Taxol

[Rupali]

I was wondering does anyone know if taxol crosses blood brain barrier. If it does then when people are on Hercepting plus taxol regimen then what is the protocol. Also is tere a way to save my hair if I were to go on herceptin + taxol

[Lucy]

I'm not sure what you mean by crossing the blood brain barrier or the protocol with herceptin and taxol. But, I was on both herceptin and taxol for three months (until this past September) and what hair I had left (after the a/c) fell out early on. Prior to my starting chemo, a friend told me about wearing cold caps during chemo to help save your hair. I asked my doctor about it and she said it has worked for some but there seems to be some sort of connection between the cold caps and brain cancer. If she told me how that worked, I didn't hear it because I was out at "brain cancer".

Before I started chemo I had hair down almost to my waist so I wasn't excited about losing it. But, given the alternative, the hair will always grow back. You might also talk to your doctor to see if s/he has any other options to suggest. Good luck!

[Cari]

From my knowledge, Taxol and herceptin are given weekly X 12 weeks, then you finish off a full year with Herceptin every 3weeks.
Taxol does cause hair loss. The blood brain barrier is not what affects hair loss, as an aside.

My physician explained that because Her2+ liked to recur in the brain, among other places, lovely, that preventing the chemo from reaching all parts of the body was not a good idea. Like Lucy, I was out at brain cancer. That was a big nope!

I also had hair down to my waist, and shaved it off 4 days prior to chemo. I had a head shaving party, complete with Pink Mohawk to be fun. When else can I have a mohawk?! =)

[Lauriesh]

Taxol does not cross the blood brain barrier.

I was also warned against the cold caps, not because of brain mets, but because of scalp mets.

Laurie

['lizbeth]

Rupali,

You can read NCCN guidelines for more information on the US standard of care treatments.

My understanding is that you already have brain mets? Tykerb has been mentioned before and is the most effective Her2 treatment at crossing the blood brain barrier. You could add this to the Herceptin and Taxane combination. The side affects will be much more severe with the Tykerb Herception combination.

Cold caps are the most effective way of keeping your hair, however you have been diagnosed with an advanced cancer that has metastasized. It would be not be a good idea to use cold caps. If you've already done a chemo treatment then most likely the hair is going to all fall out anyway. And if you do radiation treatments for the brain mets your hair will also be affected. You should look into getting a beautiful wig to wear - it could help you feel better about your appearance.

You could try icing your hands and feet during infusions and shortly after to try and minimize peripheral neuropathy. There is a technique to icing, limit direct contact to 15 minutes then give your hands and feet a break. Ask your nurses for more information.

The brain and scalp mets from cold caps has been studied and the risk of getting them is very small. The majority of women are not at risk. Unlike you, many women who are earlier stages receive adjuvant chemotherapy without receiving benefit. So the scare tactics I see mentioned above from some physicians show that they just don't want to be bothered.

Good luck with your treatment. There is a small number of the board who have experience with Stage IV. I hope that you will connect with them and find information that helps you overcome the cancer and get back to no evidence of disease.

['lizbeth]

Rupali,

I see another post that your hair has already been affected by radiation therapy. Jackie had some good advice.

Sorry about the hair, mine did not grow back well after the taxane - much much thinner. Perhaps you could try some pretty scarfs?

[Becky]

As previously said, Taxol does not cross the blood-brain barrier. Xeloda does as does Tykerb and Temodol. Xeloda and Temodol are oral chemos so they will affect you as such.

Much love and hugs to you.