Chemotherapy with Herceptin

LisaJ · 11-28-2005, 10:30 AM

Hi am brand new and haven't even seen my oncologist yet. (I go Wednesday). I just have a few questions. Will I have chemo separately from the Herceptin or will they give it to me together? I haven't had any scans yet. Will they wait to give me chemo until I have the scans done? Is there anything I should be asking when I go into see her? I need all the help I can get!

Lisa · 11-28-2005, 10:52 AM

Lisa J,
Before we can answer your questions, we need to ask a few. Why are you going to the onc? Have you been diagnosed yet with breast cancer?

Love and light,

Lisa

LisaJ · 11-28-2005, 10:54 AM

Whoops. I am so sorry. I have been diagnosed with breast cancer. I had a lumpectomey, 2.0 mass in my left breast, had 12 nodes removed of which 7 were positive, making me at stage IIIA I was also ER/PR- and HER2+++. I learned all of this from my surgeon.

jojo · 11-28-2005, 11:50 AM

I am sorry about your diagnosis. :-(

I do not know a whole lot about chemo, but all I know is this: it is very dangerous to combine Herceptin with Adriamycin / Cytoxan. It would be too much for the heart activity, it is almost never prescribed this way.

It is more common that oncs would put us on the combo of Herceptin & either Taxol or Taxotere (whenever they think it was time for us to do a taxane chemo -- Taxol & Taxotere are from a family of taxanes). It is often said that this combo works even better in catching those dang cancer cells than doing Taxol or Taxotere alone. But your onc will know what to do in your particular case.

Come back to us after you gather all your stats, and feel free to ask us any questions or do a rant here. :-)

Good luck, you are in our thoughts.

Becky · 11-28-2005, 12:02 PM

The most current treatment is to get 4 dense dose cycles of AC (Adriamycin and cytoxan) followed by 12 weekly treatments of taxol with herceptin then another 40 weekly treatments of herceptin alone (these last 40 can be reduced to 14 treatments every three weeks (triple the dose of the weekly treatment)).

You can do radiation and the herceptin alone treatments together after the taxol/herceptin combination is done. Taxotere can be substituted for taxol.

Jojo is right that the herceptin should not be combined with the first four AC treatments.

Warmest regards

Becky

Lisa · 11-28-2005, 06:29 PM

Lisa,

There are many chemos available. Ask your doctor about them. The very best thing you can do is have a list of questions for your onc and ask until you're satisfied with the answers. You should feel a "partnership" with your onc. I assume you will be taking a friend/family member with you on Wed. You will definiitely need a second set of ears to remember everything.

Are you sure you didn't have any scans done prior to your surgery? Docs will usually get a bone scan, and body CT or Pet scan to be certain the breast cancer was only in the breast. Also, are you going to have radiation? It is usually done in combo with a lumpectomy.

When you start the chemo, unless it is Adriamycin, she will probably start you on Herceptin as well. Like the others said, you CANNOT take Adriamycin and Herceptin together due to possible heart issues. Don't let that scare you. You'll handle your chemo well. Be sure and let us know how Wed. goes? And feel free to ask anything.

Love and light,

Lisa

sassy · 11-28-2005, 07:29 PM

Lisa,

I was Stage II, .9cm mass, 5 of 14 nodes positive er+,pr+, her2+++ and had the treatment Becky mentioned. 4 dose dense a/c, 10 taxol/herceptin, now continuing herceptin for balance of one year. Also completed 33 radiation treatments, which will probably be suggested for you since you had 7 nodes positive.

Come here often to read previous posts, ask questions and get support. This has been a lifeline for me for the past few months.

Keep the Faith,

Sassy
________
WELLBUTRIN LAWYER

11-28-2005, 07:52 PM

Yes, you should get treatment that combines a taxane (taxol or taxotere) with Herceptin. There were a few studies that came out 4/05 that showed a 50% reduction in recurrance when they were combined as opposed to sequentially.

My wife was also 3A and had the combination of Taxol/carboplatin/Herceptin followed by A/C (adriamycin/cytoxan). A/C first then taxane/carboplatin/herceptin or vice versa, it doesn't matter as long as you get this combination of drugs followed by a year of Herceptin as you are at high risk of recurrance.

You are Her2 positive and ER/PR negative. After chemo you have limited options, so you need to make hay with the chemo. I feel strongly enough about this that if your oncologist recommends anything else look for a second opinion.

Scott

jojo · 11-28-2005, 08:14 PM

Lisa J,

It is pretty standard for advanged stage BC ladies to have 4x A/C (either every 3 weeks or 2 weeks, which is called dose dence), and the following Taxane could be administered either 12x every week (not sure, if it's also dose dense?), 4x every 3 weeks, and even every 2 weeks (don't know how many infusions for the bi-weekly).

My weekly Herceptin had been continued while I was having radiation. Since I am stage 4, I am still taking Herceptin indefinitely -- I will have it forever unless my onc decides otherwise or big issues of the heart (Herceptin is known for its heart toxicity, but mostly irreversible by taking a break from Herceptin, or other meds for putting the heart under better control).

jojo · 11-28-2005, 08:15 PM

I meant to say "advanced".

LisaJ · 11-29-2005, 07:17 AM

Unfortunately I think I have done some things backwards. After I was biopsied at the breast center at Northwestern, I met with a surgeon,not an oncologist. I had surgery a week and a half ago. The only things I have had done is a chest x-ray and blood work. Both were clear. I meet with the oncologist for the first time tomorrow. I know I will have to have chemo and radiation and now thankfully Herceptin. The one thing I do know is that I am HER2+++. I know I will have to have more scans and I am extrememly nervous about them. Thank you all for your help. It has been so valuable. THANK YOU!!!

LisaJ · 12-02-2005, 06:51 AM

Hi. I met with my oncologist on Tuesday and loved her. Just like many of you said I will have 4 dense dose cycles of AC (Adriamycin and cytoxan) followed by 12 weekly treatments of taxol with herceptin then another 40 weekly treatments of herceptin alone. They are not sure about radiation yet. I need to be tested for BRCA gene since breast and ovarian cancer is prevalent in my family. If I have the gene I will have to have a double mastecomy. I have a long road ahead.

I have yet to have a bone scan and CT scan for lungs and liver. I am a nervous wreck about the results from these. It will be such a blow if it has spread. I have this beautiful 2 year old that I want to see grow up. I had a chest X-ray that was clear and blood work done which also came back clear. I hope those are good signs.

I was wondering if anyone can tell me what to expect with my first round of chemo (Adriamycin and cytoxan). It would be of great help. Thanks!

Lisa

12-09-2005, 01:32 PM

I had the same diagnosis. I did 4 ac and 4 taxotere with herceptin. My advice to you is drink plenty of water and chip ice the first three days of AC.
I had no problems with AC and was on my treadmill by Monday. The taxotere
is a little harder but if you drink water right after you get the treatment and flush out your system the side effects are not bad. Best to you