Are pre-meds needed...

[Chelee]

for Navelbine? I am suppose start adding Navelbine to Herceptin this Monday. But no one mentioned if I was suppose to take decadron before hand? With TCH I took steroids the day before, day of, & day after.

Am I to assume you don't need it for Navelbine? I have compromised lung function as it is...I don't dare take any chances with my lungs. Tomorrow is Sunday and no one I can call and ask. But Taxotere damaged my lungs...so I want to be very careful. Even though I rather do anything but take steroids...I hate the way they make me feel. But to protect my lungs I'll do whatever it takes. I have enough problems with my lungs as is. Is steroids normally given with Navelbine? How long does it take before Navelbine hits you? Right away, or a day or so afterwards? Oh I'm dreading this...

Chelee

[Rich66]

Definitely try to stay away from the glucocorticoids if possible. Suggestion is that they decrease chemo efficacy (http://her2support.org/vbulletin/showthread.php?t=41877). Ask for an alternative..I believe Kytril isn't steroid. Ginger is helpful according to recent ASCO. "Navy Beans" is considered pretty mild for chemo. My mom is 73 with COPD and had no real problems other than low wbc which made for too much chemo break and lack of efficacy. Didn't know it at the time but..there are suggestions that it is better (efficacy/toxicity) to receive it later in the day/evening.

[Pam P]

Chelee - I'm on navelbine/herceptin. Navelbine doe not require decadron or benedryl for pre meds like the taxanes usually do. So no, you won't get steroids. The only premed I get is aloxi, which is anti nausea & that's with the infusion. As for navelbine side effects for me... not much, slight nausea the 1st time, but non now, some constipation, very very mild neuropathy in one foot, tiredness (of course!) & low wbc. I give myself neupogen shots for 3 days after each trt to help the wbc, but yours may not drop low enough to need anything. All in all I think navelbine is a very manageable treatment.

[Sheila]

Chelee
I was on navelbine for 4 + months back in July...no pre meds, no whiskers, no nausea. I would say watch for constipation..that seems to be a problems. I did not have it, but then my counts were always good too and i never took anything. I had it every 2 weeks with Herceptin, and i found it very easy to take. I am hoping you will too.

As far as your Tykerb question, i am taking 5 pills a day....I worked up to 5 on the advice of Flori and others here....so far, an occasional bout of diarrhea, but nothing a little immodium wont do magic on....other than that, no issues....I am loving it, especially with the good response so far.

Looking forward to bringing you good news from San Antonio on the Tykerb/herceptin Combo and the TDM-1....then you can take it to your onc. for some interesting reading material!!!
Keep Healing!!!!

[ElaineM]

Navelbine is one of the easiest kinds of chemo to take. I took it with Herceptin way back when..............
I only had a little diarrhea and tiredness the morning after my treatment. That was it. I didn't take or need any premeds. The doc gave me anti nausea pills, but I never used them.
Navelbine was developed for lung cancer and then the scientists discovered it would help breast cancer. It is one of the chemotherapies that had a plant as it's original source (periwinkle).

[Rich66]

Chelee,
What are the lung issues attributed to Taxotere?

[Chelee]

Thanks for all the feedback...I feel a little relieved. Plus I really was not looking forward to steroids if at all possible. I'm already feeling pretty tired since this femur surgery...so I'm dreading having any added fatigue. But I'll get through it some how.

I know one of the only things my onc told me is Navy Beans can be hard on the counts as I see mentioned here. We were going to start with a wkly dose of Navelbine and see how it goes? I'll be keeping an eye on my wbc because that is what landed me in the hospital the first go around with TCH. They didn't give me my neulasta & it almost cost me my life. I see some people here get to give them selves neupogen injections. I wish my place let us do our own...that's one less trip back and forth to the cancer center.

I'm happy to hear it does sound easier to deal with them other chemo drugs. I just hope it does a good job at kicking cancers butt. (Of course thats my main focus.) I'll see how well I handle the wkly dose and then move it up to every 2 weeks if all goes well? Thanks to all of you that replied.

Chelee

[Chelee]

Rich, After first go around with TCH...my 1st onc forgot to give me Neulasta. That landed me in the hospital for 12 days on a wide specturm of anti-biotics, heart moniter & oxygen. At the time the CT scans were showing ground glass infiltrates. I had alot of inflammation in lungs. After landing in the hospital my PET/CT's always mention diffuse chronic interstitial disease throughout both lungs. Goes on to say "Irregular densities in the lower lungs bilaterally consistent with atelectasis or scarring. (Always noted no change from prior exam.) But my first baseline PET/CT showed no problems in lungs...so I am blaming the Taxotere for this. I was on oxygen for almost 4 months after landing in the hospital.

Chelee

[Rich66]

I was wondering about that. I came across this last night:


http://doi.wiley.com/10.1002/cncr.10263
Abstract
BACKGROUND
Interstitial pneumonitis has not been reported as a toxicity of docetaxel. The authors report the presentation and natural history of four patients who developed a severe interstitial pneumonitis after receiving docetaxel.

METHODS
The hospital and outpatient records of patients treated with docetaxel were reviewed to identify whether any of these patients required an evaluation for respiratory problems.

RESULTS
Four patients developed an interstitial pneumonitis that could be explained only as a toxicity of docetaxel. None had metastatic disease to the lung, and all had normal liver function before receiving chemotherapy. The patients presented with acute dyspnea and fever within 1-2 weeks of receiving docetaxel. All developed progressive interstitial infiltrates and respiratory failure that required mechanical ventilation. An exhaustive workup for other causes of pneumonitis was negative. Broad-spectrum antibiotics and corticosteroids were ineffective. Two patients died of complications related to the pulmonary process. The two survivors required ventilatory support for more than 21 days. The clinical and pathologic findings of these patients are presented.

CONCLUSIONS
Interstitial pneumonitis is a rare and potentially fatal complication of docetaxel treatment. Prolonged ventilatory support is appropriate in patients with a favorable prognosis. Cancer 2002;94:847-53. © 2002 American Cancer Society.
DOI 10.1002/cncr.10263

Forgot to give neupogen? Is that what they said?

I assume you got a 3wk dose of Taxotere. What time of day did you get the Taxotere? Did they give the other components right after?

[Chelee]

Interesting abstract...thanks. Yes...I did get the Taxotere every 3 wks. (When this happened at first my onc wanted to blame it on Herceptin and take me off of it.) I was getting Herceptin wkly and I knew it was not the herceptin...I had no problems wkly with it. It was only the 3rd wk after my 1st infusion of Taxotere that my counts were in the toilet and things went side ways. I started calling my onc for 4 days in a row saying I could not breath. My face was fire engine red and HOT to the touch. It literally hurt. I looked so sunburned. I was told to take a xanax and put a cold rag on my face. (Idiot onc!) That 4th day of me calling to complain of SOB he finally said I better come in..which they found the oxy meter said my o2 level was 82...which they then immediatly rushed me to the hospital.

As far as time of day...it's been a while since I did TCH. But it was probably later in the day because that would of been my first infusion of TCH. So I'll say around 3:00 PM for the Taxotere. I think I got Herceptin first, Carbo 2nd and Taxotere 3rd. So it may of even been later...I know it was a longggg day.


Chelee

[ElaineM]

If you enjoy vegetables, fruits and mushrooms (especially various kinds of Asian mushrooms) now is the time to eat plenty of those foods. They help the immune system (white blood counts).

[Rich66]

Chelee,
Still digesting your T episode. You're saying you were in the hospital for 12 days and using O2 continuously for over 3 months? And what was that about "ground glass infiltrates"? Sounds like you went through a windshield. Probably felt like it too. Man...and they wanted to say that was a Herceptin reaction..
I..uh..well..wow.

[Chelee]

Rich, I was on the oxygen the 12 days I was in the hospital. But once I was release to go home my 02 was still low so they had me on oxygen for a touch over 3 months. I had extreme SOB after I got out of the hospital...it was so bad that I couldn't even walk in my cancer center for my infusions. My husband took me to infusions in a wheel chair. I hated that. Thanks to the bad case of neutropenia caused by the Taxotere it did permanent damage to my lungs which was the last thing I needed.

Like you I wondered about the "ground glass infiltrates?" (Loved the windshield comment...too funny.) :) Asked my onc about the ground glass infiltrates & he said I didn't have actually ground glass...it's just their way of describing things. (Medical lego I suppose?) When I first heard ground glass it freaked me out!

Herceptin is known to cause lung inflammation/reactions...so that's why they immediatly tried to blame on it. But I wasn't buying it thank goodness. I finished my yr on herceptin with no problems. I know it was the Taxotere...it's pretty rough...dropped my counts the first wk after taking it. By week 3 my wbc count was 6 if I remember right.