Taxotere, Carboplatin and Herceptin
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I believe the initial studies did herceptin weekly, then later they changed it to every 3 weeks and found it was just as effective (and easier for scheduling, controlled costs, etc., etc.). I chose to do my herceptin weekly. I preferred getting a smaller dose weekly, as I tend to have bad side effects to drugs. I don't think other than that that there is a big difference in terms of effectiveness. It will be interesting to hear if your doc thinks otherwise.
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april25,
My nails started lifting about 5 weeks after chemo ended. It seemed for me like the side effects took longer to get over with each treatment.
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I think most of us have the Herceptin every 3 weeks with our taxotere/carbo. You can reduce the side effects by slowing the infusion. Mine started at 60 with the TCHP, which was OK. Then they wanted to move it to 30 minutes for the balance of the 17 doses. I had them increase it to 90 minutes and had very few SEs.
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Welcome SpriteB!!
I also had it every three weeks. Best wishes to you!
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I had the 3 week schedule also.0 -
Thank you all! I will ask the MO next time why some do it every week in the beginning. I got my port placed this morning and treatment will start next Thursday. I'm so glad I found this site.
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I have a question for a colleague/friend of mine who is not on this site. She is getting Taxotere/Carbo/Herceptin/Perjeta. Did her 6 TCHP, and now the doc says she needs an ADDITIONAL FULL YEAR of the H/P part, every three weeks.
I have always only heard of getting the H or HP up until a full year from the beginning (including chemo) - 17 or 18 infusions, not a year AFTER the chemo portion is done, which would be 23 or 24.
She asked about it and he insisted that is the protocol for her. I have been on this board for six years and never heard of that. Have things changed since back when I went through this, or is this unusual?
Thank you so much for your answers and feedback. I am worried about her a bit.0 -
amy - I have not heard of H&P for anything other than the balance of the year - unless stage IV. Even the P for the balance of the year is a bit unusual - having both drugs for an extended period brings up the potential for GI and cardio SE.
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Amyls - So many people talk about Herceptin for year, but really mean the balance of the year. Maybe that's the confusion? But I wouldn't have minded 24 doses. I'm ER/PR negative & there are not really other ongoing options for HER2+. My MO wanted me to continue with both H&P. I think it depends on the degree of positive HER2, the size of the tumor, was there a pCR, etc. My heart was doing OK but I don't think Perjeta effects that, only the H. All the docs swore that P doesn't cause or aggravate neuropathy and that it's only listed on their site in case it might happen to someone, somewhere, sometime. Since I already had serious neuropathy from the Tax & Carbo and since I have been lucky enough to be that 'someone' who's gotten all the things "no one ever gets", I opted out of continuing Perjeta. Now I think I'm sorry since it was available to me & as Special says, it usually isn't offered. Oh well we make the best decisions we can as we go along. Let us know what your friend decides.
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Hi TCHers
Just finished up round #3 of 6. I have to say I'm getting a bit nervous watching my blood counts drop a little each time, my RBC is down below the average now and I'm really not wanting to delay my treatment (you know, you just want it to be done!). Did anyone experience levels to low that they wouldn't do your next infusion? If so how long do I have to wait to try again? Doing pretty good on side effects, except the first few days I'm constipated then the next 4-10 diarrah to the extreme...yuck!! 0 -
Hi KathMcD. My RBCs dropped below normal after my fourth infusion and never came back to normal ranges for the remainder of my infusions. My hemoglobin was low almost the entire time and is still just barely below normal. My platelets dropped below normal after my second infusion and stayed below normal for the duration, but have since bounced back. I never had a treatment delayed. I'm sure it varies from person to person, but those were my experiences.
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Kath: My MO had me take a Neulasta shot 24 hours after each infusion. This kept my blood work up just enough to continue.
Edited to say - platelets & Hemoglobin were below normal but not below their "cut off" point to stop chemo. It took me 6 months for blood work to approach normal again.
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I wonder if some treatment centers have you come weekly for the Herceptin during chemo because of time constrictions. When I went weekly the Herceptin was only 30 minutes, but when it went to every third week, after chemo, the infusion lasted 90 minutes. Adding that extra 60 minutes to an already really long chemo day, would have been exhausting.
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Some get herceptin over 90 minutes, but generally because they are having a problem with it. I think the typical infusion time is 30 minutes, every three weeks. Is that what others have had?
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Debiann - I believe you're correct that the centers want 30 minutes when it's Herceptin alone. There are a lot of people on these threads who have opted to push for 60 or 90 minutes when it's H only and have pretty much eliminated their side effects, as I did.
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Mine was 90 min from Day 1. Never had any trouble at all.
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Mine was 90 minutes when given with chemo every three weeks, and it was a very long day.The first H only they infused over 30 mins. I had horrible hip and leg pain, so every subsequent infusion was done over 90 minutes.
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Mine are doneover 60 minutes.
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My herceptin was 90 minutes the first round and 30 minutes beginning round 2, even with the other chemo drugs. My MO believes in spending as little time as possible at the infusion center.
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I think most centers want to do the Herceptin as quick as possible and as infrequently as possible. It's efficient for them and for the patient and more cost effective.
If you have trouble with that due to side effects, then you can request it to be longer and/or more frequently (once a week) if necessary. I don't think it affects treatment effectiveness either way. Just treatment efficiency and side effects, if you are prone to them.
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I had my Herceptin infusions every week for the duration of a year. My onc said he felt the every 3 week dose would be too hard on me. My EF from the echos kept going lower to where it was close to where I couldn't do Herceptin anymore. But doing the weekly dose made it possible to continue the Herceptin. I did have my chemo every 3 weeks. I had every bad side effect of the chemo (carboplatin and taxotere). There is a cumulative effect so each round of chemo was harder and harder for me. My blood counts kept going lower after each round and bottomed out after my 6th and thankfully final chemo. I, too worried about losing my hair. Sometimes thinking about it is actually worse than when it does happen.
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Hopeful - my scenario was just like yours. Hence, my decision to do weekly Herceptin. I was afraid since I was so sensitive to chemo that surely I'd develop heart issues. So I chose to go weekly, "just in case" that would be better for me. Even so I started to see a decline in EF and decided to stop Herceptin at 6 months. I have a lower risk cancer (very small), so I felt like cutting treatment short was an acceptable risk for me to take. If my cancer had been larger I would have continued Herceptin for sure.
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Mine gave the herceptin over 30 minutes, weekly for the first 18 weeks, then it went to every third week, and they took 90 minutes to infuse it. I'm pretty sure that is still their same protocol.
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I am getting the hercepton every week so far, had 2 chemosynthesis and the hercepton infusion is for about 30 minutes. I had horrible side effects first time round, this time they seem to be a bit less but some difference, the fatigue was not as bad, but I think that comes from the better hydration, in my humble opinion. I was given an option of the hercepton of 1 or 3 weeks, but seems that 1 a weeks works so far for now, I will have to see if strength changes if I go to 3 weeks apart?
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I asked my oncologist the question about how Herceptin doses are decided and she said that generally 12 are given in addition to the ones given as part of chemotherapy. That will total 18 for me. I had to stop for a number of weeks last fall after an echocardiogram showed possible heart damage. After tests and a visit to a specialist, I was cleared to start Herceptin again.
It is good to know others are dealing with issues getting your strength back. I have so little stamina compared to this time last year. I lost a little weight during chemo ( a good thing as I am overweight), but several weeks after that last chemo, food started to taste good again and the big D cleared up and I put that weight right back where it came from!
My hair is coming in slowly.....mostly white!.......and curly. I lost all my toenails but they are back except the pesky big toes. No spring pedicure yet:(
Minivan......I had the eye situation you describe and did see an opthamologist to make certain my tear ducts were open. She blamed Taxotere for my problems, made sure my tear ducts were open, and suggested lubricationg eye drops when my vision is fuzzy, etc. it was about 2 1/2 months after chemo ended that one day I noticed my eyes were back to normal! Neuropathy of my feet and fingers has also slowly gotten better. Hang in there!
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CassieCat and Kthielen -- Thanks for the info on when nail problems started...
*sigh* I'm only just in my 5th cycle, so I can still get the lovely nail lifting in future. Oh, joy!
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update on the nails.....
I finished chemo on May 28th, they were all lifted almost to cuticle by July 1st. They had fully grown out pretty much up until last week when they were really sore again. I just took my nail polish off today and yes they are all(except for the thumbs) lifted AGAIN about half way down my nail bed. What the heck!! Every time I think I am feeling better something happens:/
At least they aren't all black and nasty looking just whitish/yellowish....back to wearing nail polish all the time
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Oh dear...I'm so sorry your nails are lifting again.
That is just completely unfair.I'd like to polish mine so I wouldn't have to see them, but I'm worried about getting polish or polish remover under the nails.
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Kthielen -- really? You're still getting nail lifting so long after chemo (9 months)!??? That's terrible. Do you think some of the long-term therapies are contributing to that? .. Ah, well. I hope the lifting stops and the re-growing goes quickly for you.
CassieCat -- I hope your nails improve soon, too. ...I'd worry about getting the remover underneath, too! So far, no lifting here, but as I said, I'm only on round 5. BUT I just discovered I've got nerve damage/neuropathy. It's not painful, so I wasn't sure--but the peroneal nerve in my leg is blocked, so now I have a numb upper-foot and drop-foot! gah!
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I know it's crazy!! I hope they don't lift more than they are now. They don't hurt anymore so hoping it's done!
April, sorry to here about your drop foot:(
Cancer sucks!!
Kathy
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