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Topic: NEW 2021 HER2+ treatments 2021 for early stage breast cancer

Forum: Managing Side Effects of Breast Cancer and Its Treatment —

This is a place to discuss concerns, tips and strategies for all types of side effects from all types of medications and treatments, (chemo/rads/hormonal/targeted/pain meds/etc.

Posted on: Sep 4, 2021 07:34PM

Racheldog wrote:

I am starting a NEW post for the HER2+ triple positive gals that are truly early stage. I plan to d/c the Triple positive former posts that I had chosen to be on since that thread has gone on for 10 years! Plus the entries are getting lengthy about each other's surgeries, and too much "past" advice from participants which do not apply to approaches for Her2+ current regimens for small tumors.

I would like to start this post about smaller early stage HER2+ treatments that people have started on in 2020-2021 as drugs have changed and treatment ideas like de-escalation of Herceptin, etc. for some selected breast cancer patients.

Please jump on this new post if you have been diagnosed in 2020-2021 and what current therapies for early stage BC are being proposed for you if you are triple positive and early stage.

Dx 9/2020, IDC, Left, <1cm, Stage IA, Grade 3, ER+/PR+, HER2+ (IHC) Radiation Therapy Whole-breast Chemotherapy Other Surgery Lumpectomy: Left
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Sep 16, 2021 12:38AM Racheldog wrote:

1982M:

My early stage screen detected tumor was 8 mm and because of the Her2+ status chemo was recommended.

Your oncologist is correct that in my readings/research even small 5 mm tumors warrant chemo. Are you doing chemo now?

Dx 9/2020, IDC, Left, <1cm, Stage IA, Grade 3, ER+/PR+, HER2+ (IHC) Radiation Therapy Whole-breast Chemotherapy Other Surgery Lumpectomy: Left
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Sep 16, 2021 02:26AM SmoothOperator78 wrote:

racheldog- my oncologist suspected I would have lymph node involvement despite ultrasound and MRI saying nodes were unremarkable, so was talking about T and P as monoclonal agents before the surgery and sentinel biopsy. They took 5 nodes and apparently sliced them up so much (according to the path report) looking for any micro metastasis. There was none and so P was pulled out of discussion.

Dx 7/20/2021, IDC, Left, 1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2+ (IHC) Surgery 8/6/2021 Lumpectomy: Left; Lymph node removal: Sentinel Targeted Therapy 8/31/2021 Herceptin (trastuzumab) Chemotherapy 8/31/2021 Taxol (paclitaxel)
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Sep 23, 2021 12:17PM - edited Sep 23, 2021 12:18PM by 1982M

Racheldog:

I did start treatment yesterday. I would love to hear how other people who are getting just weekly taxol plus Herceptin are doing!

Anyone have tips for upcoming ones? Do you feel worse as they continue or pretty much the same?

Here's a copy of what I posted in the weekly taxol group with a bit of editing:

Treatment went well yesterday. I asked my husband to do all the stuff to get our kids ready in the am and I took a long bath and walked on the treadmill before treatment for about 20 min. I also walked for 15 min when I got back. That was harder since I was so tired. My med onc is pushing exercise so I've committed every day to walking. Hoping to keep it up.

It was a long day. I'm glad the next couple of times will be shorter. They gave me 10mg of dexamethasone and 25mg of Benadryl IV. I had to take oral famotidine bc we're experiencing a IV shortage right now. The Benadryl made me loopy so I struggled with the icing my hands and keeping ice in my mouth. I would forgot to put the ice in my mouth, and then forgot to put my hands in the ice packs. My feet survived though. Lol. Strangely enough they hurt in the evening- pins and needles. I can't tell if I accidentally froze them or it's the neuropathy. I wore a pair of socks, stuffed gel freezers down and put on a second pair of socks to keep them in place.

I am happy it was only 10mg dexamethasone. I'm wondering if that does is common on the weekly dose of taxol?

I'm wondering how much weight gain most ppl have gotten over the course of 12 weeks? I read most women put on weight from the steroids with weekly taxol. I'm starting out around 140lbs and 5'6 and premenopausal which I also hear is the group that gains the most (yeah me! Lol).

Yesterday my muscles in my right arm really ached during the infusion of taxol. I was pretty out of it though. I did mention it and they weren't concerned. They have to use a IV for the first two treatments since I won't get my port until the day of my third.

Last night I slept ok. I went to bed around 9:30pm with the help of melatonin (ok'd by pharmacy). I work up a few times but got back to sleep. I work up for a few hrs in the middle of the night around 3-4am but got back to sleep and up for the day at 6:50am. My face was really hot last night and is flushed this am too. I'm thinking from the Herceptin. Interestingly I did feel my lumpectomy site ache during Herceptin infusion…. Or at-least I thought I did. I was a wee bit off with the Benadryl still. Lol. I do have DCIS left in the margins they will need to remove after so might be wishful thinking it's getting cleared up. Haha.

Today I am tired. I'm working from home and works super flexible so work when I can, don't when I can't.

Dx 7/13/2021, IDC, Left, <1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2+ Surgery 8/12/2021 Lumpectomy: Left; Lymph node removal: Sentinel Dx 9/3/2021, DCIS, Left, Stage 0, Grade 2, ER+/PR+, HER2+ Targeted Therapy 9/22/2021 Herceptin (trastuzumab) Chemotherapy 9/22/2021 Taxol (paclitaxel)
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Sep 25, 2021 02:41AM Rooster8719 wrote:

Debbie,

My wife was diagnosed with triple positive invasive ductal carcinoma in her left breast in November of 2016. Further testing revealed it had metastasized to her liver. She took the same regimen you are now taking. It made her very sick- flu like symptoms and she slept a lot. As much as 20 hours or more a day. The steroids she was given with the treatment helped a lot as well as the fluids given. She would start feeling pretty bad about 3 days after the infusion. We would go back to the cancer center a few days after treatments and get more steroids and fluids and that helped a good bit too.

Her hair began to fall out shortly after her first round. She also had damage to her nails. She also got sores in her mouth- oncologist gave her a prescription for “magic swizzle” to help with the raw feeling in her mouth.

Get yourself a comfortable blanket and pillow for when you are receiving treatment- you’ll be there all day and the Benadryl will make you tired. Also bring some books or an iPad to watch.

The good news is this regimen works for your type cancer and you are tough and can handle it. It obliterated the cancer in my wife. She had a recurrence in 2020 in the same spot and had a lumpectomy. She had another recurrence in July of this year and just had a bilateral mastectomy sept 3 and is on the mend. If you have any other questions feel free to message me.

Dx 11/2016, IDC, Left, Stage IV, metastasized to liver, 0/0 nodes, ER+/PR+, HER2+
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Sep 25, 2021 11:32AM Racheldog wrote:

I saw my oncologist and am staying on the program of Herceptin monotherapy with one more to go (had the Kadcyla previously which had Herceptin in it) so I am remaining on the shorter version for early stage. Shorter plans have been in studies and are less cardiotoxic. I am older was pleased to go with this plan.

I am having an echo on Monday to see how that is 3 months out. Had good echos to start but on Herceptin now I notice my fatigue and more huffing and puffing to do things. With that and the left sided whole breast radiation there is always the worry in the back of my mind that my heart has been affected. I have decided in my own mind that if my echo has declined I am not sure I want to even do the last Herceptin. What a year this has been.

Dx 9/2020, IDC, Left, <1cm, Stage IA, Grade 3, ER+/PR+, HER2+ (IHC) Radiation Therapy Whole-breast Chemotherapy Other Surgery Lumpectomy: Left

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