Basic questions re: treatment schedule

Ingerp

I'm sure I could piece this information together from various threads but thought I'd ust be efficient and ask directly. Got the IDC diagnosis a week ago, scheduled for surgery 3/13 (lumpectomy and will have radiation), just now found out it's HER2+. From what I went through two years ago, I know it'll be several weeks/a month from surgery before I can start radiation. I did 20 sessions last time, so that was another month. What I don't know is when something like Herceptin/Taxol would start? And I am slowly educating myself on it (was hoping it would not be necessary--on physical and ultrasound examination the lymph nodes look good so keeping my fingers crossed there will be nothing detected there)--I think Herceptin is like every three weeks for a year? I've been a little too skittish to read up on anything like Taxol. It'd helpful to know the typical protocol--I gotta plan my life! TIA

NotVeryBrave

Usually chemo with targeted therapies is done before surgery for HER2 positive. TCHP is probably the most common regimen and is given every 3 weeks for 6 rounds. The Herceptin portion is continued for the rest of the year. It's becoming more likely that the Perjeta is also given for a year, but I'm not sure about the criteria for that.

Ingerp

Thanks for this, NVB. I'm wondering when the Herceptin would start relative to radiation. There was no mention of chemo before surgery.

NotVeryBrave

Have you seen a MO for a treatment plan? It seems to me that standard of care for HER2 positive is NAC.

In my case - the Stage II cancer was gone by pathology after chemo.

NotVeryBrave

Also - when chemo is recommended after surgery, that usually starts 4-6 weeks later and rads are put off until chemo is done.

Ingerp

I did not have one last time (DCIS) but will this time. I won’t meet with him/her until after surgery (and maybe after rads? I don’t know)

TabzIsMyAngel

I was diagnosed with ER-/PR- HER+ IDC/DCIS. I had lumpectomy & sentinel node dissection (negative) the end of September with A/C chemo (4 infusions spaced 3 wks apart) to start 4 weeks later. Three weeks after my last A/C chemo I started 12 weekly infusions of Taxol & Herceptin (1st wk of Jan). Had #7 this morning. After completing these, I'll be starting 6 wks of rads, with the Herceptin continuing every 3 weeks till next January.

Ingerp

Thanks so much, Tabz. I’m just trying to get prepared for what might happen in the next few weeks/months.

sheila888

Once chemo is done and you're only getting Herceptin which is a maintenance drug...they start the radiation treatment the same time. Is it in the same breast ?

Good Luck

Sheila

Ingerp

Roger that, Sheila. And Tabz I just noticed you started your chemo on my 60th birthday. :-(

TabzIsMyAngel

Ingerp - I had my surgical consult on my 53rd birthday with surgery 6 days later. Not my best birthday. LOL

And yes, Sheila, I was told rads couldn't be given with Taxol, but will be scheduled ASAP after I finish #12.

Ingerp

Sorry, Sheila—I missed your question. This is on the other side. (I put the new dxin my profile but it hasn’t shown up yet.)

sheila888

Is it a new primary or a recurrence ?

Ingerp

They’re saying new primary. Besides being on the other side, it has completely different characteristics (triple positive).

Ingerp

There we go. I had it set to private.

sheila888

I was kinda releived that mine was a new primary.....to me it meant Herceptin worked

Ingerp

So Sheila how was the Herceptin for you

sheila888

Herceptin was really nothing....my hair grew..it was just annoying going for infusion once a week for 52 weeks........I live close to the hospital I was walking...

The only effect was my nails they chipped got so thin and still not smooth.

Everybody reacts differently but I had absolutely no SE

You'll be fine.....Sending more hugs your way.

You can always PM ME if you have any questions

Sheila 💜

Ingerp

Oh Sheila you are sweet (and encouraging!). I’m holding my breath a bit til after the surgery and we know what’s up with the lymph nodes. I guess then we can lock down the treatment plan. I admit I’m pretty scared of any kind of chemo/Herceptin, even going on a long-term therapy like an AI. But every time I read about someone who’s out the other side and didn’t have a terrible time I feel a little lighter. I may hit you up by PM in the next few days/weeks.

sheila888

I'll be happy if I can answer any questions you have just one thing I had my Herceptin treatment almost 13 years ago...there is a forum all about TRIPLE POSITIVE AND IS VERY active go look at it it might help you also .

This is the link

https://community.breastcancer.org/forum/80/topics...

I also started a topic called CALLING ALL STAGE 1 SISTERS at 2009

https://community.breastcancer.org/forum/108/topics/743394?page=499#idx_14952

ShetlandPony

Ingerp, you said, "I won't meet with him/her [medical oncologist] until after surgery." Please insist on meeting your medical oncologist before surgery. It is possible he/she will advise chemo before surgery for Her2 positive. This is what NotVeryBrave above means by NAC aka neoadjuvant chemo (right, NVB?).

Ingerp

Ha! I have posted on that thread. :-)

sheila888

NotVeryBrave

Yes - I believe it's important to meet with all the possible "players" on your team before any treatment starts.