Taxotere, Carboplatin and Herceptin
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Kadyann, what part of Iowa? Just wondering where you dr.? I did allot of mine in Sioux Falls, they were awesome there, and my onc. comes to Spencer and she just deals with bc she said she has 300+ bc patients, she is good.
I asked about oncotype and my onc. said I was a strong her2neu and didn't need it. I am having 6 rounds of TCH then just herceptin for the remainder of the year.
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Kadyann: I, like you, have been wondering that as well. According to my Oncologist he only knows of studies for HER2 where the standard treatment was 6 rounds of TCH. I've been unable to find much on the 4 rounds. I would love for it to be only 4, especially because I've just completed 4!
As for Oncotype testing, it's useless on HER2+ cases according to my doc, since that would make the number high no matter what. Being early stage with a small tumor would normally not need chemo, but HER2 trumps everything. Bummer right?
I wish we could just take Herceptin, but again, according to docs, it has to be given with chemo and then on it's own after.
If anyone did only 4 rounds and is doing fine, please let us know!
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michcon - I also heard that they don't do the oncotype if you are HER2+ but then I read of some women here that were HER2+ and had relatively lower scores - so I was wondering if it would be useful for someone with a 2+.0
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The studies I have seen over and over again show Herceptin works much better when first given with Chemo. This is why they don't bother with the onco test. The onco test is expensive. No need adding additional unnecessary health costs.
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Lago - Have you seen any studies that compared herceptin only to herceptin and chemo? I haven't seen that yet and have always wondered. Most of the comparisons that I have seen are for chemo without herceptin and chemo with herceptin but not herceptin given alone.0
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I know this topic has gotten a bit of track so forgive me, I am just responding to the original post. I have been on the TCH chemo combination for 3 of six cycles now. I have had very little side effects. My hair did begin to fall out by week three and so I shaved it. However, I'm not sure I needed to as the rest of the fuzz has not come out and I think MAYBE I would still have some hair on my head (to stick out of a hat type of hair) if I hadn't shaved it. Being without hair is hard. But I have not lost my eyebrows or eyelashes so there are some who still do not know I have cancer and think I just have short hair under hats (I know this because I recently told some shocked moms who have seen me at the park numerous times with a hat on). I have heard that this is a very tolerable chemo and that has proven true for me. I didn't really realize I could get a clot from the port, so I will look out for these horrible symptoms. Yikes! I had a blot clot in my thigh a couple of years ago (long story) and had to be on blood thinners for a year. I was more scared of dying then than I am now being treated for Breast Cancer. I wish you the best luck in starting out your journey!
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Boy I really need to read here, I see that this original post was in 2007!!!
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Thanks for all of your responses. I am taking my treatments at the Mayo clinic in Rochester, MN and my oncologist is considered somewhat of an expert in her2+ and er+ cancers, so I was somewhat disappointed when he did not have a great explanation for the difference. I know that someone asked about node status and I had no node involvement. My doctor has said that he does feel that the herceptin is what I will benefit from the most.
IowaSue I live near Mason City. I did live in Emmetsburg in 1990-91 so I am familiar with your neck of the woods. I started out with the Cancer Center in mason city but ended up at the Mayo Clinic for a second opinion due to having a very complicated case.
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Omaz I'll have to check but I do remember reading the other day that Herceptin with chemo is more effective than without.
I did come across this:
"Perez attributed the benefit of concurrent scheduling to synergy between the taxane and trastuzumab."
sorce: http://www.breastcancer.org/treatment/targeted_therapies/new_research/20091213.jsp
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Kadyann - I asked the first onc that I saw about just doing the herceptin alone, without the chemo, and she said there hadn't been any studies. It is interesting that your onc said herceptin is what you need, that is reassuring. Its clear that chemo is much more effective in HER2+ cancer when combined with herceptin compared to using chemo alone. Probably more than you want to know!!
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Lago - Oh I am probably just fixing on some small point about the comparison group - I totally agree that chemo with herceptin is much better than chemo alone - tons of trials about this as you said. The comparison that I have not seen is herceptin alone compared to herceptin plus chemo. How effective is herceptin alone?0
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But that's what I think that quote might mean. The group that Herceptin after chemo didn't do as well. Taking Herceptin with one of the Taxanes suggests it works with Herceptin making it more effective. Stands to reason that just giving Herceptin isn't going to work better than giving Herceptin after chemo but givin Herceptin with chemo has proven to work better.
Does that make sense?
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Yes, I see your point - thanks, I must be a bit dim tonight!!
So Lago, what do you think about duration of herceptin treatment, the full year? Do you think there is any merit in the shorter schedule tested by FinHer?
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I think that Herceptin hasn't been around long enough to know how long we should be on it. I wouldn't be surprised if we didn't need to be on it for a year but at this point who knows.
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Thanks Lago!0
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hi brave sisters, has anyone had their tch reducted due to s/e?
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starella - Yes, my taxotere was reduced by 20% for 4th treatment due to neuropathy and my 5th is postponed until I can have nerve testing (EMG) done this week. Are you having trouble?0
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My onc mentioned it as a possibility when I told her about some slight neuropathy in my left hand after my 1st tx. Now it's my left heel. I'll see what she says tomorrow, tx 3.
Omaz, did your nueropathy start right away with the 1st tx?
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Lago - Yes, the day after the first treatment all my toes were tingling.0
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Oh and I had the front parts of my feet burn too but that seems to have gone away. Gee how come we are so "lucky".
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starella...I had 4 THC tx. My Taxotere dose was decreased due to the SEs (severe head and neck aches and chest pain, plus tanked red and white cell counts) following the first infusion. The MO didn't decrease it again after the 3rd tx when the allergic rash appeared, but instead increased the steroids.
And as far as Herceptin is concerned, all three of my docs, BS, MO and RO, have said that Herceptin is a miracle drug and they think it is responsible for many positive outcomes when they thought there wasn't anything more they could do. To hear that from all three...two of whom have nothing to gain by saying that since they don't prescribe those meds, makes me think it's a HUGE benefit. And I've recently read of new lab studies with Herceptin that give me even more confidence in it.
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I went to see the onc for first consultation. I have a "hot spot" at the 10th rib posteriorly from bone scan. although he said it is not unusual for that to be cancer but he still ordered a pet scan for me. Hope it is not related.
He recommend to have FEC 3 tx, then TH 3 tx. I mentioned to him to have TCH (I am in Canada) so I do not have to have period after T, he said he will discuss and research it further to see if I can be put on TCH directly after discussion my case at a conference and then a round table.
I have got a lot of information from this thread. Thanks to every one! Wish every one have your chemo done without too much SE.
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BTW my BS brought up how amazing the results with Herceptin are too.
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My ONC reduced my carboplatin as my platelets tanked Nov 5 to 75,000 -- but on Nov. 12 it was 390,000 and so I got tx#4. I'm day 3. I think I've finally decided to take care of myself. The last 3 tx's I went to work on Monday. And today i just couldn't do it. I have some important meetings this week, but I'm not up for it. I'm so thankful I've done 4 out of 6, but I'm really feeling exhausted. I WISH we could be done after 4. Last trip after 3 had too many problems, low WBC then platelets. maybe that's why I'm throwing down the gauntlet, I'm going to take care of myself earlier, rather than later.
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taranebraska, yes we need to take care of ourselves
. I also heard day 3-5 is the worst. Is that the same for you? Also, will the chemo be on the same day during a week, or we can change it if needed? I will need to drive my little one to skating class on Sunday so trying to schedule my infusion around. On which day usually our head is clear to drive? other days rather than 3-5 days? Thanks!
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Ladies - just wanted to let you know that I was honored to participate in the BCO 10th anniversary film, which debuted at the Harry Connick Jr fundraiser concert on 10/30. Here is the link if you want to see.
http://www.breastcancer.org/about_us/press_room/press_kit/stories.jsp
I'm not as active on this thread these days, but some of you old timers will remember me. For those of you currently going through TCH, keep pressing on. You CAN do it - and come out the other side to go on with your lives. I am proof of that. Finished Herceptin in April - got port out in May and never looked back. (BTW, getting the port out was the best day of the ENTIRE experience! What a relief!!!)
Any questions anyone has or if you need encouragement, feel free to send me a PM. I don't post that much, but I check in every day.
Love to all my TCH sisters.
Amy
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meglove - for me, Day 4 to 7 are hardest for me I think - that's when all the SEs are rolling full time, my sleep may get off and effect everything, too. But I have to say that the fatigue side effect is holding on longer and deeper each round, and it's really here now. It's hard to tell for me which is real phsycial fatigue and which is emotional fatigue from trying to keep my chin held up all the time.
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Tara - Are your arms and legs just heavily fatigued by the slightest effort?0
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omaz - more my legs. Should I be trying to fight it - mind over matter? I'm hoping a week off really won't hurt my system ... does rest really help us? I hear exercising helps, and I do try and get in 30 minute walk with dogs if I don't make it into the office. I'm sure that's not close to enough.
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Tara - I'm off an extra week too. I walk some but am so fatigued its more like a shuffle and I have been trying to keep up since the beginning. I just get slower and slower with no recovery. Last night I tried to ride the exercise bike and had to get off because it fatigued my legs so much.0
