NED Herceptin tomorrow, any advice?

[Barbara2]

I will be starting Herceptin tomorrow. The question the onc has left up to me, is whether or not to include Taxol at the same time.

History:
CEF ending March 02, followed by Arimidex
*Septic shock from CEF; ICU for a week; touch and go survival for a few
days
4.5cm tumor, 1 positive node
54 years old, now
NED so far

I am struggling so with this decision due, in part, to becoming very ill with my initial tratment. "Just" Herceptin would seem so much easier than adding in the Taxol. In my heart I know that adding the Taxol is probably what I should do. Just need to muster up the courage....

There are many women on this site who did not initially get Herceptin, and are likely pondering the same question.

Our insurance has said they will not pay, so we are in the process of trying to change their minds. Yesterday the onc told us that private pay (Herceptin only) for each injection would be $1000. $2000 for the loading dose.

Of course, our main decision is focused on which treatment to go with; Herceptin alone or combined with Taxol. Any thoughts or advice would be greatly appreciated.

Blessings, Barbara

[StephN]

Hi -
There are some blanks in your timeline.
I take it that you have never had Herceptin, but are obviously Her2/neu positive. What degree - plus 2 or plus 3?

Looks like you are more than 2 years off chemo by now. Do you have some tumor reading that is going up? I am wondering because of the offer to add Taxol. This is usually not done unless you have been restaged due to disease progression of some kind.
But you state that you are still NED.
Therefore my confusion. Is this a trial for NED patients?

Anyway - good that the onc is offering you these options now.

[StephN]

P.S.
Taxol was a good drug for me in controlling some significant liver mets, but I also had Navelbine and Herceptin for a 3-pronged approach.
There are several here who have had just the Taxol and Herceptin to control mets.
Side effects are a condsideration. You will have some neuropathy, but this is usually reversible if you don't take very much.
How much Taxol is your onc suggesting?

[Joannie]

When I went for a second opinion regarding getting Herceptin two years after completion of chemo, I asked the same question: Should I take this with Taxol? She said she would absolutely not recommend it. We are already entering "unchartered" waters for someone in my situation. I took AC and Taxol almost two years ago, double mastectomy, currently NED. She said she would recommend Herceptin for me due to the fact that I'm young (41), 3.2 cm tumor, one node and Her2 3+. She said there is no evidence it will help me this far out, but it may. She wouldn't recommend it with Taxol because they just don't know and bc. chemo drugs are so toxic. It seems to me like the logical thing to do, but that is what she said. Hope this helps.

[Barbara2]

Oh dear. I typed out a reply then lost it by clicking on "back." I will try again.

I am Her2++ on the IHC and have a score of 8.7 on the FISH.

The onc agreed to give me Taxol with Herceptin because of recent trials that have shown good results when using the two drugs concurrently. I would receive the low doses of Taxol which would be given with Herceptin once a week for 12 weeks.

A quote from Dr. Marine Piccart, Head of the Medicine Department at the Jules Bordet Institute in Brussels and lead investigator of the HERA study, helped me with my decision.

In a Monday, May 16, 2005 news release regarding the HERA trial, she said, "In the advanced breast cancer setting, Herceptin has already demonstrated that it prolongs patients' lives. To see such impressive results with Herceptin in early-stage breast cancer, already at the interim analysis, is a major breakthrough in the treatment of this aggressive disease. These results now add to the growing body of evidence that Herceptin should be considered the foundation of care for HER2-positive breast cancer patients, regardless of the stage of their disease."

It is worth a try, in my opinion. Thank the Lord for trials and the masses of individuals world wide who have contributed to our knowledge in the on- going fight with cancer.

Many blessings, Barbara2

[vpfeiffer]

I may have missed this, but what stage was your diagnosis? If I was NED and had already gone through normal courses of Chemo, surgery &/or radiation, and I was considering a maintenance-drug approach, I would take Herceptin alone. If your physicians are worried that cencer cells are lurking other places, a course of Taxol with the Herceptin would be helpful. How long are they saying you should take Herceptin with the Taxol?

Good luck!
Val

[Barbara2]

I was stage 2b, but very close to stage 3. The tumor was at least 4.5cm and 5 cm is where stage 3 begins.

I didn't take any taxol with the CEF chemo, as I became too ill to continue with more chemo and the port had to come out.

Adding taxol to the Herceptin was my idea. When I asked the onc about it, he said I could have it if I wanted it. He thought I wouldn't be so sick this time around as I was with the other drugs. I would have the Taxol each week for 12 weeks.

But I just took the 1st Herceptin a few days ago, and he said I could wait until whenever I was ready to begin the Taxol, if that's what I choose to do.