Taxotere, Carboplatin and Herceptin
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LOL moonflower...not sure I like this scenic route...especially since I'm confined to my cabin! Ba-ha-ha! Thank you for your words of encouragement and understanding. Oh, and yeah...that's one of the reasons we held off on the antibiotics. That and the possibility of causing c-diff if we blast my system with them. There is a chance that perhaps my nadir started early...and maybe, just maybe my ANC won't be lower tomorrow. However, peak time for low nadir is day 10, which would be either tomorrow or Friday...depending on how you count (do you count chemo day?).
Oh, here is a great article in case anyone is interesting in this topic:
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UMMM....since it is too late to call the MO's office...am I supposed to take the steroids before the Herceptin only infusion?? I have my H only tomorrow morning....oops!!!!!
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Had my 4th TCH today. So far so good-my blood work was great. I have 2 more to go. I will have an echo friday to see if herceptin has had an effect on my baseline.. I do have a herceptin side effect of a runny nose with some sneezing.. No bad at all.. I have gained 10 pounds from the steroids,seems all I want to do is eat and snack..I am going to try to count calories so weight gain does not continue.. After chemo today I went to Kohls-bought a couple new shirts and 2 new pair of capris,when got home I went for a walk around the block. Hope my good luck continues.
Hugs Eileen
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dougieswife I don't know what your onc plans for you. In my case I had herceptin and chemo together. Once I ended chemo I was off all other meds including steriods although still doing Herceptin.
DanceT I lost track here. Now that you have an issue can't you get Nuelasta?
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Dougieswife, never too late to call, there is an after hour number to call, so use it. However, the steroids are for the big tx, I had to call my first time! LOL
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Lago, I can get it after my next chemo. I could get it now (onc said we could if I wanted it, but recommended we wait and see how my numbers are tomorrow first). I think the jury is out on whether it helps once you've already become severely neutropenic. I've read some say it's benefit is more prophylactic than therapeutic. That is all I know. I guess that should be the next thing I read up on.
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I would think it would be less costly to get 6 nuelasta shots then a hospital stay. I sure hope it isn't just prophylactic. At least you're young so you have that going for you.
BTW I too wanted to quit after #4. So many of us do. I still did all 6. Hard to believe almost a year ago (April 17th) I went topless for the first time… April 18th had it colored. I feel so normal now.
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It's absolutely less costly than a hospital stay! I don't think this is about money (hard for me to believe that would be my onc's motivation, and I'm sure he could sell this to my insurance company at this point). I'm reading!!! So confused!
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dougieswife - I didn't have steroids for the H only infusions.
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DanceT I doubt money is your oncs motivation as well but when looking at what is standard care cost/effect/need is all part of the equation. I mean we know nuelasta works… I'm not sure who these "gods who decide what standard care" are.0
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dougieswife - no steroids for herceptin only here either - steroids were for the taxotere I think.0
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Eileen -
So glad to hear that your 4th chemo went well! Keep up the good work - you're almost to the finish line!!0 -
Thanks Fran. Hope your Herceptin is side effect free... Any hair growth yet?? One more question,did you lose your eyebrows and eyelashes?? Looks like a nice day today,hope you get out and enjoy it. Hugs Eileen
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DanceT: I truly appreciate your research into all of these items. I too HAD a small tumor and questioned all of the treatment that was being advised. It appears that there are still many holes in the knowledge-base of BC. I'm just trying to do my best to prevent going through this again. My best to you.0
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Had 2nd Herceptin only infusion on Tuesday - feeling fine with no side effects. And YES, my hair is growing! It's pretty fuzzy and from across the room it looks like I have a 5 o'clock shadow. DH thinks I can go without a hat next week. Um, no, I'm not that brave, but maybe in another month.
My eyebrows are pretty much gone. Have about half of my eyelashes on upper lid and none on the lower. But it's not too noticeable when wearing glasses and a hat.
Best wishes to everyone!0 -
Eileen - so glad to hear you are doing well...I knew you could do it!
I had my first Herceptin only last Thursday, no steroids, no side effects. It was a wonderful change to leave that chair and not have to dread the next week! I had my consultation with my RO today and go in for a CT and planning session on Monday. I will have 35 tx, which includes 7 boosts. I feel like I am ready for this and that after chemo, I can do anything!
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Kelloggs- I found that it took my subconscious a few times of going in for H-only before it sunk in that it wasn't going to be like chemo anymore. And I would encourage you to join the rads group that starts the month you are starting. Lots of good tips and support on those monthly threads.
For me, rads was an absolute breeze. No SEs at all save a bit of tanning/redness by the end. I used Calendula gel, but not religiously, as I would always forget. Hope you have an easy time too.
Congrats on starting Herceptin only. it's all an easy downhill slide from this point!
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tc9876 - thank you!!!
Congrats to all of you on the Herceptin only side...you are inspiring me to see the light at the end of the tunnel!
Rads was hard on me mentally, but I did GREAT physically! I used the calendula cream, too, and it worked great for me.
OK, so my numbers are in...down FURTHER! They were 500 Tuesday, only 284 today!!! YIKES! I was started on Cipro today prophylactically and Neupogen. I feel such a sense of relief to be starting these drugs. Oh, and yes, I did the Claritin and will continue it for a week. I printed out the trial on Claritin and showed it to my doc...he had never heard of it, but was really impressed and encouraged me to go for it. I've got some Demerol left over from my lung puncture should I need it for the pain. Go back in tomorrow for another shot, and will give myself shots over the weekend. Will be retested next week. Fingers crossed! My onc is definitely concerned about how low my numbers have dropped and definitely will be giving my Neupogen prophylactically next time.
So, the more I read, the more I question the national guidelines for no Neupogen the first time. If you look at the Taxotere drug site, it says:
Neutropenia (<2,000 neutrophils/mm3) occurs in virtually all patients given 60-100 mg/m2 of Taxotere® and grade 4 neutropenia (<500 cells/mm3) occurs in 85% of patients given 100 mg/m2 and 75% of patients given 60 mg/m2
I know that the TCH regimen is 75 mg/m2 for the Tax component. So that means between 75% to 85% of patients given TCH will get Grade IV neutropenia from just the Tax alone. Add onto that the hit from Carbo and Herceptin, and the % of patients getting Grade IV neutropenia must be huge. I know not all of them, of course, get febrile neutropenia (FN)...and that % is what the national guidelines are based upon...but...uhhhhhhhhh....why, oh why take that risk and put your patient through emotional anxiety waiting to see if they get FN??? It seems to me the risk of death from FN is higher than the risk of death from leukemia or splenic rupture from Neupogen/Neulasta...but I'll admit I haven't researched those particular numbers. All I know is I'm one scared patient, and this sure doesn't make for a patient that feels comfortable going forward with chemo (I know, I know, it'll be better with the shot). Still, how could this not affect compliance?
Rant over. BTW, I'm not mad at my onc. He was just going by national guidelines and MD Anderson's protocol, which I wanted, too.
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DanceT I totally agree. My onc is not one to prescribe/recommend anything she feels is not needed or proven. (I took the Acetyl L Carnitine any way though… I know bad but I have a feeling I would be in worse shape that just a numb heel). Yes I even ate sushi and went to the gym on chemo. That wouldn't have happened if not for nuelasta. I didn't get shingles/colds till after I stopped chemo/nuelasta but on Herceptin only. I don't even want to think what might have happened if I didn't have the drug.0
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Thanks lago!!! It sure is different to think about maybe getting severe neutropenia ("oh, i'll deal"), than actually how scary it is once you get it!!!
Ok now...I have had very slight twinges of pain in the left middle ribs (uh, where the spleen is...). Probably like 3 or 4 twinges - not severe at all, but enough to get my attention - and only lasting a few seconds over the last hour or two. Is this a normal response of the spleen to the Neupogen (aka did any of you feel this), or is this a sign of trouble brewing? Neupogen website says to report any pain in the upper L part of stomach or tip of the L shoulder as it could be a sign of splenic rupture. Well goodness I've already been at my onc's office once and called them with another question this afternoon. I think they may already be closed, so...would you all agree it is safe to just watch it and call the emergency number if it worsens?
I swear, it's always something. On a positive note, I have no redness or itching around the injection site, so I think the Claritin is doing it's job keeping inflammation down! Or maybe it's too early to tell...
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Hi, this is my first post. I have already had my a lumpectomy and reexcision. I am suppsed to start chemo next week- TCH x6 and then Herceptin for the rest of the year. I have been reading these boards everyday for the last month. I have learned so much and I am so grateful for them. I went to have my MUGA and they said I have really bad veins. It took 4 different sticks to finally get my IV started. They recommended I ask to get a port because they had such a hard time. Origiannly my surgeon had suggested I try to use an IV for infustions because of the risks with a port and an IV is less invasive but I am thinking now I should get a port. I have an opportunity to get a port on Wed. 25th then chemo start the next day Thur 26th. Is that ok? I am concerned about healing from the surgery while having chemo. What do you guys think? Thank You, Kim0
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ladybug, My treatment is the same as yours. I am surprised they would not recommend a port if your veins are bad. Although they did recommend one for me, I did not want a port. Just wasn't up for any more surgeries. I am through with chemo and about half way through Herceptin alone, and my veins are doing fine.
SE were not much fun, but really not as bad as I thought they would be. I also used cold caps and kept my hair.
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I'm headed in for my #2 TCH today. I had my last tx three weeks ago on a Friday afternoon (immediately following port placement...otherwise I was told I would have to wait at least a week for port to heal. I also am a hard stick, and so am grateful for the port placement). Bad bone pain set in Sunday night (no OTC med would even touch it). Had Neulasta shot Monday morning (my onc says insurance automatically okays it, as it's much less costly than a hospital stay). My blood counts via the port last Friday looked great getting ready for today. I had been taking a generic Claritin and nurse said to make sure that I'm taking Claritin-D to help w/bone pain, so bought that (haven't compared ingredient list to see if there is a difference in Claritin-D and generic??). HOpefully this will help, plus I was given an Rx narcotic to take if and when bone pain kicks in. I resurrected after a hard first week and felt human again. Hair is almost out, just a few stubbles. My 16-year-old son cut and husband clippered. It actually felt good to get it off, as my hair is thick and long...getting it cut took away any scalp tenderness.
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Hey Lago - how many mg of acetyl-L did you take? I need to research more on that particular one.
Well everyone I only had a few more twinges in that same area the rest of the night. Still alive and kicking. LOL And no major pain at all...didn't even need Tylenol...is the ball about to drop (ie. could it still be coming)...or did the Claritin work wonders for me???
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Hi maginutah...and welcome! You made me curious as to to what the difference is. The difference between Claritin and Claritin D is that the D also has pseudonephrine, a decongestant. Pseudonephrine is not an antihistamine. My understanding is that the reason Claritin is theorized to decrease bone pain with neupogen/neulasta is that it decreases the associated histamine response, since claritin is an antihistamine. I can't understand how a decongestant would help further in this goal...plus it causes insomnia. I'll be curious to hear what others say. I'm taking generic claritin (loratadine, 10 mg).
What are the differences between Claritin and Claritin-D, and Allegra and Allegra-D?
And here is the clinical trial that uses Loratadine.
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ladybug I was glad I got a port. I got it the day before chemo. My port surgeon was actually trying to set up chemo for the same day but there wasn't a chair available. I have no problems with my port. I've now had it for 1 1/2 years. You'll be a little sore at first and takes getting used to but I found it not a huge issue. After the port surgery I was all dressed (and I had a BMX with nodes 5 weeks prior so still recovering from that) and waiting in the chair to talk with the surgeon. I was a little spacey from the local anesthesia but otherwise felt fine.
DanceT because I didn't have my onc's approval (my NP just said no. I don't think she even asked my onc. I was pissed at her anyway so didn't listen to her. I don't recommend people ask this way) I just took the 500mg daily. I don't like to mega dose without a doctor recommending it.
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Maginuntah....I had extreme bone pain after my first couple treatments. That is one SE that does get better. I had my bone pain BEFORE the neulasta. It is a less common DS from the chemo caused by your marrow feeling out because all of your cells are being attacked. (That's the laymans version of what my MO said).
Ladybug...I totally recommed getting a port. My MO won't do chemo without a port. You can get a lidocaine cream to put on it sobthat you don't even feel the stick. My MO wanted me to wait 2 weeks to start chemo after the port was placed to allow for healing, but I have seen ladies on here who get the port in on one day and have chemo the next. That's just my .02.0 -
Ladybug -
I got TCH x 6 and started out without a port. After #5 TCH I decided it was time for the port. ( veins were not cooperating - each infusion was more difficult than the previous one). I got my port on a Monday and had my last TCH the next day.
My port will now "be my friend" for blood draws, Herceptin until November, and upcoming MUGA scans. The port has not caused any issues so far.
Best of luck with your treatments!0 -
LOL Lago I'd be pissed by that, too. I'm taking 500 mg daily, too - just was wondering if that was enough. Oh and my onc approved all of my supplements...he didn't even ask me how much I was taking of each, though. He knows I'm a researcher, though, and probably know more about the supplements than he does (not that I know a lot, LOL! I really do need to read some more on this.). Thanks! P.S. He did say if he felt I developed any side effects that were interfering with my treatment we'd have a little talk about it. LOL He always reminds me subtly that he's willing to discuss any and all of my ideas/input, but he's the doc and has the final call.
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Thanks Amy....I'm heading to the rads thread today!
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