the beginning for the last couple of weeks. Its addicting! And so, so helpful. I get my port put in tomorrow and my first TCH the next day. And I'm scared to death but reading about everyone else on this thread has helped me with that so much. Thank you, thank you, thank you!
My DH is going with me for my first treatment but I'm hoping I can go by myself after that. I think that will work okay, right? Most people don't have immediate side effects and can drive home alone, right?
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Terry
Glad our thread has been helpful. You may want to also join a chemo thread that starts in June. They have them that start each month. The ladies on them are not getting all the same chemo, but they ARE going through it at the same time, and are able to support one another with hair loss, etc. all together. I was in the April 2009 group and we still are very close and supportive to one another, even another year out. The combination of this thread, which is specific to your type of chemo, and the monthly thread really covers your bases.
Re driving - they give you benadryl in the drip and it made me very sleepy. I slept through most of each chemo infusion (several hours) and would not have been able to drive home. My husband would stay until they finished the pre-drugs (benadryl and steroids) and started the taxotere, and then he would leave and I would call him when I was almost done to come get me.
Once I was done TCH and on Herceptin only, I declined the benadryl and would drive myself. I LOVED the independence of that. But driving to/from chemo, no.
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Terry
Glad our thread has been helpful. You may want to also join a chemo thread that starts in June. They have them that start each month. The ladies on them are not getting all the same chemo, but they ARE going through it at the same time, and are able to support one another with hair loss, etc. all together. I was in the April 2009 group and we still are very close and supportive to one another, even another year out. The combination of this thread, which is specific to your type of chemo, and the monthly thread really covers your bases.
Re driving - they give you benadryl in the drip and it made me very sleepy. I slept through most of each chemo infusion (several hours) and would not have been able to drive home. My husband would stay until they finished the pre-drugs (benadryl and steroids) and started the taxotere, and then he would leave and I would call him when I was almost done to come get me.
Once I was done TCH and on Herceptin only, I declined the benadryl and would drive myself. I LOVED the independence of that. But driving to/from chemo, no.
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Thanks AmylsStrong. I guess I'll be scheduling some drivers then. My husband will do it, of course, but I hate for him to use up all his time off from work for this. I have lots of friends and a very sweet stepdaughter who have offered. I just hated to inconvenience anyone, you know?
My onc's nurse just sent me home with 5 prescriptions in preparation for my first TCH and I only paid $8.69 for all of it! Shocking! I was expecting $100 or more. One that has no instructions is lydocaine/prilocaine cream. I guess that's to put on the port area. I have an appointment with my onc just before the first treatment so I guess she'll tell me about that. After being in the chemo waiting room to get labs done this morning it looks like I'll have plenty of time to let it work. That place was packed! I go to Baylor in Dallas. Anyone else been there?
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Terry- I only had benedryl during treatment #1. My oncology nurse said it was just to help with a reaction to the Herceptin the first time ( I slept for an hour). But I was not given it with TX #2 or #3 so you'll have to see whether they give it to you everytime. My DH goes with me to every TX but afterwards he goes back to work and since I take every treatment day off from work I go shopping afterwards just to stay up and moving around. I am fine to drive for the rest of the day.
I agree with everyone else...the scariest part of chemo is going in for the 1st one because you have NO idea of what to expect. For me it's actually kind of nice to go and relax, watch TV, read my book and not have any other responsibilities for about 4 hours. The day of and the day after I feel fine. Days 3-6 are the roughest for me, but my biggest complaints are nausea (never thrown up, though), muscle aches, fatigue and mouth sores, but I have prescriptions for all that. When I went in for treatment #3 I told my onc that my fatigue lasted a bit longer after #2 he gave me a prescription that they give to people with narcolepsy and now I don't even have a problem with fatigue. They have always made it clear that no matter what your side effect they have a drug to fix it, I just need to let them know. I go in for #4 next week and while I dread it with every fiber of my being, I know I will get through it.
Don't be afraid to let them know what side effect you are having, because believe me, they know what will fix it. Best of luck and I will be thinking of you!!!Lady_Madonna- you are SO lucky to have only had minor side effects. TCH has kicked me in the butt just a little bit more each time. Hope #5 went well!!!
Jennifer
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Lady Madonna - yea, the weekly TC is a reduced dose, so should be less side effects. My onc tried to get me in the trial, but they kept refusing because it was not my 1st diagnosis. Anyway, had to miss last taxol last week due to low counts, but it is doing ok. Think a few se's are finally catching up with me after 4 treatments, but still not bad - fingernails, swelling of feet, kinda hard to tell sometimes what is SE's and what is due to concussion, lol. I know with the Taxol - I have to sign a paper saying I have someone to drive me, or I can't get it. Between the benadryl and the taxol being alcohol based, they say.
tbyrd - I put a thin layer of the lidocaine over my port, then cover that with saran wrap. Instructions say 15 min before port is accessed, but the longer it is on there, the better I think. I would shoot for at least 30 min....hour is probably better.
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Suepen - thanks for the notes on Herceptin. I just had #5TCH last week so am in the dregs of the yucks, but tomorrow is a better day! #6 comes up on June 16 --- 24 more days and I am free. Sort of. Then I start the Herceptin.
Can anyone tell me about their fingernails? Mine are absolutely sore to the touch. They were throbbing today and I have dark marks across most of them. Am I on a path to lose them? And so close to the end. Yarrggh.
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Hi Frosty...if you already had #5 with #6 coming, and you only have dark marks, you may be okay. My fingernails weathered the TCH very well...they did seem to get a little more thin (or was it brittle!?)...they tore so easily! My final chemo was on 12/10/09 and I swear my chemo nails have grown out...it was my two big toes that had a bit of a rough time. Both got those weird purply dark lines at the crescen of the nail (the edge of the moon). One toe nail had about 1/3 of it pull from the skin underneath. Yes, they throb and do get sore
There was a point I couldn't have any pressure on the toes. Keep them as clean as possible. Your Onc will look (should look) at them to ensure no infection is starting up...Hang in there...you are so close to being finished!!! Are you starting to notice any little sproutlings? I swear my hair started to sprout after the 5th chemo... 
Lady Madonna...when you say your bimarkers were negative, you mean your BCRA tests? Mine were all negative, too... what is "EIC" (you mention this is also a "poor" prognostic indicator). What are poor prognostic indicators? Funny...my Onc is definitive that I have my H every week, even when I told him so many other people are getting it every three weeks. I mentioned the fact that one poster put up that the 1/2 life for H is 3 weeks...he shook his head at me and told me that based on accepted protocol, he will only permit his patients to go weekly (I asked if we could change to bi-weekly). I have 13 more "weekly" H's to go...seems like an eternity, plus I am doing the Bisphosponate Zometa trial. Think about all that we throw at this!!! Surgery, Chemo, Rads, Herceptin for a year and aromatase inhibitors for 5 years. I get to make it six things with the Zometa for three years.
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Thanks Toughmom38 and Gin52. I just love being able to ask a question or voice a concern and the next time I check in there are people with actual experience giving me advice and letting me know what to expect.0
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Oh...I meant to add that I was never given Benadryl during any of my treatments. I ended up being quite allergic to the Dexamethasone, but they did not figure that out until my 5th chemo. Was awful...the nurse made me feel like my reaction was psychosomatic...I rolled with it assuming she was right. After the 4th chemo, though, I couldn't take it anymore and told them it must have been the chemo...and that I couldn't do it again. When I saw my Onc, he discovered that I was having an allergic reaction to it...amazing that I toughed it out all that time. Of course, they laugh now and say it's amazing...that I was supposedly one in the 3-5% that gets an allergic reaction to Dexamethasone! Pay attention to your body and what it tells you. I cannot tell you how much easier chemo 5 & 6 were from a steriod perspective! Now, nausea and other SE...that's a different story. But I could definitely tell that the steriods were not my friends
Zofran for nausea was good, but the samples Kyrtil were amazing! My insurance wouldn't cover the Kyrtil...and it really helped me in the final #6... #6 was the first chemo where I actually had some vomiting, the others just gave me some nausea (some worse than others, but never true vomiting until #6...then Kyrtil came to the rescue!).
Hugs...
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sanaisa, that's odd about the weekly Herceptin thing. My oncologist is with UCLA, and his boss invented Herceptin, and they all follow the three-week protocol. So what your doc is saying doesn't quite make sense. Although as long as we're all getting it, we're good.
GAGirl, you've done your homework, and you'll be okay. The more prepared the better. TCH isn't fun, but it's doable, and before you know it you'll be on the other end of it. (I had my last TC a week ago.) Get Emend if you possibly can-- I haven't had a moment's nausea. Now they just have to invent a drug that does for intestinal problems what Emend does for nausea.....
In my early rounds, I could work and be pretty good on days 2-3, then 4-7 were bad. The last couple of rounds have been harder. Still okay on days 2-3, not-as-bad intestinal stuff days 4-6, but tired (able to work, though), then the gut stuff gets worse days 7-10 or so. Doesn't seem to be much to do about it except make myself eat some very bland food, stay hydrated and don't be too active (I'm a walker but have learned the hard way to chill for a few days or I'll be in the bathroom a whole lot more). But that was only the last two rounds, and now I'm done! By July it will be a memory.... well, except for the Herceptin and Avastin, and the radiation, and the Tamoxifen.... ah, hell.
Anyway, onward and upward. Glad my nails have hung in there. They're weak but not discolored or separating or anything. My psycho baby hair looks crazier than ever, but I don't care anymore. The real stuff will start coming back in a few weeks.
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Sanaisa, your onc probably is most comfortable following the herceptin dosage as it was orignially tested, which was weekly...but now it is commonly given every three weeks, as writer also mentioned. It's much more convenient, costs less for the patient, and is just as effective. If your onc has any affiliation with UCLA maybe he can check in on the current protocol. It's your body and it's tough to have to come in every week if you don't have to!!
Writer, we're very much alike!! Although I've been very lucky with pretty minor se's the intestinal rumblies get me at about the same time. My nails are pretty normal too, just a little more week...knock on wood! My hair was pretty scary looking, I went and had it shaved down even again and it's much better... I'm hoping it'll just keep coming in for real- soon!
ToughMom, I think part of what makes my se's feel "easier" is that I've had migraines all my life so I'm used to dealing with a lot of misery! And actually, since the first round of chemo I haven't had much problem with headaches (thank God!) Maybe the chemo will kill the migraines- lol! I had a few se's on the first cycle and then it felt like my body addapted and I didn't get most of them again...like mouth sores. Now I just mostly have fatigue and rumbly intestines, but I find that if I eat small frequent meals I do pretty good. Chemo #5 is done and I'm so excited to almost be done!!!
All my chemo ladies are in my thoughts and prayers this morning- Have a wonderful day, try to focus on the positive of how blessed we are to have this fantastic drug herceptin availabe to us... and I'm expecting to be keeping up with every one of you ladies for many, many years!
Just when the caterpillar thought the world was over, it became a butterfly.
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LadyMadonna - I hope your chemo went well. I was having my 3rd yesterday, so I'm six weeks behind you.
As for the weekly Herceptin, my oncologist talked about doing weekly Herceptin through the first three-week cycle, but instead gave a loading dose and so TCH were all on a three week cycle.
I finally got an official diagnosis! I have invasive ductal carcinoma, and it's stage IIIa. Based on how scary my first visit was, the stage is a relief!
Now for the great news. After two full rounds (round 3 infusion was yesterday), my doc had a hard time finding my formerly 5 cm+ mass! She mostly felt a thickening, but it was nothing like the prominent and proud tumor masses displaying themselves in my breast at first visit. She also couldn't find the lumps in my lymph nodes. Those measured 2.1 and 1.8 cm at the pet scan. So the TCH is kicking butt, and it's only 1/3 of the way done! So I asked some questions about staging with my two masses versus one large one, and she said they still treat them as one large. Then she said she's seen some small tumors that are very stubborn and large ones that just melt away. She'd much rather have the ones that melt, and that is what mine is doing. She said I'm clinical stage IIIa, but she expects to possibly see a pathologic complete response (no live cancer and surgery time)! She was very pleased, yet quite reserved, but my husband did get a high five from her.
My white blood cell count was low, and she decreased my carboplatin by 8%. Other than that, all is going well. I got the go ahead to skip nausea pills this time. I haven't had any nausea at all. I guess I'm very lucky, but the nurses said I might not have it since I didn't during pregnancy.
To those just starting, best of luck. I hope your side effects are minimal and your cancer's response is phenominal.
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Dawn, that is so AWESOME!!! What an incredible, amazing result!! I'm so happy for you, and this is really inspiring to those who are just getting started and frightened at what's ahead.
Thanks for sharing, keep the great attitude and keep kicking that cancer to the curb!!!
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Lady Madonna: Wonderful! My cancer reacted the same way to chemo. When I finished TCH I had no scannable signs of cancer and later the pathology done at the time of my bilateral also showed no signs of cancer. It was just amazing what only two rounds of TCH did.
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Well, I got boobs yesterday. I finally finished all treatments and could start rebuilding my body image. So I got fitted for fake boobs (prosthesis) and pretty bras and got my hair trimmed to even it up. Heck I'm starting to feel normal after a year. :-)
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SWAMPY - Good for you! After all we've been through, we deserve anything that can make us feel pretty!
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Sanaisa, this is cut/pasted directly from the Genetech Herceptin Prescribing Information...maybe you could print up the prescribing info and take it in to your doctor? Or maybe you can't change now that you've already started? Sorry, that's frustrating.
Here's the full link: http://www.gene.com/gene/products/information/pdf/herceptin-prescribing.pdf
------------------------DOSAGE AND ADMINISTRATION---------------------- For intravenous (IV) infusion only. Do not administer as an IV push or bolus (5.2). Adjuvant Treatment of HER2-Overexpressing Breast Cancer (2.1)Administer at either:
Initial dose of 4 mg/kg over 90 minute IV infusion, then 2 mg/kg over 30 minute IV infusion weekly for 52 weeks, or
Initial dose of 8 mg/kg over 90 minutes IV infusion, then 6 mg/kg over 30-90 minutes IV infusion every three weeks for 52 weeks.
Metastatic HER2-Overexpressing Breast Cancer (2.1)Initial dose of 4 mg/kg as a 90 minute IV infusion followed by subsequent weekly doses of 2 mg/kg as 30 minute IV infusions.
RE: the negative biomarkers... obviously the Her2+, also my ki-67 score was incredibly high (and by poor biomarkers they generally mean the cancer is very aggressive and/or very likely to recur.) The EIC is extensive intraductal component, meaning I had high grade DCIS, much larger than my tumor, all around my tumor spreading into the surrounding ducts. It hadn't reached my nodes yet, but it was already creeping out...another poor prognostic factor. All these things were a clear indication for chemo. I'm just hoping the chemo takes care of them ALL!! They didn't even bother doing an oncodx score on me, no need after those other scores...! Haven't had BRCA test either, don't really have a family history and will probably have to have ovaries out anyway because of all these poor biomarkers and being er+/pr+. Sometimes the combo of er/pr/her2+ makes tamoxifen ineffective, so out go the ovaries. That's why this cancer scared the sh*t outta me and chemo doesn't seem so bad... I'm a pretty happy, mellow girl usually and now I feel so stressed... and I'm trying not to be stressed since that's not good either! I'm already in chemopause and finally yesterday got medication that helped tremendously with the hot flashes so I could sleep last night- yay!!
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Swampy, how wonderful to be coming out on the "other side!" Congratulations!! I bet when you look back on it now the year went by pretty fast, didn't it? And to be kicking cancer butt in the process, it's all good. You're a warrior!! I'm so happy for you. Enjoy! Nothing like a little retail therapy and a good makeover to perk you up...blessings!0
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LadyMadonna,
I'm curious as to what medicine you were given for the hot flashes. I've got them bad! 25-30 a day, sometimes so bad I'm sick to my stomach during them. I was in chemopause, but now in official menopause because I just had TAH/BSO (hysterecomy/oopherectomy) in April. I want to get some of your meds!
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I'm on the three week cycle with my Herceptin, too. They did mention doing it weekly at first but now that the schedule is in my hands it shows the three week thing.
Weety, I have hot flashes too but from natural menopause. The gabapentin they gave me for my arm pain from taking out my lymph nodes was supposed to also get rid of the hot flashes. If anything they're worse. If you find something that gets rid of them I'd sure like to hear about it.
Lots of good news on here today. Let's hope we keep it up. First chemo for me tomorrow. Nervous as a cat in a rocking chair factory!
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OK, I have a fingernail question...The half moons at the bottom of my fingernails are a little bit darker than normal but have been growing out with my nails (like it was damaged a little during the infusion but then just kept growing). I have #4 of 6 next week, will I likely start having soreness with the last 3 treatments or would I already have started having problems? I don't notice them being any thinner or breaking any easier than usual. When did the rest of you start noticing soreness or them being thinner?
Jennifer
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Weety and Tbyrd - my Onc gave me Effexor for the chemopause hot flashes. It's an improvement from before. They're not nearly as intense and don't seem to be waking me up at night nearly as much as before. An added bonus - it works wonders for anxiety! lol
Toughmom - my nails are doing the same thing as yours are. I started having soreness in the fingertips after the 3rd cycle, but it decreases with time so that the last half of the cycle they are ok. A bit tender, but ok.
I will be doing Tx 5 next week ladies. Wish me luck! I'm struggling with fatigue and with what used to be muscle aches especially in the legs, to just plain heaviness and stiffness in the legs now. 2 more tx...2 more tx...2 more tx...
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Hi All,
I had my first treatment yesterday, and you guys are so right. The treatment itself is not a big deal, but I was scared to death, actually started crying when they started taking my vitals beforehand. I was almost late for my appt because I couldn't get off the "throne". For you ladies who haven't started yet, try not to worry too much, it really was not the big deal I had built it up to be.
I have not had any SE's yet, but I see from some of you that days 3-7 are the worst. Guess I'll find out soon enough! I was given ALOXI which is supposed to be a long-acting nausea med, and have a prescription for Phenergen. They did tell me to let them know if that didn't work, they had other meds they could prescribe.
Thanks again to all of you ladies who are sharing your stories. It is so helpful and comforting to know that I'm not alone in this, and to have some idea what might be around the corner.
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Good luck, IsThisForReal. Have they given you anything for you side effects? You are so close to the end!
MelMel10 - Good luck and stay ahead of the nausea!
As for my trying to go without nausea meds, I had a headache today, and didn't feel like eating. I finally put the word nausea to the not feeling like not eating when I threw up after getting a whiff of what dh was cooking for the boys. At first I thought it was just a sick headache, but I guess it's the chemo, too. I guess I'll be doing nausea meds on day 2 from here on out.
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