Taxol and Herceptin for small node negative breast cancer

I don't think there is any study that has released results for the treatment. There are some studies underway of Taxol and Herceptin for Stage I, but the ones I've seen were just getting started 2 years ago and I expect it would take longer before they would have preliminary results.

Tdsmgb the penguin cap is a cooling cap to save ur hair check out the thread call penguin cold cap users past and present or click on my name n see where I have posted to find it that way there are lots of us who have kept our hair through Chemo tch has great results not positive about ac but the woman will answer u if u post there lots of woman do tch with her2 positive especially if ur node negative but there are lots with node positive too who have done tch b/c of the heart issue possibility with ac and with herceptin keeping my hair meant so much! Let me know if u have more questions!

update on my care:  finished the E/C chemo (adriamycin was in short supply), it was tough, but predictable. The week of chemo spent in bed or bedridden, the following week, high energy and got everything done for 2wks in 1.  The Taxol/ Herceptin regiment, for me, a lot harder to tolerate.  The Taxol at 100% strength, I cannt tolerate.  Have had it reduced to 75% for treatment 2 & 3, back up to 100% for #4, could not tolerate it.  I have severe neuropathy, the numbness doesn't leave on 100%.  Had it reduced again to 75% for #5 and #6 we tried it at 7/8 strength.  Have had some neuropathy, but it is tolerable.  I have reflexology and that helps.  I ballroom dance and have not stopped, it is hard at times, my balance is affected.  I have #7 this coming Monday.  Cannot wait for the weekly Taxol to be over! No taste buds, still, it has been 4 months without taste buds and my mouth always has a sickly sweet flavor to it and my saliva is very thick.  My hair loss began on day 14 of the E/C chemo and is coming back in on the Taxol.  I eat only 1 meal a day as I am not hungry, but the weight gain hasn't come off.  Gained 10 lbs on the E/C and on the 1st Herceptin treatment, I gained another 8 lbs.  Have lost those 8, but have had to buy clothes 2 sizes larger than I normally wear.  My liver panel is all over the place too, have been sent to a liver specialist.  Had a full body scan before the E/C chemo was started and no cancer was found.  I am also anemic, which my oncologist knows about but is not concerned, the liver specialist is tho. I am concerned as my glucose is high, no one is concerned about that either.  Father and his mother were adult onset diabetics, my Drs. know this and are not concerned.

My dx was stage 1B, but am being treated as if I were stage 4 as my tumor grade was a 3.  No lymph node involvement, cancer was invasive, but have clear margins after 2 surgeries.  I am er- / pr- but am Her2+.  I had a partial mastectomy against my own better judgement, was talked into that proceedure by 3 Drs and my husband.  Radiation will begin after Taxol is completed.  That will be the std 6 wks daily and the Herceptin continues every 3wks til end of March 2012.  Long process and then the 2 yr wait begins.  I have been told that I have a 90% chance of recurrence in the 1st 2 years. I hope they are wrong. Tying to stay possitive is not an easy task, but am living day to day and sometimes hour to hour or min by min. 

Was told that because of the tumor grade and the type of receptor I have that the treatment recommended is for stage 4.  Looked it up online too, and the protocol that I am on is for stage 4.  It is the the gold standard for grade 3, hormone neg and her2 possitive, but also same treatment for stage 4 bc only the herceptin is an added drug.  No tamoxafin for me.  As far as the 90% recurrence, they do not know if it has invaded the blood, if so the 90% stands as a chance of recurrence.  2-5 yr survival is 50%.  I hope they are wrong, as it is not in lymph nodes and I truely believe it did not have time to travel w/in the blood. Just want to this to be over done with, want the radiation to be here and gone too.  So far diag to time in treatment has been 5 months and it is getting really old!  The support here at the chemo ctr, is not good, they are way over booked and overwhelmed w/cancer patients. My network of friends who have gone thru this those who have not, has been remarkable. I wouldn't be getting thru this w/o them.  I

My Drs all thought for sure that it would be in my nodes, the only Dr who said it wasn't was the radiologist.  It is what is is, I am trying to make the best of this situation, but it is already getting old, wearing the wigs, and I have 9 so far, too many to choose from.  The process is much longer than any of my friends had to go thru.  I know this is not curable as I was not insitu but still feel like for all the inconvoence and annoyances this bc has caused, I will survive, I have to, way too many ppp in my life that I need to piss-off!  Thanks for responds Sue, btw love your nickname

tdsgmb,

I still believe that the % risk of recurrence you got is wrong. I am Stage 3, Grade 3, ER+ and highly HER2 positive. I had 7 tumors in my armpit. I got the risk of recurrence at 20 % without any AI's, if I take any form (Femara, Aromasin) it will lower the risk to 10 %.

They don't know if any of the cancerous cell traveled with my blood either.

Renee,

I think the steroids and the other meds can cause you to gain weight while on chemo. I had DD AC and then Taxol (and Herceptin) and I didn't gain any weight at all. After chemo I weight pretty much the same as before, a couple of  Lb up and down every week.

steroids and lack of stamina and energy have played a huge part in my weight gain. 

rgd1959, I asked me onc for the tch protocol and he said no, it was not, in his opinion the recommended treatment for my cancer.  A friend of mine, she was on it, but her bc was not the same as mine either

It is my understanding that Stage IV is treated with a completely different philosophy than early stages. Early stage the are very aggressive assuming they can cure. Stage IV they treat as a manageable disease hoping to slow, stop or remission growth also considering quality of life. Many times stage IV is NOT treated as aggressively as earlier stages. As the cancer becomes resistant to treatment then more aggressive treatment follow.

Teri my point is you should be treated more aggressively than stage IV… and it's a good thing you are. I also think you misunderstood your recurrence risk. I would ask your onc for the numbers again. The reason they are treating you so aggressively with chemo is chemo, Herceptin and radiation are the only guns they can use on you. After the year of Herceptin you're done with treatment. Hormone positives have another 4 years of treatment with a drug. Yes they want to hit you hard so it kills what ever might have escaped, if anything at all.

Teri, if you haven't misunderstood your oncologists, then you need to find some other ones to talk to because it seems like they are giving you very incorrect information. HER2- tumors are almost always grade 2 or 3 because the are aggressive, but the chemo you are getting is very effective.

Retrospective studies of women with node negative tumors less than 1 cm (i.e. stage 1a or 1b) who didn't have chemo at all, found 5-year recurrence free survival of 77%. That means that recurrence occured for about 23%. That is why chemo is a good choice for all stages of HER2+.The reserach was done by MD Anderson and the results were presented at the 2008 San Antonio conference.

There also were some recent small retrospective sudies on women with Stage I HER2+ who had chemo and Herceptin that found no recurrences. So, it seems that chemo may have taken our chance of recurrence down from 23% to less than 1% - a far cry from the 90% that you were told.

The research on chemos until recently has focused on stage II and higher so they don't have different chemos for stage I, though there is currently some research underway to see if something like just Taxol and Herceptin would be effective for Stage I Her2+. That is why us Stage I folks often get the same chemo as Stage II through IV. I think TCH which is about the same effectiveness as AC-TH but less long term side effects is generally a better choice for early stage.

There were two small studies mentioned on this board a while ago. I've bumped the thread that has the links to them just in case the link I put here doesn't work:

http://community.breastcancer.org/forum/80/topic/763528?page=1

The title of the thread is:

Chance of recurrence small node neg her2+ treated with herceptin