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All TopicsForum: HER2+ (Positive) Breast Cancer → Topic: Neoadjuvant TCHP - Post Results Here

Topic: Neoadjuvant TCHP - Post Results Here

Forum: HER2+ (Positive) Breast Cancer —

Testing, treatment, side effects, and more.

Posted on: Aug 25, 2014 11:57AM - edited Jul 15, 2015 06:57PM by agness

agness wrote:

I completed my course of neoadjuvant Taxotere-Carboplatin-Herceptin-Perjeta (TCHP) at the beginning of July 2014. Since this is the first year of having this treatment option available to general breast cancer patients I thought it would be helpful if we could track outcomes.

Please summarize your clinical and pathological reports, also any imaging you had along the way. If you can describe any modifications to this treatment, as well as any other complementary therapies, that would be helpful. Maybe include a few tips or personal experiences with this particular drug regime?

Hopefully as time rolls on we can also track longterm results as well.

Looking forward to reading your stories.

-Ann


Ann - PCR 8/15/14


HER2+/HR-. TCHP 3/14, PCR 8/14. Proton therapy. Mets: Brain tumor to cerebellum (5 cm) 7/2015. SRS 9/15. Leptomeningeal (LM) dx 11/2015, Ommaya Reservoir/IT Herceptin 12/15. Partial brain rads 1/2016. More LM & new chemo 9/16. Stable scan 12/16
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Dec 16, 2017 07:17PM Clynnejohn505 wrote:

Emalyn

I finished my treatment on 11/9/17. I found the side effects to be on point with what the doctor said. I know you just had your first one a few days ago. For me it took 2 to 3 days to feel it. After the first one I had constipation and diarrhea. This lasted throughout the 6 treatments with varying degrees of intensity. It’s like my body couldn’t find that happy medium and now 5 weeks after last one it’s just getting back to normal. Be ready with the Imodium and if you find it unmanageable there’s prescription lomotil.

It wasn’t easy but I worked throughout my treatments. After one I’d be out for a week then back on Monday. With the exception of #5 - I got a stomach ulcer and was hospitalized for blood in my stool.

The big thing to know is communication! Tell your doctor how you’re feeling. The solution could be as simple as going in for a bag of IV fluids. You’ll be amazed how much better you’ll feel after a little hydration. Keep your head up and don’t think you have to suffer for it to work. There is help for the side effects.

Cathy

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Dec 27, 2017 04:52AM - edited Dec 27, 2017 06:36AM by Hope99

Hello sisters, hope all of you will be fine in Christmas.

According to this topics, I try to understand the relationship between the complete respond pCR and grade, ER/ Pr and HER2 receptors status (negative or positive), Grade and Ki-67 . I know this is researcher jobs but I want to imagine why some doctors, as my case, said maybe your chances is 50% with chemo! how he know this percentage and what is the indication that help him to said that? I think high ER+ doing well with chemo. WHO KNOWS!!

About the tumor become softer and shrinking physically. Is that good condition? some times I feel its become softer and shrinking a little after one round chemo ( FEC) . sometimes I feel it is same as before!


https://www.ncbi.nlm.nih.gov/pubmed/16507401

Dx 9/14/2017,IDC, Right, 2.5 - 3 cm, stage 2, ER+/PR+, HER2- chemo: 12/11/2017 ( FEC-T protocol ) crying solve a lot of problems in this life.
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Dec 27, 2017 07:37AM Hope99 wrote:

Moreover, I am positive- receptors ER/PR and HER2 Neg. with one positive nodes checked by biopsy. I am worry now after reading this study ( but its good for HER2+) that shows the chemo (FEC) its not good with hormone positive !! why my doctors waste my time with chemo and the effective percentage not high enough to pCR my tumor and node?!

Dx 9/14/2017,IDC, Right, 2.5 - 3 cm, stage 2, ER+/PR+, HER2- chemo: 12/11/2017 ( FEC-T protocol ) crying solve a lot of problems in this life.
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Dec 27, 2017 09:11AM MinusTwo wrote:

Hope - from your post you are not HER2+. This thread is specifically for HER2+ patients who are having TCHP chemo before surgery. You might want to join one of the fall chemo threads to talk to women with your same specs.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Dec 28, 2017 07:57AM Emalyn wrote:

Happy New Year to all of you! Wishing you the best health possible, the mildest side effects, and good times in spite of our diagnoses and treatments. I very much appreciate all your contributions to this thread. For me, infusion 2 of 6 is scheduled for January 2. For my personal psychological therapy, I have been making a few 30 second animated videos. This one is about my New Year 2018. I hope you enjoy it. Please comment.


Dx 11/15/2017, IDC, Left, 2cm, Stage IIA, Grade 2, 0/0 nodes, ER+/PR+, HER2+ Targeted Therapy 12/11/2017 Perjeta (pertuzumab) Targeted Therapy 12/11/2017 Herceptin (trastuzumab) Chemotherapy 12/12/2017 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Jan 12, 2018 09:14AM mle78 wrote:

Question for those who have gone before me. I just got diagnosed and haven't started treatment yet. I'm anticipating this regimen based on my diagnosis and HER2 status. Plus the nurse navigator mentioned it to me. How many of you were able to continue working while getting chemo? I work as a nurse and I'm the only income in my family while my husband is finishing pharmacy school. Worried about significant loss of income.

Thanks!

Dx 1/9/2018, DCIS/IDC, Left, 2cm, Grade 3, ER+/PR-, HER2+ (FISH)
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Jan 12, 2018 09:33PM - edited Jan 12, 2018 09:43PM by misslil

I worked, more or less, through my process for TCHP chemo. My office has a lot of flexibility which helped. Over the six cycles, I'd miss Thursday for the infusions, be at the clinic again Friday for Neulasta and IV fluids, and back there Monday for more fluids. Most often, I was out of work those three days of each cycle, although sometimes I felt ok to go in on the Friday / Monday part-time.

I tried to work the days after that in each cycle. It got harder over time to work the rest of the week after the Monday IV fluids. Toward the end of it all, I just wrote that week off and pre-planned to be out M-F. The second week I was usually ok to work, same for the M-W on the third week before treatment began again.

I had radiation and worked continuously through that with no problems. When I got off the TCHP phase, and to Herceptin alone, I worked pretty much all the Herceptin days, leaving work early or coming in late to do the treatment.

I got an authorization to work part-time on training at home through this timeframe. It was a good idea to have that option, but in reality if I didn't feel well enough to go to the office I didn't feel well enough to do training at home or was sleeping things off lol.

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Jan 12, 2018 10:31PM - edited Jan 12, 2018 10:42PM by DATNY

I continued to work as well. In fact, I could say that I felt better when I worked. Physically is doable, especially if you are on the younger side. Worst days for me for fatigue were 3-5, which overlapped partially with the weekend. Neulasta gave me terrible bone pain, so I changed to Zarxio. Other than that, the worst side effect was acid reflux. Being a nurse, you'll have to make sure not to come in contact with sick people as wbc can drop unexpectedly, in spite of the shot.

Also, I drank about a galon of water the first 4-5 days, in the first cycles. Being well hydrated made a huge difference to how I felt. Later on, was difficult to keep drinking that much.

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Jan 13, 2018 02:51AM Jedrik wrote:

Working as a nurse might not be adviseable since chemo will seriously compromise your immune system. However fit (or not) you might feel: Sick and infected people are not your company of choice.

Dx 9/17/2015, IDC/Paget's, Left, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER-/PR-, HER2+ (FISH) Surgery 10/5/2015 Lymph node removal: Sentinel Chemotherapy 10/18/2015 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 10/18/2015 Herceptin (trastuzumab) Targeted Therapy 10/18/2015 Perjeta (pertuzumab) Surgery 2/22/2016 Mastectomy: Left; Prophylactic mastectomy: Right
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Jan 13, 2018 06:16AM mle78 wrote:

Thanks for your responses ladies. I definitely understand the risks working with people who could be infectious and those receiving chemo. I work with the pediatric population including those with cancer going through treatment. I'm actually a supervisor where I work and I'm hoping they'll let me do more paperwork type things at times. I just didn't want to exhaust all of my time at once with chemo and not have enough time after surgery.

Dx 1/9/2018, DCIS/IDC, Left, 2cm, Grade 3, ER+/PR-, HER2+ (FISH)
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Jan 13, 2018 02:33PM - edited Jan 13, 2018 02:35PM by misslil

For me, the only compromise to my system was anemia which got bad enough I had two blood transfusions. Plus a potassium deficit at one point that went away quickly after absorbing some nasty stuff to bump it back up. The Neulasta seemed to work great for white blood cell issues...

From the beginning of chemo to today, I made big friends with hand sanitizer, and avoided touching with my bare hands things like door knobs, elevator buttons, bathroom fixtures in the office, hospital, dr offices, and other public places. My MO recommended I do the flu shot for elderly people so I did that vs. the normal one i would have taken.

Don't know if any of that helped, but didn't hurt. I did not catch a cold or flu thankfully throughout that period of time to today.

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Jan 29, 2018 11:04PM Debsmisto wrote:

Hi, I just found this thread, trying to find where I fit in with all of this. I will start TCHP treatment next Thursday and am pretty scared at this point. I am 60 and not in great physical shape so I'm worried I won't be able to handle it all. I will update my dx and treatment info as soon as I figure out how to do so 😐 in the meantime any encouraging words would be amazing, thanks Deb

Dx 1/4/2018, IDC, Right, 1cm, Stage IIIB, Grade 2, ER+/PR-, HER2+ (FISH) Targeted Therapy 2/7/2018 Herceptin (trastuzumab) Chemotherapy 2/8/2018 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Jan 29, 2018 11:50PM MinusTwo wrote:

Deb - I was 69 when I started TCHP. It's not a walk in the park, but if you rest when you're tired, try to walk as much as you can, and take the meds as ordered you should be OK. I also had Neulasta 24 hours after every TCHP infusion. I found it useful to join one of the current chemo boards (probably Winter chemo or January chemo now) so I could talk with women going through the same thing right then. You should find those on the 'active' boards.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 29, 2018 11:51PM MinusTwo wrote:

Here's an oldy but goodie with lots of suggestions to get ready for chemo

https://community.breastcancer.org/forum/69/topics...


2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 30, 2018 02:25AM - edited Jan 30, 2018 03:05AM by sweetp6217

Hello all,

I finished getting my main TCH infusions a week before Thanksgiving. They took me off of Perjeta after #2 of 6 because of the lovely SE. Things improved down there once the perjeta was out of my system. #5 & #6 infusions were pretty bad for me; made good use of zofran, etc. As for immunity, etc. I happened to catch a mild virus a week before my lumpectomy. Nearly rid of it by then, thankfully...no fever. Where I work, I am proximity of patients and wore masks for about a week, then gave it up. My WBC was amazingly good, but once or twice, my platelets were low. As for missing work, I missed about a total of 4 work days in the 19 week stretch. Chemo brain didn't help me a couple of times; forgetting things. In addition, today, my boss asked if I was OK (a bit dizzy from doing kneeling to standing tasks). I guess I looked like grumpy cat, a little.

One of the worst parts was infusion #5 and the aftermath. Weeks before, a close family member wanted to come visit me on my birthday. Not a good idea since it would follow infusion by a day. Had to convince him to come a week or so later. They just don't get it (experiences with side effects). Thankfully, he took my word for it (turned out to be really rough).

I will continue with Herceptin until June, I think. My onc told me that dropping perjeta wasn't a risk at all (contrary to the info early on). I also begin rads maybe next week, depending on insurance. I still have a black stripe between my boobs (one of the markings) underneath tape. Can't even tell where the tattoos are since I have little spots/moles on my skin already. I'm not looking forward to Rads because they warned that I might be fatigued (more than with chemo). I can't have that. Already experienced fatigue the later I worked. Hopefully, I won't get nauseous (SE of zofran: dizziness, drowsiness). We shall see. Still, I'm glad I'm done with the T&C of the TCH.

Good luck to you all and Hugs!

Dx 7/7/2017, IDC, Left, 3cm, Stage IIB, Grade 3, ER+/PR-, HER2+ (FISH) Targeted Therapy 7/27/2017 Herceptin (trastuzumab) Chemotherapy 7/27/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 1/4/2018 Lumpectomy: Left; Lymph node removal: Left, Sentinel; Reconstruction (left): Fat grafting Radiation Therapy 2/21/2018 Whole-breast: Breast, Lymph nodes Hormonal Therapy
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Jan 30, 2018 04:44AM Debsmisto wrote:

Thanks sweetp and minus two, so glad you're all here to help me through this. I'm also terrified I'm going to get this flu going around, anyone get a bad virus during treatment and was it much worse because of treatment? TIA Deb

Dx 1/4/2018, IDC, Right, 1cm, Stage IIIB, Grade 2, ER+/PR-, HER2+ (FISH) Targeted Therapy 2/7/2018 Herceptin (trastuzumab) Chemotherapy 2/8/2018 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Jan 30, 2018 09:32AM - edited Jan 30, 2018 09:32AM by sweetp6217

Debsimisto, I almost forgot. I got my flu shot in August and I had no SE from it, but I did ask my oncologist's nurses if I could get the flu shot. I try to keep an open line to the medical team; let them know what other appointments I may have so as not to derail the treatment. For example, before trying to treat my virus, I asked them if I could take any over-the-counters (they got right back to me).

Dx 7/7/2017, IDC, Left, 3cm, Stage IIB, Grade 3, ER+/PR-, HER2+ (FISH) Targeted Therapy 7/27/2017 Herceptin (trastuzumab) Chemotherapy 7/27/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 1/4/2018 Lumpectomy: Left; Lymph node removal: Left, Sentinel; Reconstruction (left): Fat grafting Radiation Therapy 2/21/2018 Whole-breast: Breast, Lymph nodes Hormonal Therapy
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Feb 13, 2018 09:20PM - edited Feb 13, 2018 09:23PM by embmom

I just got the call from my surgeon that I had a complete response to my tchp treatments! No cancer at all detected in the breast that was removed last Friday, and 4 clear nodes! Good news for me, a stage 4 triple negative survivor from 10 years ago! The TCHP was hard, harder than the first go round with just the tax/carbo combination, but I am 10years older at 64. I was glad the last 2 treatments were after Christmas cause they were the roughest! I own an embroidery business and was able to get thru Christmas successfully. My surgeon said that 40-60% will have the complete response after tchp! Feeling kinda crappy was definitely worth it!

Btw..haven’t figured out how to change my stats, this time around I was er-pr+her2+. Stage2..2.2 cm tumor. Tchp,treatment

Dx 1/2008, IDC, Stage IV, Grade 3, 0/3 nodes, mets, ER-/PR-, HER2-
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Feb 17, 2018 08:49PM LKinKC wrote:

Hi Embmom, What great news! thank you for sharing your results it is so encouraging. I just finished my #2 of the 6 TCHP treatments. Good luck to you.

Dx 12/26/2017, IDC, Right, 2cm, Grade 2, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/23/2018 Herceptin (trastuzumab) Targeted Therapy 1/23/2018 Perjeta (pertuzumab) Chemotherapy 1/23/2018 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 20, 2018 07:04AM Bliss58 wrote:

embmom, you were Stage IV in 2008? Was it in your bones, then in remission, and this time around just in the breast? That's awesome you had a complete response. Congrats.

Dx age 56, married, mom to one DD. "Eat half, walk double, laugh triple and love without measure..." (Tibetan proverb) -- Six rounds of TCHP ended 10/22/15. Zometa started 11/12/15 every 3 months. Quit Letrozole 1/17/18. Dx 6/1/2015, IDC, Left, 4cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Dx 6/30/2015, Stage IV Radiation Therapy 12/16/2015 External: Bone Surgery 2/16/2016 Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy 5/8/2016 External: Lymph nodes, Chest wall Hormonal Therapy 2/1/2018 Aromasin (exemestane)
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Mar 20, 2018 09:16PM Cheska wrote:

I had a 6cm tumor and 1 positive node when I started. I had 6 cycles of TCHP and then had a double mastectomy. Pathology report after surgery indicated a PCR. I start radiation tomorrow- 28 tx. My question is how many ladies are receiving both Herceptin and Perjeta after chemo? My oncologist and breast surgeon both agree that Herceptin alone is enough but I am not totally convinced

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Mar 20, 2018 10:44PM DATNY wrote:

Perjeta was approved to be used along Herceptin back in December. I found out about this here and then I asked my oncologist to add it and he did. He told me he would have asked me anyway if I wanted to include it.

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Mar 20, 2018 10:56PM lily2 wrote:

Cheska, I too had a PCR. I finished the year out on Herceptin and Perjeta.My Mo added Perjeta for the year because I was hormone negative and could not take any hormone therapy.I was told it was extra security.


Dx 2/27/2017, IDC, Right, 4cm, Stage IIIA, Grade 2, 0/2 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 3/21/2017 Herceptin (trastuzumab) Chemotherapy 3/22/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 7/29/2017 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy
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Mar 26, 2018 01:10AM Giveityourall wrote:

Cheska, I was diagnosed with my HER 2 on March 6, 2018. Twenty days later, March 26th, I begin my exciting new life titled “Port and meds.” According to my cancer specialist facility in Florida, the TCHP, surgery, and HP method is considered the “gold” method. So, that is my given plan. I am very excited and can’t wait for the side effects (facetious). The truth is I am brutally scared and shaking. I want to wake up tomorrow and breath and see the sunshine through the window.

Dx 3/8/2018, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2+ (FISH)
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Mar 26, 2018 01:18AM Giveityourall wrote:

I send you one BIG healthy congrats. You so deserve the positive news... we all do, but I am glad you shared yours.

Dx 3/8/2018, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2+ (FISH)
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Mar 26, 2018 09:23AM - edited Mar 26, 2018 04:27PM by raleighgirl

Hi ladies!

Just wanted to check in here. I was diagnosed in December of 2014 at 37. At the time, I had a six month old and 1.5 year old child. I had ten(yes ten!) tumors in my left breast that covered a ten cm area. I was astounded and so worried that my regimen would not work.

I did TCHP, followed by a double mastectomy and then radiation. I also had a PCR!! I could not feel any tumors after the first chemo.

My hair has grown back, I feel great, and my children remember nothing. I did fat grafting in November and might do another round in the future.

We were about to try for a third child when I was diagnosed. I was devastated that breast cancer had interrupted my child bearing years. Now, three years later at 40, I am miraculously pregnant again. Big surprise!

I hope this gives some hope to other women going through this!

Dx 12/23/2014, IDC, 4cm, Grade 3, ER-, HER2+ Targeted Therapy 1/14/2015 Perjeta (pertuzumab) Targeted Therapy 1/14/2015 Herceptin (trastuzumab) Chemotherapy 1/14/2015 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Mar 26, 2018 12:05PM LTWJ wrote:

I have a question about PCR. I did 6 rounds of TCPH. My breast MRI said it was all gone. My lumpectomy came back w/o clear margins anywhere so I had a BMX. Tne pathology them came back as the cancerous breast was completely clear ( weird how no clear margins then) and the good breast had IDIS in it- which never came up on multiple breast mris or scans. So did I have any response? It did shrink some, and didn’t show up on any scans but was still thete

Dx 4/14/2017, ILC, Left, 3cm, Stage IIA, Grade 2, 0/1 nodes, ER+, HER2+ (FISH) Chemotherapy 6/1/2017 Chemotherapy 6/2/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 10/10/2017 Lumpectomy: Left Surgery 11/17/2017 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Targeted Therapy 12/10/2017 Herceptin (trastuzumab) Hormonal Therapy Arimidex (anastrozole)
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Apr 4, 2018 09:51AM - edited Apr 4, 2018 09:55AM by Emalyn

Good News. I hope my story will be helpful for some of you. Last week I completed my sixth and final TCHP infusion. Yesterday I had followup mammogram & ultrasound studies. My 2.5cm lump has dissolved, is no longer visible. In two weeks, I will have a very small lumpectomy and sentinel node biopsy followed by one month of daily radiation treatments (except weekends).

The two most difficult chemo side effects for me were digestion problems and fatigue. I had lots of smelly diarrhea and passed a lot of stinky gas. Various medications and diet changes were helpful. The meds that helped were Imodium, Prevacid, Tylenol, Sucralfate, Zofran. For diet, I had become lactose intolerant. So I stopped eating milk products. However, as recommended by my MO ( medical oncologist) I did eat plain Greek Yoghurt with active cultures. The diet changes made a big difference. As for fatigue, I have been fortunate enough to be able to take daily afternoon naps lasting one or two hours. Our cat liked to curl up near me and nap too. Also, I needed to and could worked less. All in all, the side effects were uncomfortable but tolerable.

So, this is one view of an apparently successful round of neoajudivant (pre surgery) chemo. I'm feeling relieved and optimistic. I write this hoping to give you some useful tips and add some optimism to your experience.


Dx 11/15/2017, IDC, Left, 2cm, Stage IIA, Grade 2, 0/0 nodes, ER+/PR+, HER2+ Targeted Therapy 12/11/2017 Perjeta (pertuzumab) Targeted Therapy 12/11/2017 Herceptin (trastuzumab) Chemotherapy 12/12/2017 Carboplatin (Paraplatin), Taxotere (docetaxel)

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