Could stroke be related to herceptin treatment??

[Cathya]

Hi all;

I haven’t posted in quite a while but have enjoyed lurking. I am still NED but undergoing tests (contrast CT’s mostly now) every two months as my onc thinks I might have a hidden tumor (??). I think his concern is my rising tumor markers…..particularly the Serum Her2. It dropped slightly a couple of months ago after being on a rising trend the past two tests and so he is holding off herceptin until he gets the results of the one I just had done yesterday. Problem is that twice before my heart function has dropped on herceptin and I’ve had to stop its use so he really wants to be sure it’s absolutely necessary. I’ve had a couple of MRI’s and some time between the one in February and the one in May I had a stroke!! What a surprise. If I had symptoms I am not aware but he sent me off to see a neurologist last month who ran some tests and I will be getting his report on Friday. I haven’t had high blood pressure but am overweight…..sigh….a constant struggle. The one test looked was an ultrasound of my neck. The neurologist wondered if my radiation treatment of my supraclavicular node tumor had damaged the area but the technologist said I was very lucky and everything seemed clear….also no sign of tumors….Yes!! I wonder if this stroke is related to herceptin in any way?? I hadn't been taking it for about 6 months. I wonder if there’s any other treatment like herceptin available for me….without the heart impact? I have been feeling pretty low over the last couple of months but am feeling better now.
Best regards,
Cathy

[Becky]

Hi Cathy

I am sorry you have been having your ups and downs. I do not think Herceptin is directly related to your stroke. However, heart problems and possibly LVEF can very much be related to strokes. Atrial Septal aneurysm (really value problems or heart murmurs) slosh up the blood and can cause clots that can cause stroke. I am not sure of the effect of the low LVEF and if that causes sloshing - however, it does cause residual blood to be left in that chamber and maybe sloshing around too that could cause a clot. I found an article below that studies this as most research is done on stroke after heart attack (with the heart attack causing LVEF) but then one wonders, is it LVEF or the fact that there were clots to begin with since the people did have heart attacks first. So, perhaps indirectly Herceptin can be involved.


http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=96489&Ausgabe=232313&ProduktNr=223840&filename=96489.pdf

[Cathya]

Thank you Becky;

I am continuing this discussion with my neurologist and will post any info here should it suggest this is another herceptin potential side effect. I'm beginning to think that it could be just me though....lol.

kind regards,

Cathy

[anne2]

Hi Cathya,
I am sorry to hear that you had a stroke. How bad was it? Are you back to functioning now. It is funny but my mom had a stroke in 05/06 also. I asked on the board and no one else had had this happen after Herceptin. The onc thought that it may have been the chemo. Regardless, my mom was bordeline diabetic and HTN. I hope you are doing well,
Hugs,
Anne

[Cathya]

Anne;

Thank you so much for your concern. I am doing well (it was a small stroke thank goodness) but I think now the whole concept of having had a stroke is hitting me.....and the worry of potential future strokes. Luckily for me I have a wonderful neurologist and will be having a telephone meeting with him tomorrow to discuss this further. My Serum Her2 test has been trending upwards and is now above normal. I am one of those who suffers heart problems...my muga was 41 when I went off herceptin last time ...... and I worry if I need it again (my heart has recovered) that it will also increase my risk of stroke. I did see risk of stroke as a potential side effect of herceptin somewhere....on genetech I think.....here it is

WARNINGS Cardiomyopathy Herceptin can cause left ventricular cardiac dysfunction. Cardiac dysfunction in patients receiving Herceptin therapy can be serious with disabling cardiac failure, death, and mural thrombosis leading to stroke (see BOXED WARNINGS: Cardiomyopathy (http://www.gene.com/gene/products/information/oncology/herceptin/insert.jsp#boxedwarn)).

I don't know what mural thromobosis is. If I hear more I will post but you are right....no one else i know of has had a stroke....just your mom and I.....so perhaps it is not from bc treatment at all.

Cathy

[Sheila]

Cathy
The definition of mural thrombosis is
<DD minmax_bound="true">Formation of a thrombus in contact with the endocardial lining of a cardiac chamber or, if not occlusive, with a wall of a large blood vessel. </DD>Seems this can occur frequently in the left ventricle...red wine has been thought to slow the process of mural thrombosis developing....
basically its a small clot. Have you ever taken any typr of blood thinners?
Hoping they can get to the bottom of all this for you...take each day and try to regain your health and strength...you are in my prayers Cathy.

[MJo]

Dear Cath- Thank you for adding to the valuable knowledge and experience base here. I had to stop Herceptin too at 9 months. Hope your your heart recovers and that you (and I) remain NED. Best of health to you in the future.

[Cathya]

Thank you. I spoke to my neurologist today and he told me that I have suffered a lacunar stroke and one that is not caused by a clot from the heart. From what he told me there are different types of strokes and mine is caused by tiny blood vessels deep in the brain being blocked. Although these strokes affect small areas they can cause serious effects but mine didn't .... thank goodness. He said there are three causes:

1. age (I'm 58 which seems young)
2. diabetes (don't have it)
3. family predisposition (my grandfather had many tiny strokes until he died in his 80's with a big stroke)

So, this is good news really for me as strokes caused by blood clots apparently affect larger vessels, not so deep in the brain, with more damage generally. And, this would lead me to think that herceptin had nothing to do with my stroke. Unfortunately there is not too much I can do to keep from having others in the future. I can't control my age or my grandfathers history. I can only take my aspirin, watch my blood pressure and eat well so not to get diabetes.

Thanks,

Cathy

[lilyecuadorian]

yahoooooo herceptin http://gfx1.hotmail.com/mail/w2/pr02/emoticons/smile_party.gif good that means after the muga increase you can get more herceptin ? I think is a good news after all no?