Taxotere and Carboplatin Side effects

[Melinda]

Ok it was "d-day" today. My onc has suggested Taxotere and carboplatin accompanied by herceptin, 1 round every 3 weeks for 6 courses. All that I have read indicates this for mets but I have none. He says that this combination will decrease the possiblity of having any heart damage. Does anyone else have a treatment plan similar? I know there will be hair loss and I can deal with that... after all Brittany Spears just made baldness a fashion statement . What I am very concerned about is the fatigue and my blood cell counts. What can be done on a proactive manner to keep energy levels and blood cells counts to where they should be? I work in a retirement community and senior citizens have their share of illness. Someone suggested Emend? What about those TV adds on Procrit and Neulasta? Has anybody tried any of these?
Anxious for any info. I can not begin to tell you how grateful I am for this support group. Just when my surgeon and radiologist said this would be a walk in t he park...that damn HER2+ showed up. Onco was 23. Just like everything else, my onc siad that I am in the middle of the road for treatment. No clinical trials being such an early stage, but his concern with the HER2 made my mind up that chemo is a must. I want to fight this with everything I have
Thank you all
Melinda

[Dinogirl]

Melinda

testing this is the first time I am trying to post
Dianne

[Dinogirl]

Melinda,

I was diagnosed March 2006 (at age 52), and I received 1 cycle Taxotere and Cytoxan, then 3 more Taxotere, Cytoxan, Herceptin every 3 wks with Herceptin to continue every three weeks for one year. I am node neg IDC 6 mm lumpectomy her 2 fish positive. There is a good article on breastcancer.org about Taxotere/Cytoxan. I don't know why I received Cytoxan instead of Carboplatin. Anyway, my onc and I discussed using the above to avoid Adriamycin due to possible cumulative heart effects with Adriamycin followed by Herceptin, and so we could start the Herceptin right away instead of waiting until after the Adriamycin. I received Aloxi before each chemo, so no nausea. I received Neulasta the day after each chemo session, had no infections or dangerously low counts. (Be aware of recent literature relating increased incidence of leukemia with Neulasta, though not conclusive as I remember) Hemoglobin went from 14 to 10 (after last chemo), then popped right back up to 13 with no red cell stimulation. I stayed home from work for 2 weeks after each treatment, went into hibernation with Darvocet when needed. (mostly for the leg pain from Neulasta). I remember insomnia for the first few days after treatment (probably from the Decadron)

My understanding is that there is a 20% incidence of distant mets even though node neg, I was in a grey area also, but went for the max treatment we thought safe in my case.

I hope this helps,
Sincerely,
Dianne

[Jean]

HI Melinda,

I had the same treatment TCH....
It went very well and I was able to work and function pretty well.
Of course there were side effects but doable. Of course I took
Emend for the nausea....a must! Take your nausea meds even if
you don't feel you need them. It can sneak up on you and then
it is too late. You want to stay ahead of that. There is fatigue
I found that the day of treatment went well...then about two days
later it hits. Therefore I always had my treatments on Thur.
was able to work on Friday and then rested (needed too) on Sat.
Sun. if I was feeling exhausted I could take Monday also.
But by Tues. I was feeling better. The pre- meds are the hardest.
You will more than likely need the Neulasta and Procrit I had both.
There can be some kick back from the Neulasta but I just took
alieve and it worked fine along with the resting. (There can be
some bone discomfort) I had made up mind to embrace the treatment
and I do think that is half the battle. Your state of mind is very
important during treatment. I did lots of things for myself to keep
my spirits up and positive. Yes - you will loose your hair - not a major
deal in all of this when you consider that your taking drugs
to kill this devil. I could not stand my hair falling out in batches, so
I did the GI Jane look right away after it started to fall out. It was
much easier for me that way I had my wig ready -
For me and others you more than likly will get a metal type of taste
after treatment and it effects your taste buds for
days. Certain foods will taste bad and strange. It is different for
everyone. Ice-cream for me was perfect - it was cold and did not
have a sour or metal taste. I also enjoyed iced-coffee which did not
leave an after taste. Try to eat yogurt during treatment. It is important to be hydrated prior and during treatment so drink generous amounts of water during treatment to flush your system.

Just take one step at a time....and remember you are not alone.
Do comfort things for yourself.. I would take nice long warm baths
and curl up in a very soft terry robe and my husband would give
me back messages and foot messages....what ever works to make you
feel better.

If you have more questions or just want to chat you can e mail
me.......you will get through it! I now have 4 more herceptin treatments
to complete my year....I can't beleive how the time has passed.
It all seems so over the top when you have to begin. Just think of
it in small sections and one step at a time.

Sending you all good wishes,
Jean

[Chelee]

I did TCH myself. Jean already covered many of the things I would have. I took the Zofran for nausea which worked great. Around my 3rd chemo trt I didn't even take the Zofran and was fine. I always felt like I might get sick..but never did. I always found if I *forced* myself to put a small amount of anything in my stomach...it got rid of that sick feeling. So thats the trick..to TRY to keep food in there. Plus remember...this is no time to try to diet. So eat whatever tastes good and worry about it when your off chemo. I know with TCH it ruins your taste buds in a big way. Leaves an awful taste in your mouth and on your teeth. (That was my experience anyway.) Try to drink plenty of water. Around your 3rd chemo I think you will find water tastes nasty...but if you put it in the frig and drink it cold its much better...or if you add some flavor to it. Or drink some gadorade or "Power Aid" if you have too. That was really good COLD. Plenty of fluids.

I am pretty sure it was the Taxotere to blame for the aches and pains in bones and joints. I just ached all over. Its bad about the first week & a half after chemo and it gets better for about a week BEFORE you go back for your next cycle of chemo. The taxotere is no doubt to blame for the hair lose also. But hair grows back...so thats not to worry about.

I noticed you were concerned about your fatigue level and blood counts. I am not sure there is really much you can do to help that. You are going to have a *certain* about of fatigue no matter what you do it seems. (However...that being said...there have been SOME women that have actually breezed through their chemo trts and done quite well.) So everyone is different. I do know I felt better and less fatigued when I got some real protein in me which was hard to do. At one point I could hardly eat and was drinking "Ensure" with protein and Omega 3 & 6. I just know its very important to make sure you eat right if possible. But expect to be tired to some level. I don't think there is anyway around that one?

As to procrit and neulasta. You will probably get that depending on your lab work each time you go in. They always do labs before you do your chemo. If your RBC (red blood count) or WBC (white blood count) is low...then you will get a shot. Procrit you can have the *same* day as chemo...but with Neulasta they usually make you come back the following day to get it. But again..you ONLY get it if your counts are down..they will let you know.

I think its great you have decided to go after this now with guns a blazing...I think thats a very smart idea. You will get through this...take one day at a time. Each time you get through one chemo...just tell yourself, one down and five to go. It goes by quicker then you would think. Hang in there and if we can help just holler.

Chelee

[janet11]

I also had TCH and will add: Biotene mouthwash (over the counter) was my best friend when I had "sewer mouth" (*grin*). When the taste was bad, there were times I'd use the Biotene every 15 minutes! It really helped.

My favorite drink is plain water and I was lucky: it didn't taste nasty until cycle 6. And even then, that didn't last long.

Each cycle things changed a bit on what I felt like eating and what I could eat. So if you find that something tastes bad, just look for something else. You'll find that you classify things as 'good', 'ok', and 'disgusting' (*grin*).

When I started on TCH, I also ended up having to take an over-the-counter reflux med daily. I treated the side effects of chemo as I had them and they were quite manageable.

I was told to keep active -- that that helps with the fatigue. I don't know. I'm not particularly active, but didn't have much fatigue. After cycle 2 when my white counts dove, I took Neulasta shots. But that was all. Other blood counts were never dangerously low.

Remember, there are a lot of side effects people have. Most of us have a few of them. Some even most. But generally we all get hit a bit differently.

I had nausea meds, but not Emend. My onc said that she gives that to people getting AC, but that most of her TCH patients didn't need it. Turns out that I didn't either.

TCH was very doable. Thanks to Prevacid, Immodium, Senekot, and Biotene mouthwash (hated the toothpaste), the worst of TCH was the taste changes. By the end of chemo, I was dreaming of salads. (Yep -- one of the first things that tasted bad to me early on was vinegar, and I love vinagrette dressings (*grin*)).

Good luck.

Janet

[Jean]

Janet,
It is true we do forget.....I am a big salad lover and during TCH the vinger
was just dreadful....soon as treatment was complete and taste was back
to normal boy did I hit it strong and hard with my Basalmic Vingar and Olive Oil.

Jean

[Erin]

Hello,

You have exactly my same routine...welcome :-) (LOL). You can see from my bio below that I am node negative and with a small tumor, but my onc felt that chemo was warranted due to the HER2 status. Also, he told me being HER2 positive, ER/PR highly positive, AND with a small tumor was very unusual....so he was concerned. I also felt I wanted to be agressive since I am ONLY 50 and I'm willing to suffer some now to give me a better shot at living until I'm 95

I started my chemo on 2/13 and it was not a picnic :-(But, nausea was completely controlled by meds. Felt really bad day 2-8, but I kept up with most of my daily routine - had to push myself though. Found that keeping fairly active really helped...at least it kept my mind off it. Had some serious chemo-brain issues. That has improved.

I feel almost normal now (day 13)...tired with exertion (planting some flowers yesterday felt like working out at the gym!), but at rest things are pretty OK. Lots of hair sheding but no big patches yet..onc says day 16 will be it...we'll see.

Best of luck with your treatment - keep us posted.

[Hopeful]

Erin,

Being strongly ER+/PR+ with a small tumor and node negative are all positive prognostic factors. What was it about your pathology (other than Her2+) that had your onc concerned?

Hopeful

[Erin]

Hopeful,

That was it. I have since met several women (at the chemo clinic) with the same dx and the same chemo protocol. We all have onc's from the same group, so perhaps they are of the same mind when it comes to chemo. I have also heard (on this site?) that being ER/PR strongly positive and HER2 positive corralates with a high Oncotype DX score for recurrance (though I did not have the Oncotype testing done myself).

Also, my second opinion was with Ravi Patel, who is one of top onc's in Bakersfield - working out of UCLA. He agreed with the suggestions of my onc regarding chemo.

As I said I wanted to be as agressive as was reasonable in my situation. I do get the feeling that if I had said I absolutely didn't want chemo, my onc would have not tried to talk me into it....but it was his recommendation.

[Hopeful]

Erin,

Thanks, I was just curious, as I am also highly ER+/PR+ Her2+ with stage 1 IDC. I can attest to the high Oncotype score (mine was 42 = 30% recurrance odds), however, I take it with a grain of salt since the Oncotype test results specify that the results are only comparable to someone with the same genetic score who was ER+ and took Tamoxifen alone. Since it has been shown that unopposed Tamoxifen (the treatment for the validation set for this test) has the potential to promote rather than inhibit Her2+ ER+ bc, I think it artificially inflates the score somewhat for those of us in that group. Since I was dx post-menopause, Tamoxifen was never a consideration, and I now take Arimidex.

I wish you the best of luck with your treatment plan, and hope that your remaining chemo treatments go smoothly for you.

Hopeful

[Melinda]

HI Ladies,
Well I went to Atlantic City for the weekend just to have a break before Chemo. While I was there I listened to a MoTown group that sang oldies form the 60, 70,80's. At some point and I dont exactly know why, one of the singers congratulated all of the bald men in the audience. Right after that he congratualted the bald women as a joke but I politely went up and said thank you in advance... I'll be bald in about a month. He shook my hand and smiled. MAybe it was lost on him what I was saying, but you know it felt good being able to admit it.
So tomorrow I am getting my already short hair even shorter. I will probably be the only 54 yr old that looks "punk". Right now people say I resemble Jamie Lee Curtis... lets see what they say after tomorrow!
Thank all of you for posting to my question. I will keep posting and let you know how I am doing.
LEt me know how day 16 goes for you Erin, and all the other days as well. I am about 2 weeks behind you.
Melinda

[Penny]

During my course of treatment I used a 3 day pack of Emend and then a shot of Nulasta 24 hours after treatment to keep my blood counts up. Eventhough I ended up catching some colds, (I work in a high school, lots of germs!) my counts were always good and I never missed a treatment. Good luck!

[rinaina]

Melinda, the Emend worked great for me and I also had a regiment in addition to the emend for nausea that consisted of Compazene, Ativan and dexamethosone. I never had bad nausea so the combo worked. I did receive 2 neulasta injections the day after treatment 3 and 4 due to low wbc. They must have worked because I never got an infection. Are you receiving herceptin along with the chemo?

[Melinda]

Hi girls,
I went to my dentist today to have a tooth removed. We have talked about the chemo that is aboaut to start and I asked him about oral hygiene and what can be done to "help any possible decay or mouth issues while on chemo. He gave me a prescription for PREVIDENT5000 Booster... a Colgate toothpaste with a booster of floride to help with mouth bacteria. Hope this info helps any one experiencing dental difficulties. Also highly recommended Biotene mouthwash.

And yes I will be receiving herceptin, taxotere and carboplatin for my cocktail
Melinda

[tousled1]

I had 4 rounds A/C followed by 4 rounds of Taxatore. The taxatore was very effective in shrinking my large tumor. Major side effect that I had with the Taxatore was bone/joint pain. My red and white counts continually dropped so I would get Procrit the day of chemo and Neulasta the day after treatment. Keep a positive attitude as you have a good chemo regime.

[janet11]

My dentist gave me a surprise when I went for my post-chemo appointment. After 6 cycles of TCH with the taste problems, my dental checkup was the BEST I've had in years. I credit this with the fact that I was absolutely on top of my dental/mouth health: brushing after meals, using the mouthwash after brushing and whenever I had dry mouth or 'sewer mouth' (bad taste in mouth).

I also never had mouth sores (to the surprise of my onc). All hail Biotene mouthwash (*smile*)

[Melinda]

Today was my first chemo. I started taking the decadron the day before to prevent any allergic reactions. I am to take that until tomorrow. They put Aloixi and benadryl in my cocktail to prevent nausea. It was a long day.8AM to 5PM all at the hospital. I had an echocardiogram and blood work done. Apparently my ONC nurse told me I was a "one sticker" meaning she did not want anyone else using my veins except her. I have no port as yet. I go back tomorrow for Neulasta. I work around elderly and teenagers (retirement community) and they felt my risk of infection my be greater. They also gave me two prescriptions for nausea in case I need it. One Zofran and the other Tigan. THe difference being in price. Apparently thought they tell me the zofran works better. My guess.... its the expensive one. Two weeks form today I go for a RBC count. All in all the only thing I think is visible is that I am not sleepy for having gone through such a long day. I was also very agitated aboaut having to wait so long before the actual IV was started. They tell you once you get there it will take 4-41/2 hours, but that does not include waiting for the ONC to talk to you or review you file.
ONe thing I was told however was that haviang the chemo in his complex (inside the hospital) was not considered "outpatient". I bring this up becasue soem insurance probably including my Personal choice does not pay as much of the bill in this circumstance. You can bet I will be on the phone on Monday to find out all the particulars such as expense versus location...or just a crazy IBX personal choice rule?????
I hope I feel this good the rest of the week, but they did warn me that side effects kick inlater. Hear is hoping for the best and being prepared for the worst.
Thanks for eveyones support!
MElinda

[Jean]

yes it is a long day....also, the decadron is keeping you wired and maybe difficult to sleep, try a nice hot bath to help you relax. Okay one treatment
down already.


Sending you hugs and prayers
Jean

[Melinda]

ITs hard to tell which drug is causing what. My guess is that the decadron that they give to eliminate the allergic reactions has probably taken its toll on me the most. Sunday was the fist night that I got "some" solid sleep. Tylenol PM did not help so I think next time I will take the advise of one of our sisters and ask for some Sonata. I also attribute the "chemo brain" syndrome from lack of sleep as well, I just read my last post and noticed all the "typos" . Sunday is when the achiness set in, probably due to the Neulasta shot. But if this is what it takes to keep my WBC count up... bring on the aches. I managed to work Saturday and Monday altho Monday was a stretch being the only manager on duty that day.
Taste buds are not what they used to be. Oddly enough I enjoy those egg and cheese hot pockets. At least they have a flavor that I recognize. I have been drinking water, as much as possible and that helps.
This regiment I am told is fairly new, and is being reviewed as better tolerated than A/C and some of the others. My ONC nurse just attended a seminar Saturday on this regiment. She said that in comparison, this was quite a doable combination.... time will tell!
I am off to work now. I really want to keep some type of reasonable pace while all this is going on. BUT NOT OVERDUE AND TO RECOGNIZE MY LIMITATAIONS>
Thank you all for listening and maybe I am helping someone who is about to undergo this regiment.
Hugs and prayers
Melinda