Taxotere, Carboplatin and Herceptin
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Joy - I haven't heard that so far. Do you remember where you saw it? Since Chemo put me in menopause they want me to do tam for a year to make sure menopause is permanent then probably will switch to an AI.
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I'm not seeing anything on chemocare regarding tamoxifen and HERstatus and I know several that had that after TCH chemo; if the people writing what you read weren't doctors then it doesn't really have any merit, if they were doctors then what backup did they have to their claim?
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Joy - Is this what you saw? Interesting!
Source:
Paul E. Goss, MD, PhD, FRCPC, FRCP:
Only a small subset of ER-positive patients had HER2-positive tumors, but this is an important subset of patients. It is possible that HER2 positivity confers a degree of tamoxifen resistance; preclinical and other data suggest that the HER2 positivity may cause tamoxifen to behave like an estrogen, and actually drive breast cancer growth or at least be less effective. Blocking HER2 activity is important on ER-positive disease.The findings in this study suggest that early use of an AI is strongly superior to tamoxifen, because it helps prevent the early recurrences to which HER2-positive patients are susceptible. However, neither of these treatments may be the optimal endocrine therapy because HER2 positivity confers ligand-independent signaling to the ER response element machinery. Consequently, fulvestrant, rather than tamoxifen or AIs, may be particularly useful in preventing the HER2 pathway from stimulating the ER pathway.
In general, ER-positive patients, if they are also HER2 positive, receive short-term anti-HER2 therapy and long-term antiendocrine therapy, and this may not be the optimal approach. Concurrent ongoing blockade of the HER2 pathway may be more fruitful. That may be in contrast to the situation with ER-negative patients, in whom short-term anti-HER2 therapy may be sufficient. I think these issues have yet to be confirmed in clinical trials.
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Hi All,
Here are 2 links to information re Tamoxifen for patients who are HER2+. I've just skimmed the information and found it fairly confusing -- hence my question to you all about what you've heard and learned:
http://www.medscape.com/viewarticle/407813_5
http://www.ncbi.nlm.nih.gov/pubmed/15199112
Here is a third link to a discussion on BreastCancer.org that gets somewhat testy, as you'll see but may be quite informative. The discussion suggests that the information reported in the links above may be dated.
http://community.breastcancer.org/forum/79/topic/756673?page=1
I will ask my oncologist for his views and reasoning regarding Tamoxifen. If you all have words of wisdom on this subject -- questions to ask, information you've found helpful -- please let us all know.
Thanks very much,
Katherine
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Joy - check out this thread on HER2 site as well:
http://her2support.org/vbulletin/showthread.php?t=44143&highlight=oncotype
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Joy I too have read that some HER2+ women do not metabolize Tomaxofin but I don't think it's 100% of all women. I know my onc is putting my or Armidex. She did mention that Chemo will put me in menopause and at my age it isn't coming back. I'm 49 (will be 50 in Feb.). So far my period is 2.5 weeks late and I just had my 2nd tx Tuesday. Looks like she might be right. I'm never late.
Anyone having white tongue/thrush issues. I think I have a little bit. Just sent m onc a picture of my tongue… and I find that picture very wierd to send. ;-)
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Hi i am 6 days post 1st chemo, i cant sleep any suggestions? I have ativan 0.5 but doesnt seem to work. I cant believe how tired i am. Maybe i should use more ativan, i really dont want to but if could help i will.
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Hello Sistahs!
Tomorrow is the 2 year anniversary of finding our that I had breast cancer!!! Unbelievable.What a ride. I wanted to stop in and say this is all doable. Horrible but doable. It is truly amazing the stength that is with in us. Fight a good fight and take care of yourselfs. You are precious and valuable. So many people depend on us that it is easy to forget that we depend on us too. Drink bukoo water and take your stool softers before and emodioum when needed. Claritin for bone pain from nurlasta.
My thoughts and prayers are with us all.
In love and peace
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starella - I had trouble sleeping too. Just wanted to sympathize, big hug to you!0
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meglove, I am working 8-430 M-F and find it very doable, but of course depends on what you do. I have my own office so I can close my door and keep annoying people out of here, I can also get up and walk around or sit in here and do paperwork. I don't think I could be doing any career that counted on me being friendly and upbeat but that is true even outside of chemo lol. I go on Wednesday afternoon (for chemo) as late as possible so I can work the partial day and with only one treatment down I made it through with Monday being my worst day. Could be that changes with more treatments but so far so good. I have about 1/2 hour drive one way. Good luck, I find working makes me feel better than lying around. Or I guess I feel the same, I can just put my attention elsewhere.
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Thanks Bold~
You were one of the first ones that calmed me down when I was diagnosed...
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elaineg, thank very much for the information. You are a strong lady. I am thinking to go on Tues, may take Friday off if needed as Jag suggested. See if you can get treatment on Tues so your worst day would be Sunday. Good luck on your next infusion.
I also read about Tamoxifen and Her2+. worried what to do.
Hang in there everybody!!
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Starella - call your onc if you can't sleep. They can prescribe you something. Mine gave me 3 different nausea meds at the start, and one was also for anxiety and insomnia. The onc should be able to help you with any side effects.
Just checking in with y'all. It's good to see this board so active and supportive, but not good that any of us has a reason to be here. I finished my last TCH 3 months ago. I restarted herceptin last week, after skipping two. My ejection fraction came back up! As for other "on this side of it" news: my hair is about 3/8 of an inch long. My nails never fell off. They had darkening at times during chemo, and right after chemo, they released from the nail bed about halfway to the cuticle (leaving an extra large white area at the end). It scared me, but they hung in there. They still have some very thin patches, in stripes across them. I'm sure those will be fun as they grow out. Everything tastes like it should now. Energy is up, and overall I feel normal. I started rads yesterday. Moving along. We all take it one step at a time.
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Starella when did your taste buds change? I've done 2 tx and have had no change. I'm hoping to be one of the lucky ones granted I have some neuropathy which is less common that taste changes. Did your eyebrows fall out? So far I still have mine.0
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Does anyone else have heaviness in the arms? My forearms feel like they have heavy weights on them.
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Sounds like lymphedema.
From: http://www.stepup-speakout.org/What_ is _Lymphedema.htm
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Please call your doctor if you notice the following symptoms as they may indicate an early onset of lymphedema:• Your affected arm, hand, or breast feels full or heavy.
• Skin in your affected arm or body side feels tight or firm.
• Swelling in the affected body side (including breast, hand, fingers, elbow, shoulder, neck, breast, or chest area).
• Less movement or flexibility in your affected hand, fingers, wrist or arm.0 -
Lago - thank you - its both arms and exactly the same on each side. It isn't swollen, it is more of a weakness or ache/heaviness. I didn't have any surgery except port placement on the left and I don't *think* ports that cause LE.0
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You may still be retaining fluid although I found my fluid retention was more my legs and stomach. All of the chemo we're on can cause fluid retention as well a Herceptin.
No I wouldn't think port placement would cause that.
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lago - I will ask the nurse about it then. Is the numbness in your heel going away?
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It's better but not gone.
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lago, my taste buds are gone, my hair is going, im sad, no energy...10 days post 1st chemo, maybe the "T" is too strong for me..i have four different types of sleep aids, i got three hours from ambien last night thank God how do you control the intestinal issues? im not sure i want to take alot of immodium because it cause cramping, any ideas?0
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Starella, I'm so sorry you are having all these issue the first time out. Do not let your diarahea get out of control. According to the binder I was given:
Call your doctor if:
• Lose more than 5 pounds or more after diarrhea starts
• Have new abdomincal pain or cramps for 2 days or more
• Do not pee for 12 hours or more
• Are unable to drink liquids for 24 hours
• Have a fever or 101 or higherSuggestions to help limit diarrhea:
• Try diet of clear liquids (water, broth, apple juice
• avoid milk or milk products (inclulding ice cream)
• Eat small frequent meals
• Eat foods or drinks rich in potassium such as bananas, apricots, potatoes and sports drinks
• Try eating small amounts of low fiber foods that are easy to digest
• Aviod caffeine, carbonated drinks, milk, alcohol
• Avoid greasy, fried or spicy food
• Take Imodium as directedLow Fiber Foods:
Main Meals
• skinnless chicken or turkey
• cooked refined cereals
• cottage cheese
• eggs
• fish
• noodles
• potatoes with out skin, baked or mashed
• white bread
• white riceFruits & veggies
• asparagus
• bananas
• clear fruit juice
• vegtable juicesnacks
• gelatin
• saltine crackers
• sherbet or sorbet
• yougurt (plain or vanilla)0 -
Starella -
I had horrific diarrhea after the first TCH, too. Turned out the dose was too high and it effected my liver enzymes. Definitely call your onc - When I went back for my herceptin week 2, I couldn't do a treatment. They gave me fluids because I was dehydrated, and potassium because that, too was low. They ended up reducing my Taxotere and Carboplatin by 25%, and I did much better. He also wrote me a prescription for Lomotil to alternate with Immodium if I needed it. Turned out, I only needed immodium a couple of times after TCH #2.
Onc. also told me that if I still had trouble tolerating Taxotere, they could give it weekly in smaller doses rather than every three weeks. Said that theraputic dose is generally calculated by height and weight, but even then some people have to have adjustments made.
Again, definitely call. Don't think that is "just your normal" because it's probably not. And feel better!
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thank you....will email my onc now since all this started i have lost 15lbs0
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starella - 15 pounds since your chemo? Good to call and get some help. Take care!!0
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meglove - I'm working full time, except when I feel like crud - which now seems to be from Day 3 to Day 12. I'm going in for treatment #4 this Friday. My job is willing to be flexible and I call in when I can't make it. I'm working on pulling together work I can do if I stay home.
I'm very interested in the discussion to do Tamoxifen or not, and/or AI.
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taranebraska not sure if Tamoxifen is the best for HER2+. I read somewhere that those of us that are HER2+ and ER+/PR+ are not highly ER+/PR+ and sometimes we don't metabolize it well. I know I'm only 30% ER+ and 5%PR+. I'm going on Armidex (my onc is assuming my chemopause will be perminent. Friday make my period 3 weeks late… and I'm never later). You might want to ask about it.
There was a discussion about if this hormone therapy is worth it. I'm not looking forward to the SE but the more a read from reliable sources for me I would be nuts not to go on it. Especially since I was in a grey area for radiation and based on my treatment I'm not doing it. Granted I am a higher stage but I don't know how the Hodgkins will be a factor as well.
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Lago- Not sure if you got an answer from doc yet on your tongue. I ended up with thrush after tx #1. When I called the nurse over the weekend she said what I was explaining was a normal SE of chemo and basically I needed to deal with it! Said to use mouthwash with out alcohol, etc. Thankfully I go in weekly for Herceptin and showed my infusion nurse my tongue and instantly knew I had thrush. I suffered for 4 days with it. It gets worse FAST. It also clears up fast with anti fungal med. I ended up getting an IV dose before Herceptin and then took a pill for 5-7 days, can't remember exactly. I also got 2 refills for it, because once you get it you are susceptible to getting it again. Hope this helps...hang in there.0
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are the se from the chemo treatments about the same?
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Jag: My onc forwarded the message to nurse Ratched. She said she didn't think it was thrush and if it got worse to send another picture. It started to get a little bumpy by that point but I refuse to deal with NR. What I did was eat some yogurt then sprinkle some acidophilus powder from some capsules I have in the fridge on it. Today it's gone.
The trick is to catch these things early. I wasn't going to wait 24 hours till it got out of hand. Who knows maybe it wasn't thrush but what I did seemed to make it go away.
20 years ago I had a chronic yeast infection problem for about a year. I know all the home remedies. I always have the acidophilus capsules in my fridge. I also ended up with a yeast infection from the antibiotics after surgery. Used those same capsules you know where for 3 days and infection was gone.
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Starella some of the SE are similar and some are different. Click on a drug and see the SE here: http://www.breastcancer.org/treatment/druglist/ Granted not all SE are listed but this should give you a good idea.
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