MUGA from 68 to 55, stop Herceptin?

[Donna]

Hi Amazing Group,

My first MUGA before AC regimen was 68, after AC but before Herceptin it fell only to 66, but now after Herceptin for 3 months it has dropped to 55. The way I read it, that is over 10 points so when I see my oncologist tomorrow I am assuming she will tell me to take a Herceptin vacation.

Is this correct?????? I don't want to end up with permanent heart damage, kind of defeats the purpose of getting healthy and cancer free. I really wasn't expecting this - it truly is asymptomatic - I have resumed my workout at the gym and was a little fatigued, but I thought it was due to the rads - only 3 left!

I would really appreciate any input on this I can get before I see the oncologist tomorrow - thanks!

Best to you all!

Donna

[Hopeful]

Donna,

I started Herceptin with a LVEF of 74. After 7 treatments, it is down to 60, totally asymptomatic. After 5 treatments, it was down to 64, my onc ordered another MUGA and said as long as it came back "normal" he would keep going. I asked my internist about the scores, and he said I was still in the high normal range for a person my age. I value his opinion and felt better short term, but I, too have reservations about beating cancer yet winding up with a heart problem. CHF has an even worse prognosis than mbc, believe it or not. If he wants to keep going this week, I am asking about involving a cardiologist. I am willling to put faith in the FinnHer study and the positive results after 9 weeks of Herceptin at this point.

Good luck to you tommorrow.

Hopeful

[MGordon]

Lisa's onc stopped trusting MUGA's and started ordering EEG's. He says they are much more accurate.

Love and Light
Mel

[Lolly]

Donna,

I started in the high 60's also, and am now in the low 50's, but still considered "low/normal". If there's any question in your mind about your heart health while on Herceptin, I know some women who've posted here in the past reported that they saw a cardiologist, as Hopeful mentions. There are medications to help support your heart function while finishing your Herceptin, if that is your goal.

<3 Lolly

[Sheila]

As a reminder, my first echo showed a low score due to the implant from reconstruction...a little contrast injected made the walls easier to visualize and my echo came up 13 points.

[MJo]

My onc stopped Herceptin when my muga dropped from 70 to 54. I remember him or his nurse saying something about 15 point drop is the stopping point, but I could have misheard them. I had had A/C, Taxol and 36 weeks of Herceptin by then. My oncologist confirmed that there is a study of 5000 women going on in Europe with the aim of proving that 6 months of Herceptin gives the same protection as 12 months for non metastic BC. I felt comfortable stopping at nine months. You might want to try to get in a few more treatments, but that's up to you and the doctor to decide.

[Donna]

MJo, you hit the number on the nose - my onc says it is a 15 point drop - although I am sure when I read the Herceptin information it said there a drop greater than 10. She is going to have me get MUGA reports every 6 weeks to monitor this drop - I have only been on herceptin for 3 months so I would rather keep going unless it gets worse.

Thanks so much once again for all the input!

Have a great day!

Donna

[Hopeful]

Here is the link to the letter on the Genetech website which describes cardiac monitoring procedures for patients on Herceptin: http://www.herceptin.com/herceptin/docs/DDL.pdf

Hopeful