Help with EF
 

After being on Herceptin and perjeta for a year my EF has dropped to 40. So scared now that a can't get my treatments. What's the best way to get it back up? I started taking COQ10. Anything else I should be doing?

Re: Help with EF
 

Did you have it checked by MUGA or by ECHO? I had a big drop with MUGA and had it rechecked with ECHO to confirm and ECHO put me back up at 67%. It may be worth rechecking. ECHO is more detailed, more accurate and uses no radiation. I often wonder why MUGA is prescribed over ECHO. ECHO is only as good as the technician who does it though.

Re: Help with EF
 

It was checked by ECHO.

Re: Help with EF
 

Have you visited with a cardiac oncologist? It might be a good idea to set up a consult with one if you are not under the care of one yet. DFCI recommended one to me when I went there for a consult for Stage IV Dx. They were concerned about my EF drop too which is how I ended up getting an ECHO to recheck the result.

Hopefully, they come up with a good plan for you. I know some of the ladies here have had to take Herceptin breaks until EFs improved.

Re: Help with EF
 

My endocrinologist recommended taking COQ10 several years ago and I have been taking it faithfully since then. I have been on Herceptin almost 6 years now and my EF is still at 65-70. It certainly can't hurt.

Re: Help with EF
 

I had a 10% drop in my EF a couple years ago and was referred to cardiologist who deals with cancer patients. I take heart medication (Coreg) and I have maintained an over 60 EF since then and continue on Herceptin for over 5 years now.

Re: Help with EF
 

Valley Girl

The doc should have put you on an ACE inhibitor immediately. Also possibly a beta blocker like Lopressor. The Coreg mentioned is a combination alpha and beta blocker. No need to get into the minute pharmacology.

An ACE inhibitor should have been started at once. Some examples of ACE inhibitors are Zestril (Lisinopril) Vasotec (Enalapril) and Lotensin (Benzepril). The heart damage of Herceptin is not permanent like that caused by Adriamycin. Often after a few weeks the heart function reaches a level high enough to continue therapy with Herceptin. Once you get back on the Herceptin STAY on the ACE inhibitor. They are using ACe inhibitors for prevention of Herceptin heart damage. If you develop a bad cough (not uncommon) very probably and angiotensin 2 receptor blocker like Cozaar (Losartan) could be substituted. Ill check this out.

Paul

Re: Help with EF
 

Just adding my 2 cents.

You can see my history in my signature.

I have had high blood pressure since forever and am on Coreg 2 x a day and Vasotec.

I was on Herceptin for 10 years. Been off since 2008.

I take dozens of supplements per my integrative oncologist in Manhattan since 1998 when I recurred.

Among them are 150 mg of Co Q 10 -- 2 x a day w/food.

Also, it was suggested by this onc that I take ARGENINE to get my EF up and keep it up.

I remain on 2 first thing in the morning -- 500 mg of sustained and immediate release. As I say, been on that since 1998. My EF is around 65.

I did a MUGA at the outset but did every 6 month ECHOs for many many yrs. Had a peri cardial effusion surrounding my heart from the Taxotere given to me in late '98 and early '99. So they keep checking. The effusion doesn't seem to interfere with my heart function and remains small. I even graduated to annual ECHOs a # of yrs ago and now -- neither my onc nor my cardiologist feels there's any reason for me to continue.

I hope this helps.

I lived in fear of my EF going below 50 and not being able to get my Herceptin (Vitamin H as I call it).

BE WELL Sister.

Andi

Re: Help with EF
 

Good point Andi - I also take Coreg twice a day and I'm sure that is helpful as well.

Re: Help with EF
 

I hadn't realized till your post that Coreg helps more than high bp...

I looked through my pages long list of supplements (that I give all my docs who roll their eyes and say something like -- you actually take all these????).

One said -- all this shit. I no longer go to him. LOL.

For heart (per my integrative onocologist, Dr. Gaynor) I also take:

B-6 -- 50 mg

Carnitine -- 500 (AM / PM)

Folate w/quatrefolic 400 mcg

Grapeseed Extrct

Resveratrol -- 250 (AM / PM)

Hope this helps!

Hugs,
Andi

Re: Help with EF
 

Thank you all so much, I really appreciate all you help. :)