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Old 04-02-2010, 09:05 PM   #1
LoriG
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Tykerb through mastectomy??

I have had a great response to Tykerb and Xeloda and am finally having my bilateral MRM this week. My onc told me to go off the Xeloda for the surgery (my last dose in this cycle was today, surgery is wednesday) but continue the Tykerb through surgery and beyond. I have had 2 people tell me they were told to stop tykerb in advance becasue of potantial wound healing issues. Anyone else continue Tykerb through their surgery? I guess my case is unusual in that most people out on these agents have probably already had surgery.

Thanks so much!
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Lori, age 33
*IBC (ER+,PR-,Her2+) on right diagnosed 8/09 with metastatic lymph node left axilla (Er-,PR-,Her2+) vs possible bilateral breast cancer
*A/C x4
*Taxol x4 with weekly herceptin
*Breast MRI 12/09- no improvement
*PET scan 12/09- no evidence of mets
*Tykerb/Xeloda 12/09
*Bilateral MRM 4/10
*Twice daily rads to both chest walls and both axillas 5/10-6/10
*9/10 PET/CT- NED
*Tykerb/Xeloda until 12/10
*Tykerb and Tamoxifen 12/10-current. Bye bye Xeloda
*2/11- malignant pleural effusions bilaterally (likely lymphangitic lung mets) and skin mets
Herceptin and Ixempra
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Old 04-04-2010, 11:18 AM   #2
Ellie F
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Re: Tykerb through mastectomy??

Hi Lori
Sorry I have no personal information to offer however a couple of years ago a small trial (about 40 women )of tykerb for IBC was completed. The women on the trial continued tykerb throughout mastectomy surgery and had no problem with wound healing.
Sorry I can't locate the actual trial info to send you but I remember this information well.
Hope this might help.
Ellie
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Old 04-04-2010, 02:19 PM   #3
Chelee
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Re: Tykerb through mastectomy??

Lori, I recurred last Sept. & started on Herceptin asap. But I was suppose to start chemo when we found out I had an "impending fracture" of my femur and needed surgery. I wanted to add something to the Herceptin due to the down time I would have with surgery & recovery. So I asked my onc if I could start on Tykerb? She was adamant that it would cause problems with my healing. After surgery I had an open hole from where the drain was and my incision--and it took forever to heal when I was only on Herceptin.

So I don't know if Tykerb would of slowed the healing or not...but my onc insist it would have. I also met this woman that is scheduled to have surgery on her shoulder and was told to stop her Tykerb by her onc. But now I question this advice since the trial Ellie mentioned had no problems with continuing Tykerb? Since a trial allowed it I would be more inclined to believe it's ok. Is there any other 2nd opinon onc's you have seen that you could call this wk before your surgery? Wish I could help more.

Chelee
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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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Old 04-04-2010, 03:25 PM   #4
Jackie07
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Re: Tykerb through mastectomy??

Lori,

The link from the American Cancer Society

http://www.cancer.org/docroot/CDG/co..._lapatinib.asp

has a long list of drugs that interact with Tykerb, including some antibiotics.

I'm thinking that your doctor probably had weighed the situation and thought it's worth the risks since you've responded to the drug so well. You can always stop taking Tykerb if it indeed causes problems.
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Old 04-04-2010, 06:16 PM   #5
LoriG
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Re: Tykerb through mastectomy??

Ellie, Chelee, and Jackie,

Thank you so much for the advice! I would be extremely nervous to go off Tykeb for surgery since I am stage IV, and I think that would leave me uncovered systemically. Although my mets are only to a cross axillary lymph node, which will be addressed in surgery with my bilateral axillary node dissection, who knows what else is lurking out there! I did verify multiple times with both my MDA onc and my local onc that I was supposed to continue the Tykerb. The one thing on my side from a healing standpoint is that I am young and healthy with no other medical problems so hopefully it will be ok.

You ladies are awesome. Thanks again so much!

Hugs,
Lori
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Lori, age 33
*IBC (ER+,PR-,Her2+) on right diagnosed 8/09 with metastatic lymph node left axilla (Er-,PR-,Her2+) vs possible bilateral breast cancer
*A/C x4
*Taxol x4 with weekly herceptin
*Breast MRI 12/09- no improvement
*PET scan 12/09- no evidence of mets
*Tykerb/Xeloda 12/09
*Bilateral MRM 4/10
*Twice daily rads to both chest walls and both axillas 5/10-6/10
*9/10 PET/CT- NED
*Tykerb/Xeloda until 12/10
*Tykerb and Tamoxifen 12/10-current. Bye bye Xeloda
*2/11- malignant pleural effusions bilaterally (likely lymphangitic lung mets) and skin mets
Herceptin and Ixempra
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