please check out the following thread:
http://her2support.org/vbulletin/sho...h+goblet+cells
ie, I put in "Lani herceptin & goblet cells" into the search function on the burgundy bar above and went several pages to find a thread called cough
Old 02-02-2008, 07:42 PM #1
Angela
Senior Member
Join Date: Apr 2006
Location: North Carolina
Posts: 45
Question cough
I have been on herceptin by itself for almost a year now. I had a CT scan of my chest on Dec 10th and it showed only a 2mm spot left in my lung. But I got a cold at the beginning of January and I am still coughing. I finally went to my primary Dr. yesterday and they just gave me an antibiotic and some cough medicine with hydrocodone in it. Good Stuff! Has anyone else developed a cough on herceptin? Has it been long enough since my last CT scan to ask for an x-ray or another CT scan?
Any suggestion are greatly appreciated. I am sick of coughing and my co-works have started coming into my office asking question like: How are you really doing? What did the Dr. say on your last visit? One person even asked when my last CT scan was done and what were the results. I get tired of people always looking at me and thinking cancer.
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Old 02-02-2008, 08:37 PM #2
Sherryg683
Senior Member
Join Date: Feb 2006
Posts: 1,014
Yes, I have coughing spells and times when my chest feels so tight that I get worried that somethings going on..there are times when I find it hard to breath (although I think some of it's anxiety). If you had radiation that could cause it and I don't know about Herceptin, but it messes with my sinuses so I figure it's probably messing with other things such as breathing too. In fact, I do find I usually get real tight in the chest after Herceptin. If you had a CT in December, I wouldn't think you would need on right now. Is the spot in your lungs cancerous? I had 2 lung spots too but they went away with chemo. I had PET/CTs every 3 to 4 months for the first 2 years. Now, I will do them every 6 months. As far as the coughing, it's that time of the year, I wouldn't worry about it at all with a scan as recent as yours. And to think of it, before I was diagnosed I had no coughing or breathing problems at all, no symptoms. I wish that I felt as good as I did before the cancer was discovered. Most of my symptoms now are due to the chemo and medicine...sherryg
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Old 02-04-2008, 03:15 PM #3
John21
Senior Member
Join Date: May 2006
Posts: 85
Cough
It seems to me I have ask this question too. My wife has a little cough now and then and I atrribute it to the Herceptin. I have read others on the site claiming the same symptom. I believe you are experience the side effect of Herceptin. But to be safe, check it out if you are concerned. It is hard for me to believe a 2mm spot will cause a cough, but in the beginning I was worried about every little change. Drove my wife crazy!
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Old 02-04-2008, 05:56 PM #4
Jean
Senior Member
Join Date: Oct 2005
Location: New Jersey
Posts: 3,123
Hi Andrea,
It is common to have a dry hacking cough while on herceptin. In fact
I am off herceptin since May 07 and I still have a slight dry cough now
and then but it is eased up about 90% since I completed my one year
of herceptin. Since you just had a CT in Dec. I would think you would
not check this again for at least 6 months. I had a small (MM nodule)
which my lung specialist was tracking. It stayed the same during one
checkup and then 6 months later was smaller, we continued to check
it for 2 yrs. which it has remained the same. The lung dr. is convinced
it is not cancer. Now I have a check in once per yr. Hope yours
is the same and remains the same or gets smaller. From what I have
been told these small nodules are rather common.
All Good Wishes,
Jean
Last edited by Jean; 02-04-2008 at 05:58 PM..
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Old 02-04-2008, 06:54 PM #5
CLTann
Senior Member
Join Date: Oct 2005
Posts: 476
Cough is a very complicated event and its cause can be traced to many, many factors. It is a body's own mechanism trying to correct some problems in the upper respiratory organs, from throat down to wind pipe to the lungs. Eating or drinking too fast, resulting in having some foreign substance going to the wrong pipe will cause cough, until the situation is corrected. A small abnormality in the breathing system can cause cough. Accumulation of water can induce cough. Of course, the presence of any growth, whether benign or not, will trigger cough. Some cough is associated with bad mucous sound and some are dry cough. It is a symptom that we should not take too lightly. Drug side effects can include cough, which is probably caused by irritation to the throat or windpipe. If the cough does not go away in three weeks, it is advisable to check in for an x ray first. I always hesitate to recommend CT scan due to its high level of radiation. Of course, radiation is another cause of cough too.
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Old 02-04-2008, 08:08 PM #6
Lani
Senior Member
Join Date: Mar 2006
Posts: 4,675
two of my previous posts on herceptin/coughing
from a previous post of mine ( I added others too)
#1
LOPSIDED
Senior Member
Join Date: Apr 2006
Posts: 91
Sick & Tired Ofcoughing Everyday
I Was Really Starting To Worry About Mets To The Lungs. I Can't Quit Coughing. When I'm Talking, I Don't Sound Like I Have A Cold But Everyday I Am Having Coughing Spells. My Cough Sounds Terrible. I Went For A Chest X-ray And It Came Back Normal. Now My Doc Is Sending Me For A Ct Scan To Be On Safe Side. I Know Its That Time Of Year For Flu's & Cold But This Coughing Is Exausting. Any Cough Remedies.......anyone?
12-05-2007, 05:39 PM #2
Grace
Posts: n/a
Sheila,
I had a similar cough last year (twice) where I simply couldn't stop coughing. It lasted for many weeks, but it did finally get better. I was on herceptin at the time. I know that others have had something similar, and I understand it's a particular type of flu that's going around. I used Tylenol for coughs and it helped some but not a whole lot. Have you tried honey before going to bed? I didn't but I read an article yesterday that honey is now being recommended for children in lieu of cough medicine. Hope you're better soon.
12-05-2007, 06:28 PM #3
Lolly
Senior Member
Join Date: Aug 2001
Location: Oregon
Posts: 1,552
Sheila, my husband had pneumonia this spring and to get some relief from the terrible coughing at night so he could sleep, his doctor prescribed codeine cough syrup, but only to take at night. It really worked, but it's strong stuff.
I don't think raw honey is recommended for chemo patients, if you're still on chemo, so talk that over with your doctor if you want to try it, or make sure you get pasturized honey.
<3 Lolly
12-05-2007, 06:44 PM #4
Lani
Senior Member
Join Date: Mar 2006
Posts: 1,946
from an old post of mine
For those complaining of nasal/sinus symptoms/coughing which they relate to Herceptin, I submit the following two articles. The nose, like the more distant airways/bronchiols have ciliated epithelial cells (lining cells with tiny hairs which help trap bacteria, molds and other particulates) . These articles raise questions which may help explain symptoms while on Herceptin--showing that her2 is necessary not just in embryogenesis, but also in adulthood for repair of these kinds of cells. They may help explain your nasal complaints, the reports of rare pulmonary problems in patients on Herceptin and perhaps the dry-eye problem I posted on before. The more they look into what her2 does, the more they find!:
Am J Physiol Lung Cell Mol Physiol. 2006 Feb 17; [Epub ahead of print]
Related Articles, Links
*
Differentiation of Human Airway Epithelia Is Dependent on ErbB2.
Vermeer PD, Panko L, Karp P, Lee JH, Zabner J.
Internal Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA.
A clinical case documented a reversible change in airway epithelial differentiation that coincided with the initiation and discontinuation of trastuzumab, an anti-erbB2 antibody. This prompted the investigation into whether blocking the erbB2 receptor alters differentiation of the airway epithelium. If so, blocking or exogenously stimulating the receptor would lead to consequences on differentiation. To test this hypothesis, an in vitro model of well-differentiated human airway epithelia was treated with trastuzumab or heregulin-alpha, an erbB ligand. In addition, co-culturing with human lung fibroblasts tested whether in vivo subepithelial fibroblasts function as an endogenous source of ligands able to activate erbB receptors expressed by the overlying epithelial cells. Epithelia were stained with hematoxylin and eosin and used for morphometric analysis. Trastuzumab treatment decreased the ciliated cell number by 49% and increased the metaplastic, flat cell number by 640%. Heregulin-alpha treatment increased epithelial height, decreased the number of metaplastic and non-ciliated columnar cells while it increased the goblet cell number. We found that normal human lung fibroblasts express transforming growth factor-alpha, heparin binding-epidermal-like growth factor, epiregulin, heregulin-alpha, and amphiregulin, all of which are erbB ligands. Co-cultures of airway epithelia with primary fibroblasts increased epithelial height comparable to that achieved following heregulin-alpha treatment. These data show that erbB2 stimulation is required for maintaining epithelial differentiation. Furthermore, the mesenchyme underlying the airway epithelium secretes a variety of erbB ligands that might direct various pathways of epithelial differentiation.
PMID: 16489114 [PubMed - as supplied by publisher]
1: FASEB J. 2005 Aug;19(10):1374-6. Epub 2005 May 27.
Related Articles, Links
*
ErbB2 activity is required for airway epithelial repair following neutrophil elastase exposure.
Fischer BM, Cuellar JG, Byrd AS, Rice AB, Bonner JC, Martin LD, Voynow JA.
Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710, USA.
In cystic fibrosis and chronic bronchitis, airways are chronically injured by exposure to neutrophil elastase (NE). We sought to identify factors required for epithelial repair following NE exposure. Normal human bronchial epithelial cells were treated with NE (50 nM, 22 h) or control vehicle. Following NE treatment, we found a marked and sustained decrease in epithelial proliferation as detected by Ki67 immunostaining. 3H-thymidine incorporation was also initially depressed but increased over 72 h in NE-treated cells, which suggests that DNA synthesis constitutes an early repair process following NE exposure. We hypothesized that ErbB2 receptor tyrosine kinase, a regulator of cancer cell proliferation, was required for epithelial DNA synthesis following NE exposure. Immediately following NE treatment, by flow cytometry analysis, we found a decrease in ErbB2 surface expression. Protein levels of the full-length 185 kD ErbB2 receptor significantly decreased following NE treatment and smaller ErbB2-positive bands, ranging in size from 23 to 40 kD, appeared, which suggests that NE caused ErbB2 degradation. By real-time RT-PCR analysis, we found no change in ErbB2 mRNA expression following NE treatment, which suggests that changes in ErbB2 protein levels were regulated at the post-translational level. Following NE treatment, full-length 185 kD ErbB2 levels increased to pretreatment levels, correlating with the increase in thymidine incorporation during the same time period. Importantly, inhibition of ErbB2 activity with AG825 (5 microM) or Herceptin (3.1 microM), an ErbB2-neutralizing antibody, blocked thymidine incorporation only in NE-treated cells. These results suggest ErbB2 is a critical factor for epithelial recovery following NE exposure.
PMID: 15923396 [PubMed - in process]
I started the post with my summary:
"For those complaining of nasal/sinus symptoms which they relate to Herceptin, the following two articles may hold clues as to what may be going on. The nose/airways have ciliated epithelial cells (lining cells with tiny hairs which help trap bacteria, molds and other particulates) and other specialized cells (including further down the "airways" in the bronchi and bronchioles). These articles raise questions which may help explain symptoms while on Herceptin--showing that her2 is necessary not just in embryogenesis, but also in adulthood for repair of these kinds of cells. They may help explain your nasal complaints, the reports of rare pulmonary problems in patients on Herceptin and perhaps the dry-eye problem I posted on before. The more they look into what her2 does, the more they find!:"
A “translation” of the “Greek” of the two articles:
Because of a case of a patient whose airways changed when Herceptin treatment was started and when Herceptin was stopped in terms of which types of specialized cells were present/absent they tried in a petri dish to see what happens to airway cells and found:
Trastuzumab treatment decreased the ciliated cell number by 49% and increased the metaplastic, flat cell number by 640%.
Thus the cells necessary to fight infection were more than halved and the cells with little specialized function, which do not secrete or trap bacteria, mold or particles went up by more than 6 fold.
In the other article, after bronchitis or other diseases where a white blood cell enzyme injures airway (bronchial) lining tissue her2 is necessary to repair the damage caused by this enzyme in an adult. The "Greek" is just describing how they proved the mechanism of how this occurs, at what step it occurs and whether the changes were on a gene or protein level.
Both articles emphasize that her2 fulfills physiologic functions in an adult and Herceptin can potentially adversely affect those functions. Epithelial cells are numberous throught the body--thhey line organs facing the "outside world"(which is sometimes inside as in the stomach and intestines) they function to keep infectious and dangerous particles out, secrete substances to lubricate and or digest, etc. Her2 seems to be necessary to keep these cells specializiing to serve different necessary functions and to repair/replace damaged cells.
Thus it seems it is not just the heart that Herceptin affects.
01-01-2008, 10:43 AM #3
Lani
Senior Member
Join Date: Mar 2006
Posts: 2,068
another thread I posted to on the same subject
#1
Caroline UK
Senior Member
Join Date: Nov 2006
Location: London, England
Posts: 93
Herceptin cough
I've had a little, wheezy cough for the last 8 weeks or so, nothing too troublesome but always just there. Had a chest x-ray last week and it's fine, thank goodness. My oncologist said about 20% of people on Herceptin experience this cough. Not exactly allergic, sort of hyper-sensitive to it. Has anyone else experienced this? Have you noticed if anything helps or makes it worse?
05-10-2007, 11:26 PM #2
Roz
Senior Member
Join Date: Oct 2005
Location: Sydney Australia
Posts: 91
Hi, Yes I have had the same cough! Feel as if I am asthmatic with the little wheeze. It is a shame for me as I also have tended to get my "cancer return" in my right upper lobe, so I tend to panic if I get too much wheezing. All part of the rich tapestry etc.. I suppose.
05-11-2007, 09:11 AM #3
tousled1
Senior Member
Join Date: Feb 2006
Location: Acworth, GA
Posts: 1,895
Caroline,
I had the cough almost the entire year I was on Herceptin. Had my last Herceptin April 20th and my cough is almost gone.
05-11-2007, 09:50 AM #4
Jeanette
Senior Member
Join Date: Oct 2005
Posts: 127
cough
I also had the cough all the time i was on Herceptin. Sucked on a lot of hard candy to control it. It is gone now, thankfully, very annoying.
05-12-2007, 08:02 AM #5
Caroline UK
Senior Member
Join Date: Nov 2006
Location: London, England
Posts: 93
Ok, thanks everyone, always seems to help when I hear from others who've had the same thing, even if it wasn't anything too serious. Sometimes I just feel a bit alone with all these little niggly things, and I feel reluctant to wear friends down by 'moaning' about them.
05-12-2007, 09:00 PM #6
Adriana Mangus
Senior Member
Join Date: May 2006
Location: California
Posts: 272
Me too
Hi Caroline:
I have been coughing for at least 8 months, I have scratchy throat wheezing,a lot of phlegm, also. I feel like am producing excesive saliva. Do you have phlegm, too?
I went to see my personal physician, she said the lungs are clear, -thanks to God-, since my mets are in the upper lobe rt lung- so based on that the diagnosis is chronic rhinitis, but I really doubt it very much. I did not know that herceptin may be the cause. I feel good about knowing this information, but it's annoying to deal with this cough. The doc recommended Benadryl which it seems to help, I also take cough medicine like Robitusin. I have had many sleepless nights due to this, no FUN!..
How is it for you ladies? I can rest on my back, walk; but sometimes when I talk or want to eat, sip on water; then I feel like urgency to cough, like I said it's annoying!!!!!
Thanks all for sharing!!!!! I FEEL MUCH BETTER!!!!
05-13-2007, 03:38 PM #7
Lani
Senior Member
Join Date: Mar 2006
Posts: 1,947
I posted this before---role of her2 in maintenance of upper airways explains cough
as well as nasal symptoms
For those complaining of nasal/sinus symptoms which they relate to Herceptin, I submit the following two articles. The nose, like the more distant airways/bronchioles have ciliated epithelial cells (lining cells with tiny hairs which help trap bacteria, molds and other particulates) . These articles raise questions which may help explain symptoms while on Herceptin--showing that her2 is necessary not just in embryogenesis, but also in adulthood for repair of these kinds of cells. They may help explain your nasal complaints, the cough and the reports of rare pulmonary problems in patients on Herceptin and perhaps the dry-eye problem I posted on before. The more they look into what her2 does, the more they find!:
Am J Physiol Lung Cell Mol Physiol. 2006 Feb 17; [Epub ahead of print]
Related Articles, Links
*
Differentiation of Human Airway Epithelia Is Dependent on ErbB2.
Vermeer PD, Panko L, Karp P, Lee JH, Zabner J.
Internal Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA.
A clinical case documented a reversible change in airway epithelial differentiation that coincided with the initiation and discontinuation of trastuzumab, an anti-erbB2 antibody. This prompted the investigation into whether blocking the erbB2 receptor alters differentiation of the airway epithelium. If so, blocking or exogenously stimulating the receptor would lead to consequences on differentiation. To test this hypothesis, an in vitro model of well-differentiated human airway epithelia was treated with trastuzumab or heregulin-alpha, an erbB ligand. In addition, co-culturing with human lung fibroblasts tested whether in vivo subepithelial fibroblasts function as an endogenous source of ligands able to activate erbB receptors expressed by the overlying epithelial cells. Epithelia were stained with hematoxylin and eosin and used for morphometric analysis. Trastuzumab treatment decreased the ciliated cell number by 49% and increased the metaplastic, flat cell number by 640%. Heregulin-alpha treatment increased epithelial height, decreased the number of metaplastic and non-ciliated columnar cells while it increased the goblet cell number. We found that normal human lung fibroblasts express transforming growth factor-alpha, heparin binding-epidermal-like growth factor, epiregulin, heregulin-alpha, and amphiregulin, all of which are erbB ligands. Co-cultures of airway epithelia with primary fibroblasts increased epithelial height comparable to that achieved following heregulin-alpha treatment. These data show that erbB2 stimulation is required for maintaining epithelial differentiation. Furthermore, the mesenchyme underlying the airway epithelium secretes a variety of erbB ligands that might direct various pathways of epithelial differentiation.
PMID: 16489114 [PubMed - as supplied by publisher]
1: FASEB J. 2005 Aug;19(10):1374-6. Epub 2005 May 27.
Related Articles, Links
*
ErbB2 activity is required for airway epithelial repair following neutrophil elastase exposure.
Fischer BM, Cuellar JG, Byrd AS, Rice AB, Bonner JC, Martin LD, Voynow JA.
Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710, USA.
In cystic fibrosis and chronic bronchitis, airways are chronically injured by exposure to neutrophil elastase (NE). We sought to identify factors required for epithelial repair following NE exposure. Normal human bronchial epithelial cells were treated with NE (50 nM, 22 h) or control vehicle. Following NE treatment, we found a marked and sustained decrease in epithelial proliferation as detected by Ki67 immunostaining. 3H-thymidine incorporation was also initially depressed but increased over 72 h in NE-treated cells, which suggests that DNA synthesis constitutes an early repair process following NE exposure. We hypothesized that ErbB2 receptor tyrosine kinase, a regulator of cancer cell proliferation, was required for epithelial DNA synthesis following NE exposure. Immediately following NE treatment, by flow cytometry analysis, we found a decrease in ErbB2 surface expression. Protein levels of the full-length 185 kD ErbB2 receptor significantly decreased following NE treatment and smaller ErbB2-positive bands, ranging in size from 23 to 40 kD, appeared, which suggests that NE caused ErbB2 degradation. By real-time RT-PCR analysis, we found no change in ErbB2 mRNA expression following NE treatment, which suggests that changes in ErbB2 protein levels were regulated at the post-translational level. Following NE treatment, full-length 185 kD ErbB2 levels increased to pretreatment levels, correlating with the increase in thymidine incorporation during the same time period. Importantly, inhibition of ErbB2 activity with AG825 (5 microM) or Herceptin (3.1 microM), an ErbB2-neutralizing antibody, blocked thymidine incorporation only in NE-treated cells. These results suggest ErbB2 is a critical factor for epithelial recovery following NE exposure.
PMID: 15923396 [PubMed - in process]
A “translation” of the “Greek” of the two articles:
Because of a case of a patient who developed a chronic cought on herceptin (which disappeared when herceptin was stopped) whose airways changed when Herceptin treatment was started and when Herceptin was stopped in terms of which types of specialized cells were present/absent, they tried in a petri dish to see what happens to airway cells and found:
Trastuzumab treatment decreased the ciliated cell number by 49% and increased the metaplastic, flat cell number by 640%.
Thus the cells necessary to fight infection were more than halved and the cells with little specialized function, which do not secrete or trap bacteria, mold or particles went up by more than 6 fold.
In the other article, after bronchitis or other diseases where a white blood cell enzyme injures airway (bronchial) lining tissue her2 is necessary to repair the damage caused by this enzyme in an adult. The "Greek" is just describing how they proved the mechanism of how this occurs, at what step it occurs and whether the changes were on a gene or protein level.
Both articles emphasize that her2 fulfills physiologic functions in an adult and Herceptin can potentially adversely affect those functions. Epithelial cells are numerous throught the body--they line organs facing the "outside world"(which is sometimes inside as in the stomach and intestines) they function to keep infectious and dangerous particles out, secrete substances to lubricate and or digest, etc. Her2 seems to be necessary to keep these cells specializiing to serve different necessary functions and to repair/replace damaged cells.
Thus it seems it is not just the heart that Herceptin affects.