Has anyone's Onc. dropped the "C" from TCH?

Ukkate

So I was supposed to have dose dencse TCH every 3 weeks x 4.  I've had two treatments and tolerated them so badly that my onco said we are dropping the Carbo now.  I'm so thrilled to not have to go through that anymore but my DH is worried that we might miss some cancer or something.  I'm stage 1 and already had my mastectomy (HER2+ too)

liza23

My situation seems very similar to yours. I had a lumpectomy on 4/11/13, with TCH regimen starting 5/16/13. I just completed round two and tolerate it very badly, this time worse than the first. I WISH my oncologist would suggested eliminating the carboplatin, or eliminating everything but the herceptin for that matter, but he won't hear of it. How do you find a more flexible oncologist? I have seen talk on the on various discussion boards of some patients with similar early stage cancers to ours just getting Herceptin. I guess if I were you I would be glad to get less of the toxic chemical, and maybe less of the SE's that can be permanent. But, I am very biased, because I HATE this toxic treatment.

jayjayc

hi ukkate,



every mo is different but my mo worked with me on treatment..... at first she wanted me to do the standard..... which was TCH x 4, followed by 12weeks of taxol/herceptin, and the herceptin every three weeks to finish the year...... I said no way to the TCH part and was ready to skip chemo altogether ..... my case fell into "consider" chemo..... then she said that the really important part was the herceptin....... so I agreed to 12 weeks taxol/herceptin and then the rest of the year on herceptin....

Ukkate

He said he will talk to us more about it at our next appointment (June 25) - I was just in yesterday to get IV fluids as I was doing so badly.  But he said he feels totally comfortable with me having two doses of Carbo under my belt considering I'm stage 1 and I'll continue with the Herceptin for the year and 6 more weeks of taxo.  He's a really renowed Oncologist here in Raleigh at Duke so I trust what he has to say.  I guess it'll make more sense when he explains to us in more detail.

Liza, are you stage 1 also?  I hate that your doc is being so unflexible.  My doctor said that these side effects are 100% not acceptable for me - he gave it a 2nd try with different pre-meds but as it hasn't helped, he said we are switching it up.  Where are you located?

SassyWell

Hi Liza, my current Med/Onc has agreed to give only the Herceptin.  I'm triple positive, however with no lympovascular or lymph node involvement, low mitotic, and 100% ER +.  These are mostly indicators of low grade/risk cancer although Her2+ has historially trumped this.  I also had a double mastectomy a month ago (nipple sparing with immediate reconstrution).  My Med/Onc decided to elected to send out the tumor out for a Mammaprint because she felt I was grey.  My recurrence risk came back low so after being asked if I would consider TCH (which is the current standard of care of all Her2+ BC) or Taxol + Heceptin, my Med/Onc agreed to only give the Herceptin (+ Tamoxifen). She believes the data is still pending on low risk Her2+ sub-types and believes in five years there will be much more supporting this.  Best of luck to you!

QuinnCat

I had A/C, T, then "C"....I am not her2+ obviously, but I found Carboplatin so much easier compared to the A/C and T.  Especially the T!

liza23

Yes, I'm stage 1A. I'm north of Washington, DC (Rockville, MD). I did get two opinions before starting the chemotherapy, and both were the same (TCH). I'm glad to hear your oncologist believes your two rounds of carboplatin will have done some good even though you're unable to continue. If anyone knows of a flexible oncologist in my area, please let me know! Thanks.

liza23

Just to follow up, today I got a second opinion from a different oncologist. She has an extremely nice bedside manner, and offered to replace my TCH ( 6 treatments with taxotere and carboplatin every 3 wks with herceptin every week) with a regimen of taxotere and herceptin every week through week 18. (In both cases Herceptin is continued for a year.)

I have had two rounds of TCH and have not tolerated it very well. The new oncologist says chemo is easier to tolerate given weekly because you get less each time. For some reason carboplatin can't be given weekly.

Has anyone heard of this weekly TH treatment plan? I'm so relieved to have it as a possibility, but have not been able to find much information about its effectiveness compared to TCH. And it may be hard to change doctors in the middle of treatment for logistical reasons. 

Ukkate

Liza - that's the regime that I'll be on now - although he said not Taxotere anymore, he was swapping to "Taxol"  I'll question him more about it's effectiveness on Tuesday.