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Old 08-01-2007, 12:12 AM   #1
Erin
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Herceptin and ankle swelling

Hi Ladies,

Two months ago, right after my last TCH I developed some swelling in my ankles. Onc put me on lasik - on four days a week, off three days. After 4 days the swelling would be completely gone, but the minute I went off the lasik it would come back. We gave it 6 weeks, but no improvement, so now I am on lasik every other day. Swelling improves slightly after I take it, but comes back on my off days. Suspended herceptin for now.

Onc says he will repeat my echo next week, but says it is pretty clear that I am having some heart failure issues, from the Herceptin. I got 5 full months of herceptin in, and as my onc says, if I were in Finland, I would have only gotten 9 weeks. Nonetheless, as you all know, herceptin feels like a magic talisman to me and I am really bummed about stopping.

Here is the question - Have any of you had to suspend herceptin for cardic issues and were you able to go back on it once the cardic function improved?

Thanks for your help.
__________________
Age 50, premenopausal
Dx 1/2/07 DCIS/IDC
Lumpectomy 1/4/07 1.1cm tumor
SNB 3 nodes clear
Stage 1, Grade 2, HER2+++ (FISH 6.8)
ER + / PR +
TCH, 6 rounds, finished 6/1/07!!!
Herceptin to continue for 1 year
36 rads finished 8/22/07
Port out 8/27/07
Switched to Herceptin weekly for joint pain
Ooph 11/13/07
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Old 08-01-2007, 03:48 AM   #2
Becky
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Dear Erin

How do you know you are having heart issues without any ejection factor testing? I would insist on the testing now because if all is well, you have been off of Herceptin (and maybe for no reason). Ankle swelling, especially in the summer, could happen just because Herceptin stimulates the immune system. You doctor is right to test the heart but he should have done so a long time ago because if all is well with your heart now, it could be from recovery (and that Herceptin did cause a problem) but it could be that nothing was wrong to begin with.

Get a muga or echo now and see what's going on. If something was or is wrong, you might need to see a cardiologist (probably not but who knows - I think you get what I am trying to say).

Let us know how this turns out.

Big hug to you
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Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 08-01-2007, 04:00 AM   #3
dhealey
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Erin, Have you had any shortness of breath? I think what your onc is worried about is congestive heart failure. You would have other symptoms though, like shortness of breath, extreme fatique and dizziness. I agree you need an echo or a muga. If the ejection fraction is above 50% you can continue with the herceptin. Some swelling is normal in the summer particularly if you are on your feet alot. Try to stay positive!
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
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Old 08-01-2007, 06:27 AM   #4
mke
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I had ankle swelling while on herceptin, I brought it to the oncologists attention and as it was not "pitting edema", that is when pressed down the skin popped back quickly, he wasn't worried. He just told me to keep my feet elevated as much as possible and let him know if it got worse. I had been having MUGAs regularly so we knew my heart function was good.
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Old 08-01-2007, 07:46 AM   #5
Gerri
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Erin,

I STILL have swelling in my ankles and I have been off of Herceptin for several months. I was never given anything to take for the swelling and my echo was always normal. They are getting better but some days are better than others. I tend to sit too much at work and need to remind myself to get up and get my circulation going throughout the day. Like others have said, summer is prime time for puffy ankles.

Really do hope that your echo comes out fine and you can continue with Herceptin.

Best of luck to you.
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Gerri
Dx: 11/23/05, Lumpectomy 12/12/05
Tumor 2.2 cm, Stage II, Grade 3, Sentinel Node biopsy negative
ER+ (30%) /PR+ (50%), HER2+++
AC X 4 dose dense, Taxol X 4 dose dense
Herceptin started with 2nd Taxol, given weekly until chemo done
then given every 3 weeks for one year ending on March 16, 2007
Radiation 30 treatments
Tamoxifen - 2 yrs (pre-menopausal)
May 2008 - Feb 2012 Femara
Aug 2008 - Feb 2012 Zometa every 6 months
March 2012 - Stop Femara, now Evista for bone strengthening
**********
Enjoy the little things, for one day you may look
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Old 08-01-2007, 07:51 AM   #6
Grace
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Erin,

To repeat what Becky said, have you had MUGA's, echos, or stress tests to confirm congestive heart failure? My ankles are huge since I began herceptin and I've had regular MUGAs and echos, and just one month ago had a full stress test. In all tests my LVEF was 60% or above. I'm convinced that the swelling for me is herceptin and that it will leave when herceptin leaves--getting my last infusion on August 7.

And I should note that I have discussed swelling with two cardiologists and neither are worried, knowing that the LVEF is fine.

Good luck.
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Old 08-01-2007, 01:59 PM   #7
Chelee
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I was going to ask the same thing as Becky. How does your onc know your have heart issues? Have you had a recent ECHO or MUGA to confirm this? If its yes...then I understand. But I hate to see your onc pull you off herceptin before he knows for sure.

I did TCH and finished my year of herceptin and just wanted to tell you I got concerned too because around trt 4 or 5 of TCH my ankles & lower legs were swelling really bad! Pitted edema and very un-comfortable. My onc wasn't concerned since my ECHO's were great so I continued with TCH. My pulmonary doc put me on lasix...40 mg. That seemed to do the trick. I stayed on lasix for about 2 months *after* my last TCH and the edema *completely* went away. I've been OFF lasix since then and no problems. I was still doing my weekly herceptin and no problems. So your onc really can't be sure its your heart, nor from herceptin. I can't help but feel its just a side affect from the taxotere? This problem did NOT start for me till the END of my TCH trt. Your situation sounds the same way. I think you will find once you are off TCH that edema will eventually go away. Keep us updated and let us know what they find out. I have a feeling you will be ok and its just that nasty taxotere messing with ya. Hang in there.

Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
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 08-01-2007, 03:16 PM   #8
CLTann
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Suggestion to get heart tested is the top priority, in my opinion. Lasix is only for temporary relief and serves no fundamental purpose. If you can tolerate the swelling, I would not take Lasix to hide the problem. Like many have said, if your heart is near normal you should continue doing Herceptin. Good luck.
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Stage 1 dx Sept 05
ER/PR positive HER2 +++ Grade 3
Invasive carcinoma 1 cm, no node involvement
Mastec Sept 05
Annual scans all negative, Oct 06
Postmenopause. Arimidex only since Sept 06, bone or muscle ache after 3 month
Off Arimidex, change to Femara 1/12-07, ache stopped
Sept 07 all tests negative, pass 2 year mark
Feb 08 continue doing well.
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Old 08-01-2007, 03:25 PM   #9
Barbara H.
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low muga

Five weeks ago I had a low muga. (45%) I exercised and went off Herceptin. A week ago it was back up to 60%.
Hopefully you will be in the normal range.
Best wishes,
Barbara H.
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Old 08-01-2007, 03:58 PM   #10
weezie1053
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I completed Taxol in Feb 07, and I take Herceptin every 3rd week til Nov 07. I have endured swollen ankles and feet. Only recently could I see the veins in my feet. My Onc schedules me for Mugas every 3- 4months or so.
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  • Diagnosis 06/06 - Stage II-A BC; BC was 2.5 cm, grade 2; ER/PR negative & HER-2/neu positive;
  • Mastectomy w/ reconstruction (implant) in 09/06;lymph nodes - negative;
  • AC/Cytoxin combo - 4 treatments (dose dense);
  • Taxol/Herceptin combo- 12 weekly treatments;
  • Completed chemo - 2/07; completed restruction 02/07; reduction of left breast.
  • BRCA 1 and 2 negative - 6/15/07;DX high risk for distant recurrence
  • MRI, 08/02/07 - NED
  • 1 year Anniversary - 09/07; completed Herceptin 11/07.
  • Mammo 02/14/08 - NED; MRI - 08/2008 - NED
  • 2 year Anniversary - 09/08
  • Mammo 02/09 - NED; MRI - 08/09 - NED
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Old 08-01-2007, 08:55 PM   #11
Erin
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Thanks for all the info! I am always sure to get some great encouragement when I ask questions here.

Not sure why my onc seems so convinced that the swelling is from heart problems without doing another echo. I will push for that before he has me miss another infusion of Herceptin. For the time being I think I'll go out and buy some new shoes that fit (LOL).

thanks
__________________
Age 50, premenopausal
Dx 1/2/07 DCIS/IDC
Lumpectomy 1/4/07 1.1cm tumor
SNB 3 nodes clear
Stage 1, Grade 2, HER2+++ (FISH 6.8)
ER + / PR +
TCH, 6 rounds, finished 6/1/07!!!
Herceptin to continue for 1 year
36 rads finished 8/22/07
Port out 8/27/07
Switched to Herceptin weekly for joint pain
Ooph 11/13/07
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Old 08-01-2007, 11:51 PM   #12
suzan w
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Thumbs up

I started a thread about swollen ankles...hmmm...in 2006 sometime. Lots of us experienced swollen ankles. Don't know how you can find my thread? I can find it and "bump it up" if you like!!!
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Suzan W.
age 54 at diagnosis
5/05 suspicious mammogram-left breast
5/05 biopsy-invasive lobular carcinoma with LCIS,8mm tumor,stage 1 grade 2, ER+ PR+ Her2+++
6/14/05 bilateral mastectomy, node neg. all scans neg.
Oncotype DX-high risk
8/05-10/05 4 rounds A/C
10/05 -10/06 1 yr. herceptin
arimidex-5 years
2/14/08 started daily self administered injections..FORTEO for severe osteoporosis
7/28/09 BRCA 1 negative BRCA2 POSITIVE
8/17/09 prophylactic salpingo-oophorectomy
10/15/10 last FORTEOinjection
RECLAST infusion(ostoeporosis)
6/14/10 5 year cancerversary!
8/2010-18%increase in bone density!
no further treatments
Oncologist says, "Go do the Happy Dance"
I say,"What a long strange trip its been"
'One day at a time'
6-14-2015. 10 YEAR CANCERVERSARY!
7-16 to 9-16. Extensive (and expensive) dental work done to save teeth. Damage from osteoporosis and chemo and long term bisphosphonate use
6-14-16. 11 YEAR CANCERVERSARY!!
7-20-16 Prolia injection for severe osteoporosis
2 days later, massive hive outbreak. This led to an eventual dx of Chronic Ideopathic Urticaria, an auto-immune disease from HELL.
6-14-17 12 YEAR CANCERVERSARY!!
still suffering from CIU. 4 hospitilizations in the past year

as of today, 10-31-17 in remission from CIU and still, CANCER FREE!!!
6-14-18 13 YEAR CANCERVERSARY!! NED!!
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