Taxol

['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.