Taxotere, Carboplatin and Herceptin
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yensmiles - I just darkened my brows with a colored brow gel, like mascara, made by Anastasia - it comes in several colors, very easy to use. They also make a set of brow stencils with powder, Japonesque and Too Faced also make similar sets - if you are not used to a brow pencil the stencils might also be something you could use, should you need them.
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Most of my hair fell out after round 1, but what is left is growing back. I finished round 4 and still have my eyelashes, but my right eyebrow is falling out. Left one is hanging on!
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Just had round 1 of tch. Very weak nauseous had shooting head pains but slightly better on day 3. I have her2+ but my tumor was only 1 cm and had not spread to lymph nodes and they 'got it all' so I am wondering why I am being subjected to such a harsh regimen. Oncologist says 3 months of this, then 3 months of somerhing else and all this will go on for uo to a year, followed by radiation themn some anticancer pill for 5 years thereafter. Does this fit anyone else's description?
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blownaway - you are receiving chemo and Herceptin because of the aggressiveness of Her2+ cancer. There is no way for anyone to know whether they "got it all" during your surgery. Surgery is done to remove the primary tumor, but systemic treatment like chemo and hormonal therapy (the 5-year pill) are to treat any errant cells that may have escaped out into your body. Cancer can spread even if your lymph nodes are negative. You will receive several months of TCH - 4 or 6 treatments depending on your oncologist's assessment. You will continue on Herceptin every three weeks after you finish the chemo regimen, but several weeks after you finish the TCH portion you will start radiation. You will receive Herceptin during that time. Your oncologist will start your hormonal therapy either after chemo and while you are doing rads and Herceptin, or will wait for rads to be done, and then start you. The Herceptin is done a year after you started the TCH, so June/July of 2015, but most people do not feel ill during the Herceptin only portion of treatment - it is not chemo, just given by infusion. This is the same treatment everyone on this thread had - give or take the need for radiation - some of us did not require it.
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Question for you SpecialK - as you have been talking about hair and nails - I am curious why my nails keep growing but my hair doesn't? I keep having to trim them and just curious if you knew the answer to this. I know they are both fast growing cells and I always kind of thought that nails and hair were maybe the same kind of cells? Guess not. Anyway - maybe you know? Thing that make me go hmmmm.
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Linda - that is a very good question. All I can say is that while both are fast growing cells, and under normal circumstances seem to grow at a similar rate, the response to chemo seems different. Your hair falls completely out, but your nails don't all fall off (hopefully!) so I think how each reacts must differ. Fwiw my nails grew all during chemo and Herceptin.
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The research I did when deciding whether to do cold caps or not revealed risk of scalp metastasis from breast cancer is less than 1%. It was a risk I decided I was willing to take in order to keep my hair, but for many, this risk plus the cost of the caps and the cold, stress involved with getting and using the caps,etc., is not worth it to them. Obviously, it is a very personal decision.
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dance - I had read that stat before and it always makes me wonder why so many oncs oppose cold caps when the hair loss is so devastating to so many women. Maybe they are just not familiar with them, or have not looked into their use?
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Does anyone who is experiencing hot flashes have any idea how long these could last? I started getting them about a month ago, around my 3rd infusion. I haven't had a period since I started chemo in April. My MO says I have a 50-50 chance of menstruation returning and going through menopause all over again.
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I think you are 100% correct SpecialK. My specific theories as to why many onc's oppose them:
1) Cold caps in the past did NOT work. So I suspect many onc's likely just assume you are chasing fairy dust if you want to try them. My onc did. He allowed me to use them but told me "My dear, you WILL lose your hair." He was completely floored that they worked for me. It was great to prove him wrong.
2) I suspect many are not up on the latest research and therefore not only do they think the caps don't work (as above) but also they over-estimate the risk of scalp mets.
3) The caps are really expensive so they probably don't want to encourage patients to pursue them, since it may not be a realistic option available to many.
4) You need extra space in the infusion room for your caps if you are using coolers to keep them cold. And there is some coordination needed with timing of the start of the infusion with the nurses (not much, but some). Some onc's may not be willing to make these few extra accommodations, so they don't promote cold caps.
5) some women on certain regimens (like adriamycin) tend to not be as successful with cold caps. I would suspect oncs don't want to be responsible for encouraging cold cap use if they aren't 100% sure if will work for all patients.
6) Onc's don't feel how devastating hair loss can be since they never really have to face it themselves (unless, of course, they have been through chemo themselves). So the motivation to investigate it for their patients is not a high priority for them. Their focus is on saving our lives (which of course it should be)...but IMO we should also be looking holistically at the losses we face in association with cancer treatments.
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dance - I think what you laid out is spot on. I had also seen that those on Adriamycin seem to be less successful, which has to be disappointing if patients have gone to the trouble and expense of attempting cold caps. It may also be that those docs who use taxanes (TC vs ACT) less frequently as their primary regimen don't realize that they have a better track record with cold caps. I know that I was the only one icing my feet and hands in my infusion room, but I was supported in that choice by both the onc and nurses, although the nurses were skeptics. I think cold caps are something that should be discussed prior to chemo and the counseled choice should be ours to make. As far as the scalp mets risk, to me it is no greater than the risk of any of our treatments being ineffective, so why not offer it, particularly in light of the risk of permanent hair loss with Taxotere. Then again, a lot of oncs seem to gloss over that too.
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specialK, agree with you 100% on all counts! The risk (albeit tiny) of permanent hair loss was what pushed me over the edge to pursue cold caps. I so wish it was reimbursed better (at all? LOL. A few women have received some reimbursement after jumping through multiple hoops.) by insurance, so that more women who are interested in it could actually pursue it.
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Ever forward, I've been wondering about the hot flashes too. I'm post menopause, but now its like going through it all over again.
My onc has the shiniest, most perfectly shaped completely bald head. He looks great in it, actually couldn't picture him with hair. But it is kind of awkward complaining about hair loss in front of him, lol.
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The hair on my head that didn't fall out (about 1/3) has been growing, even after I buzz cut everything after round 1. So now I look like a sickly Chia Pet! I hope the rest of my hair does't wait too long to grow back.
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SpecialK - Thank you so much for the response. All Im seeing on this board is hair concerns. Ive never had great hair and will probably look better in a wig anyway. I just would like to know about the nausea, headaches and general weakness. How long does it last after TCH treatment for most people. I had the infusion Thursday night and was very sick Fri/Sat, slightly better on Sunday and back at work Monday but still "hungover". Promise he Herceptin alone is better?
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blownaway - I actually would expect your subsequent infusions with chemo to be better. Many of us had a tough time on infusion number 1, but did better on the next few, some had some issues with cumulative fatigue on the last few. I had a very bad headache on my first infusion, but that did not happen again, and this is pretty common. You also learn a it as you go along in terms of what foods cause trouble, how your digestive side effects go, etc. If you are experiencing nausea you need to speak to your oncologist about which drugs have been prescribed. My first line at-home anti-nausea drug was Zofran, it did not stop my nausea and it compounded my already wicked headache, if you are having headaches you might want to avoid it as headache is a side effect of the drug itself. I switched to Compazine and did great - no more nausea or headache. I promise Herceptin alone will be easier! Hope you are feeling better soon! If you have any specific questions, please do not hesitate to ask - there are a lot of us on this thread who have been done for a while and can help you.
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My nausea drugs are Ondansetron HCL 8 mg and Prochlorperazine 10 mg. They dont seem to do the job. I went to work yesterday (day 4)but had to lie down at around 1:30 so that I could drive myself home early. Today I stopped at CVS and bought Seabands and am being more carefull about taking my Tylenol and pepsid before things go downhill. Also eating a few bites every 2 hours or so. I lost 6 pounds since Thursday. Wonder if Hollywood would buy into this diet?
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For me it was really difficult to work on chemo. I missed at least a week with each of the first two rounds. I teach so I'm off for the summer, making this much easier. I'll finish one week before school starts. What a great.summer vacation.
The "chemo diet" has its ups and.downs. I lose at least 8 pounds the first 10 days, then gain it back during the next ten when I eat everything in sight trying to get rid of the bad taste in my mouth.
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blownaway - odansetron is Zofran. It may be partially responsible for the headache you had. Ask your onc for another anti-nausea med. If you are getting a Neulasta injection the day after chemo you might ask for more IV fluids with extra decadron to help with your nausea. Are you getting Pepcid IV before your chemo? If not, maybe you should. You definitely need to discuss all of this with your onc.
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Blownaway - I had Emend in my infusion every time to prevent nausea. I also had Decadron (oral steriods) twice a day - the day before, the day of & the day after. Never had any nausea. I didn't realize just how bad the weakness & exhaustion were until my son came this week and was blown away about the improvement. I'm 6 months PFC, but then I had rads. When you live w/it every day, it seems like forever.
I had TCH & Perjeta on Wednesday and was fine Thursday & Friday - probably because of the steroids. I spent the weekends in bed and was very grateful that I'm retired and didn't have to work. For two out of every 3 weeks I had horrible diarrhea, so I can relate to the "Hollywood Diet". I lost 60 lbs over 9 months - and really 10 would have been enough. I got an extra liter of fluids w/every infusion and went in for another liter 1/2 between. I didn't get my taste back between infusions like so do & most things tasted horrible for 6 months.
Some of the side effects are less if the various infusions are lengthened. I'm on Herceptin alone now and if the infusion is extended to 90 minutes, all I have is some joint & knee aches & a mild headache & sore throat for a day or two. I do continue to insist on a liter of saline w/the drug, and those two can run in tandem.
Are you having Neulasta shots 24 hours after? That brings another batch of issues. When you get a chance, if you'll fill in your personal info we'll all be better able to understand your concerns. Where are you having treatment? I'm in Houston too - MO & chemo at Baylor, surgery at Methodist.
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Blownaway,
I am 18 months out of chemo now but just wanted to share my experience. I hated steroids so after my first round I had a half dose of steroids the day before, full IV dose day of chemo and 1/2 dose the day after. Not sure if I got SO sick because I did this or not. But, I had horrific nausea starting middle of the night Saturday (chemo was Thursday, neulasta was Friday). I would wake up early Sunday morning around 4 AM vomiting, diaherrea, pounding headaches and the worst body aches. Felt like I had been hit by a truck.
After the first round we came up with a plan. Saturday night my husband, bless his heart, would set the alarm and give me nausea meds starting at 2 AM along with pain meds so that it wouldn't be quite so severe when I woke around 4 or 5. I had such a hard time eating and taking fluids that whole week after chemo that what they found was I was profoundly dehydrated so I went to a walk-in clinic every Sunday morning and they had a standing order to give me IV nausea meds and pain meds and usually two bags of fluids. I spent most of the morning there. It would perk me up some and then the next four days were pretty bad. I HATED Zofran for nausea so took compazine and lorazepam for that, sipped ginger ale and by my fourth infusion was going in again the Tuesday following chemo also for IV fluids and nausea meds. After the first week I would rebound fairly nicely, could hike and take good walks each day until the next round two weeks later.
Just watch out for dehyrdration. I know they say hydrate, hydrate, hydrate - but I just couldn't those 3 to 5 days after chemo. All fluids tasted like metal, made me vomit and I hated drinking anything. Eating was actually easier than drinking so I would at least try popsicles or "foods" that would provide me some hydration.
Hope you do okay.
Julieho
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Blownaway,
H by itself is, dare I say, wonderful. I have had my second H only with no side effects. I think they give you chemo with it first so you appreciate the H. LOL
Hope you feel better.
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Ddgm - LOL. Great reasoning.
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Ddgm, this is wondetful news. I can't wait to get to the H only. I still have to get through 3 more TC. Everyone calls this "doeable" but I'm not feeling this yet.
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Debiann - lol! We all say its doable after we're done - in the middle of it none of us were sure.
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Thanks for that perspective specialk. Providing there are no delays, its 6weeks till my last TC tx, plus another 2 weeks for the worst of the side effects to diminish, then maybe I can consider it "doable".
I'm still struggling with the surgery decision. Not doing another lump for sure, but change my mind hourly as to a uni or bi mx, implants, diep or no recon at all. They all have pros and cons, but none of them are standing out as the right choice for me. Seeing the BS in two weeks, hoping she can help. Anyone else struggle this much with the decisions?
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Debiann
Hi. I sort of wish I spent more time struggling with the surgical choices. Oncology weighed in right away with a vote to have a BMX vs UMX or lumpectomy.
I had surgery just three weeks after diagnosis and both my team in Vermont and my second opinion team in Boston encouraged BMX mostly due to my family history, high grade and HER2 status.
What I wish I explored more were reconstruction options. I knew I wanted reconstruction but quickly went with TE to implants. I never was told about DIEP, but they don't do that here in Vt.
Just speaking for myself I would not do implants again. I did have post op infections so had the left done three times and throughout chemo had no thing on that side. But I am seriously considering the DIEP later this year. My implants are small but they are so hard and uncomfortable, I hate having my pectoral muscle stretched tight over my implants. I have spent a lot of time on the DIEP board and even though it is a big surgery it sounds so much better. Soft, natural feeling breast, over the muscle.
I would definitely choose that surgery if I had to do it over again although that would have meant I had to go out of state for the surgery.
But having given you my experience I strongly believe that these choices are all quite personal. Many are pleased they chose implants. Many are pleased they did not do reconstruction. There is not a right answer and there are many choices.
I wish you the best in whatever you decide.
Take care,
Julieho
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Hello Ladies, today is my last herceptin . how did you feel on your last one? Happy or nervous?
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Lol....You are so right SpecialK about chemo being doable after we are done. That word irked me while I was going thru treatment. My Mom and I laugh now whenever we say that word. Sometimes I just say it to make myself laugh. My last treatment was actually my easiest Debiann, I hope the same for you.
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lovewins - my last one was my easiest also - kept waiting for the normal SE I had on the other 5 tx and they never happened. So, clearly, once I had things mastered they failed to materialize, lol! Story of my life ......
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