TCH- How did it work for you

yanyan · 05-18-2011, 05:11 PM

I have had 4 sessions of TCH ( Taxotere, Carboplatin ) with weekly herceptin. My oncologist didn't discuss any other options with me. While i read that this seems to be a more common treatment regime for her2+ patients, reading support group members signatures gave me the impression that A/C followed by TCH seems to have longer disease free time. Ofcourse, the TCh regime does let you get on herceptin right away. I wish my oncologist had discussed other options with me. BTW, i am in CA. I heard this is more of a west coast treatment. For those who had TCH, how did it work for you? Thanks

BonnieR · 05-18-2011, 06:17 PM

It is my understanding that AC is being used less often in favor of the more tolerable TCH regieme. So that you would be seeing more old timers with "AC" in their signatures because it was more common years back and it does not reflect success/longevity rate. If that makes sense.
Keep the faith.

Jackie07 · 05-18-2011, 06:48 PM

Yanyan,

Since you are going to have reconstruction, I thought the previous thread on reconstruction http://her2support.org/vbulletin/sho...reconstruction

might help answer your question. You can read the signature of the members to get an idea what treatment process they had gone through.

TCH became a 'standard' for Her2 positive breast cancer around 2005 and most members diagnosed afterwards have the same treatment schedule as yours.

ginnyg898 · 05-27-2011, 10:32 AM

I also had TCH; my Oncologist said that this was the right treatment for me and after doing alot of research it does seem to be the standard. I am in Southern California.

After my 2nd infusion my tumor had almost disappeared completely. I finished 6 rounds in January; I am still suffering with pretty strong side effects but nothing out of the ordinary for this type of therapy.

Be strong and good luck!

yanyan · 05-29-2011, 09:29 AM

Thanks, Ginnyg898. After 4 chemos, my SUV went down by 50% but the tumor didn't shrink completely. I noticed the change right away after 1st or 2nd infusion but the progress seemed to have stopped there. The tumor and enlarge node shrank to a certain point and stopped there. My surgeon thought it was very small, my onco thought it was scar tissue. Anyway, i went with a BMX last week. I have been off chemo for 5 weeks now (4 weeks prior to surgery, 1 week post surgery). I am anxious to go back to chemo. I am in Southern CA as well.

Deb33 · 06-07-2011, 11:53 AM

I am also undergoing the TCH protocol. My oncologist said the statistics show TCH has the same results as ACTH without the heart damage. Apparently A with Herceptin can cause permanent heart damage.

yanyan · 06-07-2011, 06:31 PM

Thanks, Deb33. Just to let you know that i had 4 cycles of chemo TCH and had surgery on May 24. My onco wanted to do surgery before finishing the chemo. Anyway, my path report is not very good. The tumor was still there with 10 positive lymph nodes. I have seen many women on this website having surgery after they finish all the chemos. In my case, since i didn't respond so well to this regime i am wondering whether he will change the cocktail but i am guessing he will increase the number to 8 cycles instead of the originally planned 6. Good luck with your treatment !

Deb33 · 06-08-2011, 09:50 AM

Did your Onc send tissue to have it tested to see what is the best protocol go forward? Your tumor had shrunk - what did your PET scan look like before you started treatment? Did it show any lymph node involvement or was that a complete surprise? I'm just wondering if you did have improvement under TCH and only needed a little more time or if the protocol just wassn't effective. Also, I don't see if you are ER/PR + or - in addition to HER2? Will they allow the immediate reconstruction or are they going to make you wait until treatment is completed?
Sorry for all the questions but our paths are so similar and I am trying to get some understanding of what you are going through.

yanyan · 06-08-2011, 01:35 PM

Hi,Deb33. My onco read my path report and he is to continue the remaining 2 cycles. He didn't mention changing drugs, dosage or anything. My tumor and anxillary lymph node did shrink right away but they shrank to a certain point and stopped. My onco thought it was scar tissue, my surgeon said it was a very small tumor. My onco does surgery ususally after 2 or 3 cycles of chemo but in my case i was waiting for the BRCA gene test result and went with the 4th session. I saw him today and asked why i still had 10 positive nodes after 4 chemos. He said we didn't know what it was like before, maybe i had 30 positive nodes. I didn't want to ask him what my prognosis is based on the path report, honestly it didnt look very good to me. He did say that i needed the surgery. As for reconstruction, no one ever said i couldn't have immediate reconstruction. So i went with immediate reconstruction. I have IDC grade 3, stage 3. I didn't want to wait till the end of treatment for cosmetic reasons. But i am also taking the risk of possible complications, knowing radiation sometimes messes up things. I don't have much tissue on my tummy for 2 breasts but if you are going to need radiation, your immediate reconstruction choice is limited to tissue expander and exchange for implant after the treatment ends. I had lattismus flap with expander. Hope this helps..i am also ER/PR -, Her2 +

Deb33 · 06-08-2011, 01:51 PM

I was hoping for immediate reconstruction too but my surgeon isn't too excited about that. Do you mind if I ask why you opted for both breasts? Was that a preventative measure or were both affected? I'm still making my surgical decisions - that's why I'm so nosy.

yanyan · 06-08-2011, 02:07 PM

I opted for both breasts, it was a preventative measure. Although the survival rate is the same, mastectomy vs lumpectomy+radiation, the local reoccurence rate is higher in conservative treatment. The doctors won't tell you what works best if you are a candidate for both. I know my cancer is very aggressive and i am young, 36 yrs old. I just wanted to reduce my risk of local occurence, although distant mets are beyond my control.

snolan · 06-08-2011, 02:30 PM

I had TCH protocol. My situation a little different in that I had stage I Her 2+, they didn't find it at first, I was origonally dx w DCIS elected to have bilat mast. for preventive reasons then they found the Her 2+. TCH wasn't too bad as compaired to what I was seeing other people go thru. Didn't get sick a little nausea, a lot a fatigue, hair loss, nail loss on hands only. I tried to stay as active as possible the week after tx I felt better and would resume my physical activity at a lighter intensity. I chose to have tx on Fri so I could recover in the weekend and be ready for work on Mon, though was still tired on Mon, by Tues felt better. I also had reconstruction but Left side got infected had to take out, now I'm waiting ,since I had to have radiation, to do the lattismus flap. Would like to hear from people who had this done how did it go?

yanyan · 06-08-2011, 02:46 PM

Hi, Snolan. I am still recovering from surgery. But i am happy with the look overall. My plastic surgeon took more tissue and fat for the cancerous breast, knowing radiation will be needed. I have a long scar on the back. He said short incisions tend to creat dog ears. Different from what i saw on the website, my back incision is horizontal, one straight line across. I do feel some tightness on the back, not much pain though. It hurts sometimes and feels like a muscle pull. For reconstruction options, you can check on http://www.breastreconstruction.org. I found this is a great website and i got lots of useful info from there and that helped a lot with my reconsturction decision. If you are having lattismus flap reconstruction after radiation, you are likely to have a different look since they might have to take out some of the radiated skin. I am surprised they are doing radiation for stage 1.

snolan · 06-09-2011, 11:49 AM

I had to have the radiation for the DCIS, it turned out to be up against the skin and down to my chest wall. The biopsey didn't show that, otherwise the surgeon said he wouldn't have put the expander in and I had the skin saving tech.Surgeon recommended removing the skin but I elected not after talking with radiologist, she felt that radaiation would take care of it. Nothing went by the books which was what was frustrating. I am very prone to making plans on how things are going to go and when they don't I got very emotional. I am woundering how the results will look since I will have the implant on the R and the Lat muscle on the L.

'lizbeth · 06-10-2011, 09:57 AM

I'm not a fan of adriamycin. It is a very toxic treatment. I had to fight to get TH. My oncologist was insisting on adriamycin. I insisted on a TOP2A genetic test. The theory that was popular then was adriamycin was effective for those overexpressed on TOP2A. And i was not.

From my research in spring 2008 I found study results showing TCH was similar to ACT. Then I discovered an article that said the C (platinum salts) were effective for those testing postive for BCRA 1&2. So I found a study that compared TH to TCH.

You can over analyze these studies. They truly don't give the whole pictures. If they did - we would have cured Cancer by now.

Hindsight being 20/20, my intuition told me 4 treatments of Taxotere was all my body could handle, 2 were at higher doses that the standard TCH. But I suffered severe cognitive dysfunction as a result.

You can make a decision based on the best medical science at the time of diagnosis. But don't let fear guide your decisions. Listen to your intuition and learn to be flexible if you have difficulties with treatment.
I expected all adverse effects to disappear within a year after chemo.

My advice, keep a journal, a list of issues for your doctor. Ask many questions. Don't make decisions from fear, but from determination to have the longest, highest quality life possible.