herceptin and xeloda

[*_Cathy_*]

Hi- I am getting weekly herceptin and now my doctor added a drug called xeloda (capecitabine). They are big pills that I am going on for two weeks on, one week off for six months. 8 pills a day and I need to take 8000 mgs. Does that sound right? Does anyone know anything about this drug or is anyone on it, and if so, how are you doing with it? Thanks!! Onward and Upward!! Cathy

[Velva]

Cathy, What mg is each Xeloda pill? 500mgs? 8000mgs/day sounds high. I took 4000mgs/day, 2wks on, 1wk off & weekly Herceptin last year. Xeloda had to be stopped 2x, then reduced to 3000mg /day due to hand/foot syndrome. It seemed to work well, but slow on skin mets, but had a nodule, breast ca, come up on my neck while on it, then cardiiac tamponade (from breast ca).
Hope it's a good combo for you. I may try it again with Navelbine added, just on Herceptin now-until see neurosurgeon about brain MRI/WBR. V

[*_Frank&Evelyn_*]

Dear Cathy,

My wife, Evelyn, has been on Herceptin and Xeloda from April 2004.
For her palliative treatment, she was given the choice to either start with Xeloda or Herceptin alone. Or to take the combination. She choose for the combination that time. It worked very well for her. The swelling of her arm and the skinrash faded already after 1 or 2 cycles.

Xeloda does its work inside the cell, while Herceptin has its effect on the cell-surface (HER2/neu)
The onc. started Xeloda with a standard dose, based on your length and body weight. For Evelyn (1.56m, 54kg) that came down to 1800mg twice daily. (So, 3600mg/day). Xeloda comes in pills of either 500 or 150mg.

With each (three weekly) visit to the onc. there will be an evaluation on how you doing. If you have any adverse effect, etc.

With this standard dosage (1800mg twice a day), Evelyn experienced some diarrhoea and her hands/feet were getting dry.
Based on this, the dosage Xeloda was brought back to 1500mg, and later to 1350mg. (This she could tolerate very well)

As for the hand/foot reaction (which is most common side effect), take care of your hands and feet already when you start Xeloda.
Rub your hands and feet with e.g. pure white vaseline and before you go to sleep rub your feet again and wear cottonwool soks.

With Evelyn this was working very well.

To my opinion this combination (Herceptin & Xeloda) is a good and well-tolerable treatment.
Hope this have aswered some questions for you. Don't hesitate to ask if you have more.

Good luck to you, Cathy.

[Patty H]

I am just starting my second cycle of xeloda and herceptin. I am on 3 pills of 500 twice a day, a dose of 3000. I do have some hand and foot problems but I feel really good on xeloda. If my hand and feet get worse we will cut down on the dose. I won't have a scan till after my third cycle to see if it's working for me. I have lung and bone mets. I hope this is the drug for me because I feel good on it. I tried it last year and ended up in the hospital with severe diarrhea. But my scan did show I was stable the short time I was on it. They gave me a VCR tape showing how the xeloda worked. I really appreciated that. Patty H

[*_Cathy_*]

Thanks Everyone! I'm sorry- I made a mistake. I just looked at the plan for me and it's 4 500mg. tablets after breakfast and 4 500mg. tablets
after dinner. I feel a lot better that it's not 8000! Here's another question for you. I get Herceptin every Thursday. I'm supposed to start the xeloda on Wednesday, but I have an appointment with another doctor on Friday. I don't want my doctor to know that I'm getting another opinion. I really like him but my whole family wants me to do this. Do you think I should start on the xeloda or wait to see what the new doctor says? Onward and Upward! God Bless You All! Cathy

[*_Frank&Evelyn_*]

Dear Cathy,

From your last posting it seems that you are ashamed for your doctor that you had a second opinion.
The strongest advise I have for you is to be honest to any doctor about the treatment or advise that your getting.
Doctors are not the ones standing above you and telling you what to do!
Their job is to inform you about possible treatment options, adverse effects, etc.
They should also respect you wanting a second opinion.
The only good relation between doctor and patient is that the patient feels free and comfortable to speak their mind and a doctor who is willing to listen, answer your questions and chers in your concern.

Getting a second opinion is not like "cheating" on your doctor.
Don't hold back any information about the medication you want/take!
They need to know!

Choose the doctor that you feel most comfortable with.

Good luck, and remember you are the patient and the one in charge.

[*_Cathy_*]

Dear Frank and Evelyn- Thanks for your good advice. That's exactly how I felt- as if I was cheating on my Doctor. It's just because he's so nice and good to me. He will be retiring very soon in the summer and I didn't want him to think I didn't respect his treatment of me.Also, my family feels that because he's leaving his practice that I should get a new doctor. I will follow your advice in the future. Thanks and God Bless- Cathy