Is my game plan too much????
I am a Stage II cancer patient. I had a Lumpectomy in January (2.5 cm). My margins were not clear. I have existing pre-cancer cells. Two out of 10 lympth nodes tested positive. I am HER+. This is doctors game plan for me. Is it too much?????
Game Plan: AC followed by T - 4 treatments of each - Neulasta with all chemos and Herceptin to begin with Taxol (every three weeks). After chemo treatments are finished, another another major surgery since my first surgery did not clear my margins by 30 days of radiation and Herceptin to continue for a year. Hormone pills for five years following radiation treatments. Is this too much?
AC: 4 treatments of AC every two weeks. Neulasta injection two days following each chemo.
Taxol: 4 treaments every two weeks. Neulasta injection two days following each chemo. Herceptin Treatment begins with this chemo every three weeks. So I will be getting Taxol, the Neulasta injection two days later and Herceptin.
Another major surgery following the eight chemo treatments in order to get pre-existing cancer cells followed by radiation treatment followed by five years of hormone pills.
This seems to be an awful lot of treatment. What is your opinion?
Can anyone please tell me if they had any side affect to Herceptin?
Comments
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Countrywoman - I had almost the same diagnosis as you and almost the same treatment as well. I think the chemo/rads/herceptin is the standard of care now for Her2+ tumors. I had TCH (taxotere/carboplatin/herceptin) for 6 treatments and then Herceptin every 3 weeks for the rest of a year. I am now on tamoxifen for 5 years (pill, once daily).
The chemo is challenging but doable. The radiation was easy for me. The Herceptin was no problem at all. I would drive over, get the infusion (are you getting a port? Highly recommend that you do, unless you have great veins), and go back to work. I realize after the fact that it did wear me out a bit, and my pee smelled awful the day or so after (sorry TMI) but otherwise I was fine. What I mean is - I kept saying I felt GREAT during Herceptin (which I guess was true compared to chemo) but after I was done with it for a few months, then I REALLY felt great, and realized that it did affect me somewhat while I was on it. But nothing that limited my daily life.
I don't know if they want you to do ACT instead of TCH due to positive nodes. I also don't understand what you mean by having a second major surgery to get rid of pre-existing cancer cells. What type of surgery is that?
It sounds like a LOT of treatment, but as you walk through it one day at a time, it doesn't really seem like it. And since Her2 cells are very aggressive, i was glad to have so much treatment to attack with. Now that I am done (finished Herceptin in May '10), I am all back to normal and feel very confident about how I attacked the intruder and drove it off!
I'd like to offer you a few suggestions:
a. Join the chemo group that starts the month that you start your chemo. One starts every month. They are entititled "Starting Chemo April 2011" or something similar. I was in the April 2009 group and we are close & supportive to one another to this day. You will form bonds with those women and support one another in ways you cannot imagine. Then when you start radiation, join the rads group for that month as well. It will help you also.
b. Come to the Herceptin area of the site. There is a TCH message board which I am sure you will be welcome at, even if you are getting ACTH instead of TCH. It is a wealth of information and a very active and friendly site.
I'm sure more women will be along to offer more info and support to you. Please feel free to PM me if you have any more questions I could help you with.
I know so well how scary and overwhelming the beginning of all this is. It feels like your life will never be back to normal again. BUT IT WILL. I was at the cancer center so much it felt like a second home. But now I just drive by and wave and LOVE not having to turn the car into the driveway!
Amy
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Thank you so much for responding. Yes, I forgot to mention, I also had a port placed into my breast tissue. They can never find my veins. As far as another surgery.....my margins were not clear and my surgeon wants me to have another surgery after my chemo treatments end in order to get clear margins. Then I will begin radiation treatment. I have already begun my treatment plan - AC followed by T. I began the AC on March 1st followed two days later by the Neulast injection. I will be going for my 3rd treatment of AC next Tuesday. Do you think TCH is a better game plan? I am a little concerned now as I have already had two treatments. Do you think I should bring it up to the oncologist? Thank you for your other suggestions as well.
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I had the TCH plan, which is becoming more common. But the AC-T plan is slightly more aggressive. They are now more giving the TCH as A can cause heart damage and so can Herceptin so they are leaning against increasing this heart risk factor by giving both. Sometimes, I wish I got the stronger one though. The difference between the two in terms of outcome is only slightly in favor of the AC treatment. Normally, they might go in for a second surgery if the margins were not clear but I think its good that they will do this after the chemo. That way, you will know for sure if it worked. Good luck.
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Thank you Kathy. The more I read my reports, the more depressing they look to me. I am so happy I have this site to come to. You people are the best.
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Countrywoman - had a similar treatment plan - just a few more rads then you are going to get. Not Her2+ - so getting Tamox instead now... expect to get it for 5 years and then followed by 5 years of an AI. So you are being given a similar plan to the "established" medical offering for BC. Wish you well... gentle hugs to you.
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I had the same treatment plan too, but i didnt need the neulasta with the taxol. The plan worked for me and got me NED by the end of chemo.
Laura
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Did you ask them to take you off the Neulasta with the taxol? I don't like the idea of getting chemo, neulasta and herceptin all within the same treatment schedule. I just think it's too much. Did you get Herceptin with the Taxol treatment? P.S. Please tell me what NED means? Did you received Herceptin for a full year? Thank you.
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Did you ask them to take you off the Neulasta with the taxol? I don't like the idea of getting chemo, neulasta and herceptin all within the same treatment schedule. I just think it's too much. Did you get Herceptin with the Taxol treatment? P.S. Please tell me what NED means? Did you received Herceptin for a full year? Thank you.
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think your plan seems pretty standard. one thing you may want to talk to your onc about is that there is also an option to do the taxol as 12 weekly treatments, instead of the DD version. the overall dosage is the same, but the individual doses are much lower so it is easier to tolerate. you wouldn't need the neulasta in this case, and you'd probably feel pretty OK. But it takes 12 weeks instead of 8 - so maybe that's a factor for you.
the way i got through similar tx is to just take it step by step - get through each tx as it comes, and try not to think about the big picture too much.
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Countrywoman - NED=no evidence of disease. We aren't cured with the current medical treatment plans.. so NED is the prognosis we receive if we are blessed to dance with NED once all this treatment is over. Not sure about your HER2 with Taxol question... someone will come along to answer that one... but the Neulasta is to ensure that your immune system does not become so compromised that you fall victim to an opportunistic infection and/or that the blood levels are so concerning that they are forced to withhold treatments from you. It makes you hurt - but it does its job.
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