What is the standard protocol for Her2

Snowyday: I've seen some of your posts - boy, it really sucks that they "missed" your Her2+. I just finished chemo yesterdy = 6 tx of Taxol/Carboplatin/Herceptin. Now I begin Herceptin only infusions every 3 weeks for a year. There is a TCH thread on the Chemotherapy session, so I think this is pretty widely used.

Best wishes to you -

Sue

I had ACT, dose dense.  Then 1 yr of Herceptin.  I was 1.1 cm, Stage 1, Grade 3, no node involvement, ER/PR+ and HER2+.

I'm not sure you can really say that there is a "standard" protocol.  One onc recommended AC only on a 3 week schedule, followed by herceptin.  The second onc said there was a "good argument" for that approach -- less risk of recurrence = less treatment.  But, he said he thought that was like buying a Chevy when a Cadillac was available.  He wanted to give me the "Cadillac" because he said he didn't want me to feel like I left something on the table.  <shrug>

Which one was "right"?  Who knows?  Was the extra necessary?  I may never know.  Was the extra risk of heart damage worth it?  Again ... I'll never know.

Just wanted to let you know that I think it would be perfectly reasonable for diff docs to disagree.

Does your hospital have tumor board?  If so, you could ask that your case be submitted ...

Best wishes to you.  I know that this is just eating away at you.

I'm not HER2+, but I wanted to point out that Snowyday lives in Canada, and that might have influenced her onco's decision about what chemo regimen to use.  For instance, I think Adriamycin is used more often in the U.S., while Epirubicin is used in its place in Canada.  So, the "AC" here might have been "EC" in Canada.  I also don't know how often Taxol would have been used in Canada last fall, when Snowyday had her chemo.

The key difference, of course, is that Herceptin would have been added for a HER2+ tumor.

otter 

I'm the odd person out - my treatment has been so different, I haven't met anyone who's getting what I'm getting. It made me nervous, so I wrote to two different oncologist "friends-of-family" and both said not to worry - that oncology is part art as well as science. Also - I switched oncologists, and my new oncologist agrees with the treatments I've already had. Since my tumor was "only" Stage 1 and Grade 1, I fell into a "grey" area where Herceptin was needed, but not the big guns of the other standard chemo drugs. My oncologist didn't want to increase the risk of damage to my heart, nor cause me anxiety with hair loss. The studies he looked at showed that Herceptin is effective as long as it's given with ANY chemo drug - so he put me on Navelbine every two weeks for 4 months, with Herceptin continuing for a year. Also, since I'm ER+ 90% I'll be on Arimidex for 5 years once I'm finished with the Navelbine. Sometimes I still get nervous thinking how different my treatments are from everyone else who's Her2+ .................but having had a mastectomy gives me confidence that I took a "big gun" approach with my surgery.  Ultimately my prayers help me to stay calm - and trusting in God's will.

Hi, Snowyday.  I am from Canada.  I had three cycles of FEC and then three Taxotare, which is when I started my Herceptin which goes on for a year.  Just a Canadian point of view.  That sucks that they missed your HER2+.

Snowyday, I don't have any answers for you, just sending (((((hugs))))).  Take care of yourself.

Hi! I had 4 rounds of epicubicin/cytoxen and 4 rounds of taxotere/herceptin with continuing herceptin for 1 year ~ done every three weeks.  My oncologist said that studies have shown that the herceptin is our miracle drug and with his patients that were early stage Her 2 + and did not receive herceptin years ago, he called back when the gov't allowed herceptin for these stages. Some had finished chemo years before but thought that the drug was enough of a benefit, it would be unethical not to give them the medicine.

 sorry about misspellings, I am tired.

I had A/C and T/H. My onc told me they hold off on Herceptin because Adriamycin is cardiotoxic and so is Herceptin, so these two drugs are not given together. I do beleive they want you to get started on the Herceptin as quickly as possible, but I think in your case starting now would be the best thing you could do.

I also recommend the herceptin website. I am on their mailing list and get all sorts of info all the time. There is probably someone there that could answer your questions, as well.

Best of luck, Snowy..... I'm so sorry for all you're going through.

Miss S

Hi Snowy, 

My wife has Her2+ as well.

Mammogram 3 months earlier did not detect breast cancer.

Her doctor said X-ray can detect cancer with the present of calcium.

Since her cancer has no calcium, mammogram didn't work.

She has a mastectomy. She started Chemo on October.

Her treatment was 4 AC 4 TH 1 year Herceptin.

From what I read,  Taxol + Herceptin combination give the best result.

Herceptin by itself almost like a vacine.