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09-05-2007, 06:41 AM
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#1
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Senior Member
Join Date: Jun 2007
Posts: 2,210
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Quick question re: Neulesta
When do you recieve your injection, those of you receiving Neulesta? Yesterday, at my 3rd round of TCH, they determined I needed to receive it for the first time. They planned on giving the injection immediatly following the chemo.But I had literature with me (good patient advocate for myself!) and it said to not administer it until 24 hours AFTER chemo. So I said I preferred to not receive it then and will go back in today. I live very close.
Also I see it causes bone pain which is the last thing I need. That is already my worst symptom from the chemo itself...
Ah well......
__________________
Bonnie
Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
Last edited by BonnieR; 09-05-2007 at 06:42 AM..
Reason: spelling
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09-05-2007, 07:17 AM
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#2
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Senior Member
Join Date: Aug 2006
Location: Franklin, MA
Posts: 131
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It should be given 24 hours afterwards (give or take). I have a nurse who lives next door who would come over and give me the shots, and my onc said it didn't have to be exactly 24 hours afterwards.
I had bone pain when I was getting the Neulasta with Taxol...pain is hardly noticiable when I now get it after Navelbine.
Good luck.
__________________
Diagnosed 10-03-2005 (34 wks pregnant, 38 yrs old)
Lumpectomy Nov-2005. 10/18 Lymph Nodes impacted
Mets to liver, spine & femurs (thus being stage IV right from the get-go)
ER-, PR-, HER2+
Taxol/Herceptin/Zometa started Dec-2005. 11 cycles of Taxol.
Sept-2006: PET/CT scan of mets to liver, spine and femurs - Stable. Activity in R breast & mediastinum (not seen in prior scans).
Navelbine (3 wks on/1 wk off) as of Oct--2006 & continued Herceptin (every 3 wks) & Zometa (every 6 wks)
Jan-2007: PET/CT Scan - Stable. Continued Nav. through March-2007, then Herc./Zom. only after that.
June-2007: PET/CT Scan - activity in mediastinum. Back on Navelbine as of July-2007.
Scanned Quarterly since Oct-2007 - a few small scares, but otherwise stable due to continuing weekly Navelbine, Herceptin and Quarterly Zometa.
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09-05-2007, 07:20 AM
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#3
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Senior Member
Join Date: Sep 2006
Location: Marengo, IL
Posts: 518
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Hi Bonnie,
Good for you about being a knowledgeable patient! I also had to have Nuelasta after my 3rd A/C and 3 rounds of Taxol. My husband would give me the shot the day after chemo. I experienced very little bone pain and it was the day after the shot and lasted about a day.
You are doing great Bonnie.
Donna
__________________
Donna
Crystal Lake, IL
Diagnosed 8/4/06 at age 54
Lumpectomy 8/30/06
Stage llA, grade 3, ER/PR-, Her2++
1.7 cm tumor, 1+ lymph node out of 9
Completed 4 A/C, & 4 Taxol with Herceptin
36 rads completed 5/16/07
Mammograms, 7/07 clear
fractured ribs in radiated area 10/07
Finished Herceptin 12/27/07
Mammogram,CT,tumor markers 1/08 - small lung nodules in radiated area, repeated tests 3/08 stable
Mammogram,CT ,tumor markers 6/08 stable
NED 2 years!!
3 years !!!
4years!!!!
4 years, 10 months and 8 day NED, calling it 5 years!!!
Official 5 years 8/30/2011
8/31/ 2012 - 6 years!!!!!!
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09-05-2007, 07:21 AM
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#4
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Senior Member
Join Date: Jun 2006
Location: Wellington, FL
Posts: 68
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Hi Bonnie,
I always received the shot the day after chemo. It did cause me aches. After my last chemo session I asked to not get the shot and the nurses were adamant that it would be administered. I am not going to kid you, I hated that shot. But the aches did subside the following day.
Hope this helps,
Ita
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09-05-2007, 07:26 AM
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#5
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Senior Member
Join Date: Jun 2007
Posts: 2,210
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Thanks for the prompt replies. It sounds as though, despite the aches, it allowed you to not interrupt the chemo so that is good.
I can't imagine being more achy that I already become after chemo. But I guess I will be finding out later today!!!
This is not for sissies!!!
Keep the faith,
Bonnie
__________________
Bonnie
Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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09-05-2007, 09:10 AM
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#6
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Senior Member
Join Date: Feb 2006
Location: Acworth, GA
Posts: 2,104
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I received the Neulasta shots the day after chemo. I had the bone/joint pain but it was better than developing an infection or having to postpone/delay chemo.
__________________
Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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09-05-2007, 09:42 AM
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#7
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Senior Member
Join Date: Jun 2007
Posts: 2,210
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You got that right, Tousled. All the side effects and inconviences are worthwhile, considering the alternatives.....
Keep the faith everyone....
Bonnie
__________________
Bonnie
Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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09-05-2007, 09:49 AM
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#8
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Senior Member
Join Date: Jun 2006
Location: San Antonio, TX
Posts: 2,357
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I got my neulasta the day of chemo. I live 3 1/2 hours away; so that was probably the determining factor. Lots of others at the center got them the next day! But it worked for me to do it all the same day!
__________________
MA in TX.
Grateful for each and every day....
Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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09-05-2007, 09:54 AM
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#9
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Senior Member
Join Date: Jun 2007
Posts: 2,210
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Mary Anne, that is what I was told too. That some of the patients travel great distance for chemo, thus get the Nulesta same day . I happen to live close enough that I could WALK to the cancer center. If only I was not so fatigued and it was not 112 degrees and HUMID!!!!
But I am fortunate and grateful to have it so close.
__________________
Bonnie
Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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09-05-2007, 12:15 PM
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#10
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Senior Member
Join Date: Oct 2005
Location: New Jersey
Posts: 3,154
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Good for you....
Bonnie,
I had my shot the day after and as a matter of fact they were rather strong on not making my injection appt. before the 24 hrs.
I also took Alieve which helped with the joint pain...and warm soothing
baths...hang in - it gets better...also congrats on your halfway mark,
your around around the bend for the home stretch.
hugs
Jean
PS Just think Sand....
__________________
Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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09-05-2007, 01:09 PM
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#11
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Senior Member
Join Date: Feb 2006
Location: Southern, CA
Posts: 2,511
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My very first round of TCH my wbc count took a dive. They did my labs wkly & the 3rd week my ANC count was in the dirt. But *some how* my onc *missed* that & did NOT give me m neulasta. He calls me later that day & says "Whatever you do...don't go anywhere". (Too late...I went to Denny's that day for a late breakfast".)
So I landed in the hospital for 10 days on a wide spectrum of antibiotics and a heart moniter. CT's of my chest daily. It was nightmare. So its a good thing you are paying attention because sometimes these doctors just over look things and it can cost you. I'm glad your on top of things.
As for me...after that nightmare I always got my neulasta shot the *next* day. I did have bone pain really bad once. For some reason the other times it didn't bother me? So don't worry to much...it might affect you at all. I've talked to lots of women that didn't have the bone pain. Good luck.
Chelee
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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09-05-2007, 02:27 PM
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#12
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Senior Member
Join Date: Jun 2007
Posts: 2,210
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Wow Chelee, that is a cautionary tale indeed!! I will be sure to get that shot today!!
So no one had any of the allergic reactions that they say are possible from the Nuelesta??? I always worry about that. ....
__________________
Bonnie
Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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09-05-2007, 03:37 PM
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#13
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Senior Member
Join Date: Oct 2005
Posts: 3,519
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I usually got mine one 2 days after chemo...
__________________
Brenda
NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)
Nov'03~ dX stage 2B
Dec'03~ Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~ Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~ micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~ micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg
Apr'07~ MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~ Started Tykerb/Xeloda, no WBR for now
June'07~ MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~ MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~ PET/CT & MRI show NED
Apr'08~ scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~ MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~ dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~ Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~ new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~ new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~ 25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.
"I would rather be anecdotally alive than statistically dead."
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09-05-2007, 07:42 PM
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#14
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Senior Member
Join Date: Sep 2005
Location: Mountains of Virginia
Posts: 2,267
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I got mine two days after chemo too.
________
Laguna Heights Condos Pattaya
Last edited by sassy; 08-22-2011 at 09:29 AM..
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09-06-2007, 05:30 AM
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#15
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Senior Member
Join Date: Aug 2006
Location: Sheboygan, WI
Posts: 2,582
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Hi Bonnie,
I, too, received my Neulasta shot the following day and yes, I did experience bone pain. Especially in the shoulder area. BUT, it helped me I'm sure. Never experienced low blood counts and was able to keep my chemo on schedule the whole time.
Good luck to you,
Mary Jo
__________________
"Be still and know that I am God." Psalm 46:10
Dx. 6/24/05 age 45 Right Breast IDC ER/PR. Neg., - Her2+++ RB Mast. - 7/28/05 - 4 cm. tumor Margins clear - 1 microscopic cell 1 sent. node No Vasucular Invasion 4 DD A/C - 4 DD Taxol & Herceptin 1 full year of Herceptin received every 3 weeks 28 rads prophylactic Mast. 3/2/06
17 Years NED
<>< Romans 8:28
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09-06-2007, 06:20 AM
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#16
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Senior Member
Join Date: Aug 2006
Location: Poland Ohio just a little south of Youngstown.
Posts: 473
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I received my Neulasta shots 24 hours after my chemo treatments. I was required to do this with every treatment of ac. On one particular occcasion, they were closing the office on Friday (the day for my neulasta shot), they had some nurses come in in the morning just to give the shots. I did have some aches but not until a couple of days later. Good for you for being your on advocate!
Hugs
__________________
Susan
Age: 61
dx: 5/25/06
2 cm/ 0 nodes
Lumpectomy rt breast on 7/26/06
ER/PR- / Her2+++
A/C x 4
finished taxotere 2/07
finished 33 rads
Herceptin finished 12/07/07 Yippee!
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09-06-2007, 10:55 AM
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#17
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Senior Member
Join Date: Nov 2006
Posts: 42
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I received a Neulasta Injection "the day after" each of my six sessions of TCH -- whether my bloodwork results indicated that I needed it or not. I encountered major bone aches that I controlled with Extra Strength Tylenol and on occasion, Celebrex.
As a side note, I received an Aranesp Injection on the day of TCH, only if my HGB level was low.
__________________
Susie Q - North San Diego
Diagnosis at Age 41 on 10/6/06
~3cm Invasive Ductal Carcinoma Left Breast Stage II
~ER+ 45% Moderate ~ PR+ 62% Strong
~HER2/neu +++
~Sentinel Node Biopsy - Negative Four Nodes
~BRAC1/BRAC2 Negative
~Neo-adjuvant Chemo:6 rounds-every Three
Weeks of Taxotere & Carboplatin & Herceptin
Weekly Completed on 2/7/2007
~Lumpectomy (after chemo) 3/12/2007
~Switched to Every 3-week Herceptin 3/21/2007 for nine more months.
~Radiation May through June 2007 (35 rads total)
~Hormone therapy Lupron Injections + Arimidex
~Lymphedema Challenged!
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09-24-2007, 08:36 PM
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#18
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Member
Join Date: Sep 2007
Location: Northern Alabama
Posts: 10
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I found out today that this injection costs 6,000 per shot, holly crap, I have to have 7 sessions of chemo so that is 42,000 in Neulasta. Pharmacare will be contacting my insurance to see how much they will cover. Has any one else had trouble with getting this drug covered???
Sue
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09-24-2007, 09:15 PM
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#19
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Senior Member
Join Date: Jun 2007
Posts: 2,210
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SuePer, I don't exactly know the cost of the injection, nor do I want to unless it gets denied! (I have noticed that my hospital has accepted less $ in payment from the insurance company than they charge initially for various proceedures in the past), But I did not receive Nulesta every time I got chemo. Just on the most recent (third) round because my white count was low. They will draw blood prior to your treatment. If if is TOO low, chemo could be delayed. OR, if you dont get the Nulesta to boost the count, you could end up ill due to a compromised immune system and that would be a different additional expense and worry. So it is always a balancing act.
__________________
Bonnie
Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
Aromasin started 5/10
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09-25-2007, 03:59 AM
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#20
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Senior Member
Join Date: Aug 2006
Location: Sheboygan, WI
Posts: 2,582
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Good Morning,
My Neulasta shot cost 3500.00. I received this shot every other week for a total of 8 injections. Thankfully, our insurance paid the entire amount.
Thank God for insurance,
Mary Jo
__________________
"Be still and know that I am God." Psalm 46:10
Dx. 6/24/05 age 45 Right Breast IDC ER/PR. Neg., - Her2+++ RB Mast. - 7/28/05 - 4 cm. tumor Margins clear - 1 microscopic cell 1 sent. node No Vasucular Invasion 4 DD A/C - 4 DD Taxol & Herceptin 1 full year of Herceptin received every 3 weeks 28 rads prophylactic Mast. 3/2/06
17 Years NED
<>< Romans 8:28
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