AC-TH, TSH or TH?

My onc does TCH for Her2+ patients to reduce the possibility of cardiotoxicity.  I used 30g of L-Glutamine, 1500mg cap of Acetyl L-Carnitine and a 50mg cap of B6 to ward off neuropathy.  I had finger and tongue tingling that resolved between tx, and by tx#5 had numbness on the soles of my feet.  Continuing these supplements through chemo that numbness resolved several months post-chemo.  I have no problems with it now, nor did I have any cardiac issues.  I had a baseline echocardiogram prior to the start of chemo, then quarterly echos until the end of Herceptin (Jan. '12).  A number of oncs use the TH for those with smaller masses - 7mm is relatively small.  What is the "S" in your TSH acronym?  My port was installed during my BMX, and yes it does make things easier!

I had 8mm grade 3 her2 positive. Mine recommended ACTH. I did quite well with AC and now doing TH. I have had no cardiac issues upto now. AC-tH shows a few percentage points better disease free survival than TCH in a recent study (though it may not be significant), but ACTH has cardiac issues and slight risk of leukemia (.1%) (again small numbers so may not be significant). Your MO should take all these into account when recommending a specific protocol.

Thanks for sharing this article , in all my research I felt ACTH seemed to always have a slight nudge. I am also ER/pr negative and felt more comfortable doing this. I am 44 another reason they chose the ACTH regimen. I got two consults MDA and Columbia both in agreement and I am being treated at MDA. I finished AC and my fourth TH. Side effects were bearable no cardiac issues unto now. I am on low beta blockers to make sure I don't have issues.

I am er-/pr-, and her2+. My onc recommended TCH. I have tolerated it pretty well. I have heard the ACTH, has a higher rate of cardio toxicity and since herceptin also is cardio toxic, she felt TCH would be better. The cardio toxicity of herceptin is reversible however the effects of A are not. The benefit of either chemo is pretty much the same in terms of %, and even the dr who created herceptin tends to recommend TCH regimen over the ACTH.

Perfect sense.

Driftway- I did want to add that they did put me on low levels of beta blockers before I started chemo. There is a study that showed the group on low levels of beta blockers had no issues with Herceptin but 30% of the control group had issues. Can't find that study, you might want to search for it. Not sure if it helps with AC related issues. But as I was doing AC-TH and had a few palpitations before they decided to be careful. I have done fine upto now, but I am just finished with AC and partway on TH. Only time will tell if I made the right choice.

Carvedilol and I think it is 5 mg twice a day. Will check the dosage. They will do a complete heart work up for you as you are going to be doing herceptin. If they are not planning on it, make sure your MO gets a cardiologist on your team. You will have echo, Muga scan etc one before you start, and for me I had another echo after AC prior to Herceptin. I will have one every three months for the next year. I was told the same, given it is ER- they felt ACTH was the way to go. But I do feel jeolous of all the people who started after me and are now done.

My biggest problem right now is anemia. I still have 7 more Taxols. Looks like I will need transfusion