[CPA]

Sandy,

Here is some good and bad about the treatment your friend will be receiving.

Good News: Taxanes in combination with platinum salt chemotherapy (paraplatin/carboplatin or cisplatin) are often effective against HER2 cancers according to several studies in conjunction with Herceptin. My wife received adjuvant chemo containing carboplatin and taxotere (six three week cycles) with herceptin weekly continuing every 3 weeks for 1 year.

Bad News: Your friend will probably be given pre-meds including decadron (a steroid) to limit swelling and other side effects and an antiemetic (anti-nausea) medication. She should expect to take these medications for several days after each chemo treatment. If her insurance will cover the cost, I would recommend Zofran as the best (according to my wife) antiemetic. Compezine is much cheaper and can be used if she is still somewhat nauseous several days after treatment or if she is able to tolerate the nausea fairly well. She will probably get benadryl and tylenol as well because of common allergic reactions. She may already be getting these with herceptin.

You can expect a drop in white and red cell counts which may have to be treated with medications (Neulasta and Procrit are two common).

The description above may sound ugly, but it is possible to beat this. Give her plenty of support and be ready for some tough days. You will probably see special diets discussed, but my personal experience is to give her anything she can tolerate just to get calories the first week after each treatment, especially if you are worried about weight loss.

Try to give her plenty of fluids and keep fiber in her diet. Constipation is very common with this chemo regimen because of (temporary) damage to the GI tract. Better to keep things moving than to re-start them.