Taxotere, Carboplatin, Herceptin

Cristina19 · 08-27-2007, 10:00 PM

Greetings Sisters,

I am about to start chemotherapy--TCH--on Wednesday: 6 infusions, separated by 3 weeks. Then, the plan is to continue with Herceptin alone for up to one year. At some point the oncologist will throw Tamoxifen into the mix.

My question: everything! Have any of you been on this particular set of drugs for chemo? Your effects?

I know that everyone reacts differently, but any wisdom will be appreciated.

I asked for TCH (following the advice of a UCLA oncologist who took part in Herceptin studies); he stated that the cardiotoxicity was less with TCH than with Adryamicin. My City of Hope oncologist agreed to this treatment although he had been more "traditional" and had originally planned AC->TH. Both believe that the treatments are equally effective although the TCH is newer.

My diagnosis: out of the blue, no family history, DX at 37 in May 2007. Stage 1, extensive DCIS, 1.2 cm infiltrating ductal carcinoma, all margins and sentinal node negative, ER +, PR -, HER2 +++. Total right breast mastectomy (too much DCIS and too small breast) with immediate free-TRAM reconstruction.

I've done the genetic testing but haven't heard back.

Any support, wisdom will be appreciated.

John21 · 08-28-2007, 08:05 AM

My wife had this treatment. It was not as bad as a previous treatment. The premeds made things reasonable. The hair loss this time was probably the worst. She made it through with great success. I hope the same for you.

John

madubois63 · 08-28-2007, 08:15 AM

I did Taxotere, Carboplaten, Herceptin and Femara all at the same time. Within 3 months the mets to my lung were gone and another 3 months of treatment got rid of the mets to the liver. I've been NED since April 2005. I've had othr problems along the way, but this combo worked well for me. I hope it works well for you too!!

Erin · 08-28-2007, 08:50 AM

Hi Christina,

Sorry you are here, but you have found a great resource. I had almost the same dx and treatment plan, with the exception of the mast for the extensive dcis. Lots has been written on this site about it. I would love to provide you with more info/opinion, but I am currently typing one-handed cause I crashed my bicycle two days ago and have a sprained finger taped up (Yes, bicycling, and fast enough to crash hard! - You will eventually get our life back!) You may want to also search the site (I always use the advanced search - I can never get the standard search to work) Look under TCH, chemo, etc. Best of luck, keep posting to let us know how you are.

Leslie's sister · 08-28-2007, 08:50 AM

My sister had this combo and for the most part, everything went well. The biggest problem she had was not taking the anti nausea medication during the second treatment. She had a terrible time for about four days. She didn't make that mistake again and the rest of the treatments were fine. She described the low points as just feeling blah. Definitely take all the meds your onc gives you to control nausea. Hairloss is almost certain. Anywhere from around two weeks after the first treatment to right after the second treatment. That was another rough time for Leslie. But once she found a wig that she was comfortable with and got used to she was ok. I think that TCH is an awesome combo.

BonnieR · 08-28-2007, 10:18 AM

I also am on THC but my "T" is TAXOL...I had no problems during the infusion. I have had two.
But be advised that it takes hours. For the first dose I was in the treatment center for 9 hours!! So bring things that might distract you. Books etc. I brought my journal and art supplies...Although I actually slept part of the time....
The day afterwards I was "wired." I guess from the premeds. But in subsequent days I experienced fatigue and what felt like bone pain. Occassional nausea. There are medications for all of the potential side effects. Also I was advised to take Glutamine to ward off neuropathy.
You will be given literature explaining the drugs you are taking....
I am having my third treatment next week and still have enough whispy hair to not have to cover my head yet. I used to have very thick hair. I got prepared ahead of time by buying wigs, scarves, etc.
We are all different, of course. And I know you will find great support and advice here. I certainly have. Keep us posted. And keep the faith....
ETA: age may factor into this too. I am 64.....

hutchibk · 08-28-2007, 12:49 PM

I also did Taxol, Carbo, Herc... and it was reasonably easy to tolerate. Carbo can do a number on your white cells and bone marrow, but they will follow your CBC closely.

I had Taxotere early on in combo with Adria and Cytoxan. All I remember about Taxotere is that it can "leak" (from the capillaries) into your fingernails and toenails. My infusion nurses told me to use tea tree oil on my cuticles weekly and keep Sally Hanson's Hard as Nails on my nails at all times while in treatment. I had absolutely no discoloration or lifting of the nails, so I guess it worked. I recommend it!

kcherub · 08-28-2007, 02:40 PM

Good luck with your TCH! I hope that you find lots of information here, I know I did! I did my 5th (and as of today, FINAL ROUND!!!) of TCH on August 17th. I was slated for 6 rounds, but had some "issues" that they felt warranted not doing the 6th round. We have almost the same diagnosis, except for the DCIS you had. You have a great prognosis, so hang in there!!!

There are a few great TCH threads, if you use the search function with TCH, you will find tons of info on side effects. To be honest, the chemo wasn't what got me--it was the steriods. I had very ugly steroid psychosis for the last 3 treatments, but most people don't get that. I was one of the "lucky" ones.

Please, feel free to write me if you have any questions about the TCH regimen. I know how scary it is to start, the fear of the unknown is just awful!

Take care,

Cristina19 · 08-28-2007, 04:43 PM

Oh my gosh, you all are great. Thank you for responding. I look forward to hearing more.

The steroid I have been given is Decadron 4 mg. I'm only supposed to take it the day before, day of, and day after chemo. The others are strictly anti-nausea, if I'm not mistaken.

Thanks for the Glutamine recommendation. I think I'm more worried about the possible side-effects of chemo than the cancer. None of this has ever seemed "real" to me. My diagnosis came completely out of the blue. I felt healthy; I had no symptoms. I was sent for a diagnostic mammogram for what I described as a fibrous ridge and that's what it was; in the meanwhile, they found everything else.

I've been doing some reading about supplements and have started CoQ10, a coenzyme that has been used to strengthen the heart and has been used in studies with people who are experiencing heart damage/failure. I figure this may offset issues of cardiotoxicity. I'm also looking into Milk Thistle to maintain liver health. These seem to be pretty benign complementary therapies unless anyone has wisdom on this.

Also, this is probably not new to the members of this site, but the substance in Green Tea (EGCG) which works directly with a protein to which Her2 is a "client protein" to block its negative effects. It's worth a read:

http://www.newstarget.com/007972.html

http://www.aicr.org/site/News2?abbr=...rticle&id=8997

My infusion time period is slotted for 5 hours so I'm going to be taking lots of reading, my iPod, and most importantly, my Latin textbook. Crazy me: I enrolled in my boyfriend's Latin class (he's a professor and so am I). We keep laughing that the misery of Latin will distract me from the misery of chemo!

Thank you so much.
C.

BonnieR · 08-28-2007, 05:13 PM

Christina, I know what you mean about the anticipation (read DREAD!! lol) of the first dose of chemo. They take it really slow initially and first administer drugs to relax and to prevent side effects. And of course they are very vigilant. That is why my first session was 9 hours. Then 7.
The cancer center psychologist told me that when I got the first dose it would be like "popping the balloon of anxiety" and she was right. The fear was far worse than the reality! So far so good.
I have read about supplements and the fact that they are not necessarily "benign". Some can be counterproductive to our treatment so it would be prudent to take those with your doctor's blessing. They are plant based, but so are some chemo drugs, and look how potent they can be.....
Please ask us anything you can think of. It feels good to be able to offer some input even if it is only from the perpective of 2 treatments....
I very much remember how I felt a few short weeks ago....

Melinda · 08-28-2007, 09:23 PM

Here is a link to a post I made back in March of this year. I also had TCH and got tons of information from all the sisters her. http://her2support.org/vbulletin/showthread.php?t=27097
I have just finished treatment with the same regiment, so feel free to contact me at
mzerweck1@verizon.net
Would love to help in any way that I can
Melinda

Melinda · 08-28-2007, 09:30 PM

Forgot to mention in case you do not have time to read all of these posts...
drink plenty of water even during treatment, ask for a sleepaid because the decadron will wire you, take your anti nausea (zofran or tigan etc)meds each AM BEFORE you need them, and some suggest Biotene to prevent mouth sores. I worked the entire time, neer missing a day, but your body will dicatate what you can and can not do. As a professor, if you plan on working ask for Neulasta to keep your WBC up. Effects normall sow up 2-3 days later. I had my treatments on Thursday so that I could have the weekend to take it easy. You can do this... it is one of the more doable regiments available.
Keep the faith,
Melinda

Catherine · 08-28-2007, 09:54 PM

Do try the tea tree oil and Sally Hansen Hard as Nails. I had a lot of problems with my nails and wish I would have known about this. No big deal though. I am fine now and my nails are fine now.

All the best, Catherine

Cristina19 · 08-29-2007, 08:39 PM

One down, five to go.

I'm sleepy but it's hard to tell what it's from: sitting in a hospital bed all day (10-5)? I'm not so naive to believe that I will feel this "good" tomorrow or the next few days. Right now I just feel very mild aches, so I took the recommended Tylenol. My mouth and eyes are dry (the Benadryl?) and, even though I've been drinking lots of fluids, I feel dehydrated. It may have something to do with the heat out here right now.... We were 102 degrees today.

I'll let you know how the next days go.

Thanks for the support and to Melinda for the reference to the other TCH thread!

xoxo,
Cristina

Melinda · 08-29-2007, 08:56 PM

Cristina,
Try to stay positive. Tomorrow is another day. I know everyone goes thru this diffierently but who knows, you may not feel that bad tomorrow. The first treatment is like going into nowhere land. You have no idea what really to expect, and many people expect the worst. After your first week you will have a better idea and it becomes almost 'routine . I used to dread my sense of taste changing, sweets were too sweet and the "metal mouth" I called it just ruined what was what I considered good eating habits, but overall my energy levels maintained on average. It was the neulasta that caused my aches.
Take you anti nausea meds first thing in the AM. Fluids and food to keep your strength. You can do this.
Take care and keep us posted especially if you have any questions.
Keep the faith
Melinda

BonnieR · 08-29-2007, 08:58 PM

Christina, glad to hear your first session went well! We are all trudging along together! Just listen to your body the next few days and deal with things as they present themselves. As recommended, stay hydrated. And treat yourself kindly....

08-29-2007, 09:26 PM

I wish I had found this article when I was first starting out. It's a great summary of the treatments.

http://www.cancerresources.mednet.uc...er_hurvitz.htm

I opted for the AC-TH.

hutchibk · 08-29-2007, 09:56 PM

I betting that you are sleepy from the benadryl - I found that I am a real light weight and couldn't do a drip or push (syringe) of beny... it hit my bloodstream too much, too fast, drip knocked me out for about 7-8 hours and a push (which was only done once, as I was a MESS from it) caused me to basically have an out of body experience, heart raced, became somewhat paralyzed, very shaky and RLS kicked in. I finally learned that I could take just a single dose (25mg) via pill and that was all I needed, and even that knocked me out in the chair...

Dehydration is just very normal with chemo - that is always one of my most noticable side effects. Opt for occasional bottles of electrolyte water or Gatorade for the first couple of days after an infusion.

Cristina19 · 08-30-2007, 02:43 PM

It sounds like the Neulasta may the the biggest culprit in the "flu-like" symptoms that everyone is feeling on day 3 or 4. Is that possible? I'm feeling okay today, day 2.... perhaps "over-medicated," shaky and sleepy. Now I'm off for the Neulasta shot.

Melinda · 08-30-2007, 08:43 PM

I used to get my Neulasta shot on a Friday and on Sunday... I was only good for reading the Sunday paper and watching movies... a real couch potato. The good news is that it kept my WBC up to where I could continue treatment the entire time as far as WBC goes. The carboplatin effects your platelets and on round 5 and 6 I had a slight delay... 2 days the first time and 5 days on round 6. There is nothing they can really do for platelets... just let the body build them up again. The first time I thought maybe if I went home and ate half of a cow it would help.... silly me, but the fellas (platelets rejuvemated themselves.) I tell you this because I am the type of person that wanted everything done yesterday... so to find out that there was going to be a delay shocked me and I was beyond annoyed. I didn't know this could h appen. Anyway, everything worked out fine.... becareful when platelets drop "do not run with scizzors".... bleeding and bruising are something one stays away from with this condition.
I made it thruogh to round 3 before my scalp really started to show... and that is when I decided to shave my head. It looked better than having the apperance of walking out of a nuclear power plant plus I felt more in control. Prior to that I wore it like in my picture, then shorter yet and then the GI JANE look. After that it was all over but the razor.
I got a wig from www.paulayoung.com
I dont care what they say... but for 49.95 you could not beat it. I wore it a couple of months before the heat set in and then switched to a varielty of scarves that complimented my wardrobe. FOr the last 6 weeks I have introduced the retirement village where I work to tennis ball hair... call me Wilson for short as one of our eloquent sisters have suggested. Actually I have had fun being free of scarves and wigs, and feel completely comfortable with it. Its the latest rage, and I am 55.
Keep in touch, you can do this. a positive attitude and a little humor helps and lets not forget all the support you have from all the sisters here!
Melinda