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Old 08-09-2007, 05:56 PM   #1
Stephanie
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Location: San Marcos, CA
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Tykerb and weakness/shortness of breath

My mother switched from x/h to x/t one week ago. The past couple of days, she's been very weak and short of breath. These two symptoms are listed under "serious side effects" of Tykerb, with the advice of contacting one's doctor immediately. Well, she's the first person at our cancer center to be on Tykerb, so I don't know if they know exactly what to do, frankly.

So, my question is, if one experiences one of the "serious side effects", what do the docs do? Reduce the dosage? Take one off of Tykerb immediately? What's the drill?

Any input is greatly appreciated--thanks.
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Old 08-09-2007, 07:56 PM   #2
Lala
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Stephanie,
I am so sorry to hear your Mother is having side effects. I hope that the doctors act quickly to find the cause of these symptoms. I would think stopping all treatment would be in order. It seems some baseline tests should be ordered immediately to rule out any other problems. I think I would request a muga scan as one test.

I once suffered an obvious severe allergic reaction to a chemotherapy drug that was being infused for the first time. In that case we knew it was 100% caused by a chemotherapy. I think until they do some background tests it's hard to say if it is Tykerb or not. There is data out there on Tykerb and Xeloda. I am sure the doctors can consult with the drug company or other oncologists experienced in this drug line.

I wish you and your Mother the best.

Hugs
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Last edited by Lala; 08-09-2007 at 07:57 PM.. Reason: added a thought
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Old 08-09-2007, 09:19 PM   #3
hutchibk
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I have heard that Tykerb can be hard on the heart, a bit like Herceptin. I wonder if it is a heart issue. Perhaps her doc should order a Muga scan. Was she getting regular mugas while on Herceptin?
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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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Old 08-10-2007, 02:30 AM   #4
dhealey
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It could be a heart issue or her hemaglobin could be low as this would cause shortness of breath also. The should do an echocardiogram or muga and bloodwork.
Debbie in North Carolina
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Diag 10/2006-high grade invasive ductal carcinoma- mastectomy L breast
2.5 cm tumor ER/PR pos-Her2+++
4 rounds A/C, 4 rounds Taxol
Herceptin every 3 weeks until Jan. 2008
6/18/07 prophylatic mastectomy R breast
8/2007 started aromasin/stopped arimidex (side effects)
12/07 stopped aromasin due to side effects (now what?)
Finished herceptin 1/8/08
started tamoxifen for 2 years then will switch to femera
allergic to tamoxifen started femera 4/2008
June 20, 2008 portacath removed
Learnig to live life to the fullest!
Stopped Femera due to side effects
July 28, 2008 start trial for breast cancer vaccine
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Old 08-10-2007, 12:06 PM   #5
Stephanie
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Location: San Marcos, CA
Posts: 48
Thanks for the responses, ladies.

My mom just had a muga a few weeks ago. Although her numbers had dropped, it was still 64. Her PET/CT shows a slight increase in her pleural effusion, but she's not coughing like she does when the effusion is a problem. Her bloodwork gets checked every week and is always fine.

Since the symptoms came on very suddenly, within a few days of starting Tykerb, I feel they must be Tykerb related. We haven't talked to our onc yet--my mom wants to wait a few more day to see if things settle out.

I say "our onc" b/c unfortunately I was diagnosed with breast cancer in June (at age 38). Ironically, it's HER neg, after all these years of following this board for my mom. Anyhow, I'm starting chemo the week after next, and I'm so afraid of having us both out of commission (I have young children).

Anyhow, sorry to digress. I have another question that I'll start as a separate post, but also ask here. My mom's onc has her on Tykerb continuously, with no break between cycles. We understand that the regular dosing is 3 weeks on, 1 week off. My mom wanted me to ask what kind of Tykerb cycle all of you are on?
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Old 08-11-2007, 01:26 AM   #6
hutchibk
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Actually - the only dosing I am aware of is constant... I am on non-stop Tykerb. Xeloda is the one that I do 2 wks on and 1 wk off...
__________________
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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Old 08-13-2007, 07:50 PM   #7
Esther
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Stephanie, I had some SOB issues when first on T/X. I got a prescription for Advair, and used it as needed.

It took care of the problem and increased my energy as well, as SOB can cause fatigue as well.
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Old 08-13-2007, 08:09 PM   #8
Stephanie
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Posts: 48
Thanks, Esther. I"ll let my mom know about the Advair. She's getting so weak that it's hard for her to eat, and the weakness appears to be entirely from the Tykerb.

Hope to see you at the October get-together in San Marcos!
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