Quick Response on Chemo Needed (for May 27, 2004)

Hi Everyone,

I just received a call from my medical oncologist and your quick response is appreciated. I'm due for my sixth chemo this week (May 27, '04)of FAC (have been going every 3 weeks). I've asked my doctor several times about my node negative T1N0 status and my high 8/9 Bloom-Richardson score and 3+ her2-neu status and the merits of taking Herceptin at this early stage.

She just called today and said that if I would like to switch my sixth chemo to Carbo-taxol (4 cycles) every three weeks and then have Herceptin on the fourth week for 12 weeks, I can do do this.

I am in a quandary, because I have been a "curious cat" about this and now that Herceptin is being offered to me, I'm wondering if I'm doing the right thing or rushing this a bit. I was so ready to start growing my hair back and getting back to work next week. Please let me know your thoughts, especially those of you who may have a similar status (I was diagnosed in Dec., 2003 with Paget's Disease, DCIS and infiltrating ductal carcinoma and three negative nodes from Sentinel node; had surgery Jan. 8, 2004, skin-sparing mastectomy of right breast and immediate reconstruction). Thanks for everything. I appreciate your input in helping me decide before this Thursday.

Vicki in Calif.

P.S. She said ASCO is reporting on this at their next New Orleans conference.

Hi Vicki,

Not sure what FAC stands for. My cancer diagnosis is different from yours (I'm a later stage, also I'm not Paget's).

But I do know one thing, though. Based on past research data, onc's are more inclined to give Herceptin in conjunction with any taxane family (ie, Taxol or Taxotere), due to possible heart toxicity. Onc's are still reluctant to give Herceptin with Adriamycin, only because Adriamycin alone could cause heart toxicity.

Hope this helps.

I live in CA, too. :-)

Good luck & hugs

Vicki,

This combination works quite well and has been causing some excitement on how long it will keep people from progressing. Seems like big guns at this point in your treatment - this worked quite well for me once my cancer had progressed to my liver - 11 weekly treatments pretty much took care of the mets - have been on longer for preventative measures. At any rate, carboplatin is very very synergistic with Herceptin - you may recall Barbara Bradfield's clinical trial used cisplatin with the herceptin (cisplatin is similar to carboplatin) and she is still NED 10 years later with no maintenance herceptin. Good luck in your decision.
Kitty

Hi Vicki-
Wow!What a tough situation!So many questions pop into my head...
How are you responding to FAC-are your tumor markers going down?If the combo you are currently on is already working for you, it would seem unnecessary to switch to a combo that you don't know how you'll respond-regardless how positive the data on TCH is. Did you doc say why she would want you to change combos in the middle of tx? If you don't have any distal metastasis, how is your doc able to give you Herceptin (typically it's only availabe to early stage bc in a clinical trial)?
When I had to go back on tx, we started on Taxol+Herceptin.I BEGGED my onc for TCH, but she urged me start w/fewer drugs first & said if needed,we could add the carbo later, but only if needed. Fortunately TH got me to NED after 12 weeks.That was 8 1/2 mos ago!I was told that it's better to go conservatively first and not over-medicate or over-expose my body to too many drugs, that way if I need tx again in the future, I'll still have those on reserve.
I was dx'd May 2002,IDC,12/12+nodes,Stage IV-liver mets at primary dx.I had a lumpectomy & a total of 49 weeks of weekly chemo (3 different combos)Ultimately the 12 weeks of TH was my magic combo!I love NED!
I wish you good luck with a really touch decision.Keep the faith & take good care!

I have no answers. But one question. If I'm reading your post right, she wants to give you only 4 Herceptin treatments. Surely I misunderstood...

Love and healing light,

Lisa

You wrote:
"She just called today and said that if I would like to switch my sixth chemo to Carbo-taxol (4 cycles) every three weeks and then have Herceptin on the fourth week for 12 weeks, I can do do this."

I, like Lisa, am not clear on the sequence. The way I read your excited message is you will have 12 treatments of Herceptin. If that is the case, I would go for it. Targeted therapies do the trick without causing more hair loss or mouth sores - does not bother your other cells - just hunts down the cancer. I have never had carboplatin, but know that it is a good drug and did consider it in the beginning with one med onc.
I also had Adriamycin for 12 weekly doses and did not get Herceptin until mets appeared only 6 months after getting off chemo the first time. I would rather have the Herceptin with synergistic chemos than Adriamycin any old time. (But it was early on in those days and I could not get it.)
But, remember, this is my personal thought after all I have been through. Herceptin has been a very good "friend" for me and keeping me NED practically 2 years now.

Hi Lisa,

In my urgency to write Message Board members, I may have been a bit unclear. I'm still a bit confused on the specifics as the doctor mentioned "16 weeks" and will speak with my doctor today, however she said I would get 4 cycles of Carbo-Taxol every 3 weeks and the 4th week I would get Herceptin for 12 weeks. Does this make more sense to you?

My husband says to give it a "shot," because I'll always wonder and at least I can say I did everything in the early stages.

One of my questions for the doctor is if I use Herceptin at this early node-negative stage, would it prevent Herceptin from being effective later.

Thanks again for your thoughts...I truly appreciate everyone's personal opinions on the topic.

Be well,

Vicki

Hi Stephanie,

Were you node-neg. in those early days before having mets 6 months later? Thanks for your feedback. I've heard good things about the synergistic effect of carbo-taxol and I know we are all part of ground-breaking work to beat cancer.

Vicki from So. Cal.

Vicki,

None of us yet know whether Herceptin will "do the trick" in a node-negative stage. My gut, and those of many others, says yes. I believe it, or something even better, will someday be given to all women who show HER2 pos., regardless of their nodes. By the way, I had 21 nodes removed with my original bc diax in late 1999. All negative. Then in Sept. 04, mets to liver and bones. But Navelbine/Herceptin have done much, much good.

Fight a good fight, girl!!

Love and healing light,

Lisa

Hello
This is my first time on this site and need some help. I have been diagnosed with extensive bone mits. Starting Carbo/taxol/herceptin on Friday morning. Please, can anyone tell me what to expect from these drugs? Sickness, side effects. I do better knowing than not. HELP!
Thank you Susan

Susan,

Will you be receiving weekly treatments (or every 3 weeks?) I have been on weekly taxol/carboplatin/herceptin since 11/03 and will finish up in a few weeks. Weekly is very easy to tolerate and takes about 3-1/2 hours with premeds but I have not have a single problem. I work fulltime and feel great. The dose at 3 weeks is much stronger and as a result can affect you more. After 11 weeks my liver mets were all but gone...I have continued the chemo as a precautionary measure to make sure everything is good and gone and because I have not had any problems. Good luck.
Kitty

Hi Kitty,

I started my Herceptin-Taxol-Carboplatin yesteday and will do it every week for 3 weeks 12 weeks total) and the 4th week Herceptin only for a total of 16 weeks. I'm so glad you told me it's easy-going (as the nurse told me this, too) and I plan to go back to work next week. So, your news was good news to me as far as limited side effects. I am node. neg., but just finished FAC, so thought this new regimen my doctor was offering was the right time to do it since I'm already bald as a cue ball and I look at it as added insurance being her2 3+.

Happy Memorial Day,

Vick from So. Calif.