Herceptin Heart Attack

Arlene, I chose to forgo chemo and tx. The reason for me to even do herceptin for early  stage cancer is that my biopsy cut most of the tumor out leaving 1.8 C of the idc her2+++ for 3 months before mx. I feared possible seeding. From what my oncologist and the cancer nurses said herceptin would be a breeze, but not so for me. I'm hoping the smaller doses, and drinking lots of fluids the day of infusion will make the treatment easier for me as well as help my heart. After my second infusion I begin taking Qc10 (?) not sure I got it right. I believe that is what has stabilied my heart the last 2 infusions although I still have those PVC'S.

Grimbol, My oncologist said I have a little arthritis although other than my right arm, I am not experiencing artheritic pain or is my body deformed, yet. I understand about being concern about every ache and pain. Before bc, I never thought about pain, but now if it last for more than 2 weeks cancer comes to mind.  You can get LE from SNB.

A general x-ray doesn't show up everything. I would ask for further test just for peace of mind. There are women on the boards who after screening shortly discovered they had a Progression of cancer. It's tricky.

Ok thanks. Its actually been easier again the last couple of days, but i will pursue getting more tests. This week has been weird, Ive had nose and mouth sores again, plus some other slightly strange sensations, but im sure things will improve again.

I've learned alot from this thread.  Thank you.  Finished Taxol/Herceptin last week.

Went for first "alone" Herceptin today and MO said no, ECHO not good enough.  Take a month off

and repeat.  He and Cardiologist believe it will reverse.

Of course, I was fearful, but this thread helped.  Thank you all.  

Im sorry KD u have all this to go thru.

This has been quite an informative topic--I certainly didn't know all this stuff--I would get a MUGA every few months but it was always OK so I never inquired what it all was about. All of u have been thru so much with Hercetin, I'm so sorry.

You all may well kno this already...but Cancer Treatment Centers of Am put me on CoQ10 and Melaton (20mg) last October.  I was on Herceptin weekly and now just every 3 weeks since May 23 last year.  I believe in those suppliments, I've had heart issues, one time EF too low, but came back up w/in 3 weeks (this was before aforementioned suppliments) since then, my MUGA shows EF steady.  May be of interest to some of you.  In the meantime, keep fighting....find something to smile about everyday...and kno that you are all in my prayers always!

Hello ladies!  I hope you all are enjoying your holiday weekend!  I ran across this article that talks about heart damage from Herceptin in real life, not just in trials.  It's a very interesting read.  Looks like about 20% of women will have some low level (Gr I) heart damage from Herceptin (at least in this study/review they did)...but the severe heart failure is still around the low 3 or 4% we hear quoted.  And, the other interesting thing they found is that most of the time the damage is seen in the first 3 months.  This may be old news to some of you, but hopefully interesting none-the-less.

 Trastuzumab Adjuvant Chemotherapy and Cardiotoxicity in Real-World Women With Breast Cancer

Abstract

Background

Adjuvant trastuzumab therapy improves survival of human epidermal growth factor receptor 2 (HER2)-positive women with early breast cancer (EBC). A careful monitoring of cardiac function is needed due to potential trastuzumab cardiotoxicity (Tcardiotox). To date, the incidence, timing, and phenotype of patients with Tcardiotox in clinical practice are not well known.

Methods and Results

A total of 499 consecutive HER2-positive women (mean age 55 ± 11 years) with EBC treated with trastuzumab between January 2008 and June 2009 at 10 Italian institutions were followed for 1 year. We evaluated incidence, time of occurrence, and clinical features associated with Tcardiotox. Left ventricular ejection fraction (LVEF) was evaluated by echocardiography at baseline and at 3, 6, 9, and 12 months during trastuzumab therapy. Tcardiotox was recognized in 133 patients (27%): 102 (20%) showed asymptomatic reduction in LVEF of >10% but ≤20% (grade 1 Tcardiotox); 15 (3%) had asymptomatic decline of LVEF of >20% or <50% (grade 2); and 16 (3%) had symptomatic heart failure (grade 3). Trastuzumab was discontinued due to cardiotoxicity in 24 patients (5%) and restarted in 13 after LVEF recovery. Forty-one percent of Tcardiotox cases occurred within the first 3 months of follow-up, most prevalently in older patients with higher creatinine levels and in patients pretreated with doxorubicin and radiotherapy.

Conclusions

In clinical practice ,Tcardiotox is frequent in HER2-positive women with EBC and occurs in the first 3 months of therapy. Cardiac dysfunction is mild and asymptomatic in the majority of patients. The interruption of treatment is a rare event which occurs, however, in a significantly higher percentage than reported in randomized clinical trials.

Thought I'd pop in to say hello.  Looks like no one has been here for awhile. 

I do still come here to see what everyone's EF has been doing.  Just had my first echo since finishing Herceptin in March so I'm waiting for the call to know if my EF is still the same.

I am new to this site.  I have been receiving herceptin since March...a total of 10 doses.  My MUGA scan before chemo was normal...over 50%.  My recent MUGA scan, just yesterday was 29%...alarmingly low.  My oncoligest put me on beta blockers and I will be visiting a cardiologist in the near future.  I am just looking for advice, has anyone walked this path?  Do I have any hope of my heart function returning? What time line seems reasonable?

Hi

Have not posted for awhile.  I had most of the herceptin, missed 2 treatments total but it took about a year and half to get most of the herceptin since they started and stopped and started and stopped again the herceptin.  These problems did not start until after I completed the TCH .  Turns out a year of herceptin is arbitrary I think-  No one has really done the research to say that a year is as good as 1/2 year vs 2 years.  They just ran the clinical trials on one year.  

  I am still taking an ace inhibitor and beta blocker and baby aspirin.  Doing well post reconstructive surgery April 11.  I am finally going to get a real bra this afternoon after not having the girls match since Jan 2011.  My cardiologist plans to see me in July and do another stress echo.  Maybe I can get off of the cardiac meds since I am no  longer on herceptin-stopped it in April . I am still tired but not sure if fatigue is due to  stress due to  dramatic change in marital situation ) , being on cardiac meds (they can make you tired), permanent heart damage?? , post chemo  treatment??, having my thyroid out last year just before chemo??, or arrimidex (who knows what this  estrogen depleting drug does to energy??)   If you have other medical  issues it is hard to know what is the  impact on the heart is  vs chemo vs others drugs etc etc. 

The good news is that the cardiologist told me I could go hiking in mid July as long as I train in advance.  I plan to hike 7 days in  high Sierras  8-10 miles/day for a vacation.  I will see how I do before on other hikes before I do this however.  so there is life after herceptin, chemo etc etc.  Have a good wkend everyone.

I just had my first echo since completing Herceptin and my heart is back up to 60%.  Was 60-65% when I started, then went down to 50% for the last several treatments and now back up.  Still have palpitations, but mostly when I drink caffeine or am not properly hydrated.

Achpurple I am very happy for you.

I am starting training to do  7 day hike but got so fatigued just walking up a hill yesterday not sure if I can really get fit in one month.  Today I did a brisk walk about 3 miles in one hour .  It felt good.   I think I will ask the cardiologist about doing the MUGA or stress echo before the  hiking trip and plan to take out trip cancellation insurance just in case I am not fit enough to go hiking in  8-10000 ft elevation.  .  I think we really need to listen to our body in terms of recovery.  I have heard that hiking is good for the heart but do not want to totally overdo it.   Good luck to you all

Dear TonLee,

Thanks for your words of encouragement on hike.  I need to get really serious about training, if I am going to do this hike,  cause I am not nearly as fit as I need to be to go up to 8-10000 ft elevation.  I have episodes of sweating and feeling weak still.  Also have gained about 30 pounds since doing chemo, and herceptin and having had the thyroidectomy last year just before the chemo started.  At this point, I am not  sure if it is my heart or is it the arrimidex which I have been on for about 3 months. that cause the fatigue sometimes and the hot flashes/sweating.    I was told that arrimdex can cause hot flashes/sweathing but also a heart issue could do this too,  I think??.  I am very glad to be rid of port since April 9 and no more herceptin.  Just to be on safe side I may ask my cardiologist to  do a MUGA or stress echo before I go on the hike.   In any case, whether I do this rather challenging hike or not, it is good to exercise and hopefully I can lose some of this weight. Your physical activity level is an  inspiration to me TonLee

Does anyone know if cardiac meds can cause weight gain or if herceptin causes weight gain?