Perjeta/Herceptin/Taxotere

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  • pearlady
    pearlady Member Posts: 882
    edited February 2013

    For me the big D from the perjeta can be at anytime.  I've had treatments where it was very bad the first 10 days and then got better and I've also had treatments where the last week prior to my next treatment was terrible.  For me that's the frustrating part as it's totally unpredictable.  I just got a shot of Sandostatin which is suppossed to help with the big D. 

    I was also accepted for Perjeta even though I had been treated previously for Stage 1V.  My onc plans to keep me on the Perjeta and either Herceptin or TDM1 indefinitely.  He has advised that early on with herceptin he had seen some women who were stage 1V and stopped herceptin with very bad consequences.  So I'm in in for the duration, which is hopefully many more years.  Just hope that I can keep the D under control. 

  • bhd1
    bhd1 Member Posts: 3,874
    edited February 2013

    i don't understand.  is it ok to live with D for months?   or is it the D not that often?  24/7?   what do the oncs say about it?

  • scuttlers
    scuttlers Member Posts: 1,658
    edited February 2013

    I have pretty much lived with the D for a little over 4 years. (with some severe constipation thrown in at times). Would rather have the D than the C! I drink water constantly, keep it by my side 24/7 and make sure that I get salts and minerals as needed. The main problem would be dehydration and I've been able to keep that at bay. The onc does not seem to be concerned other than making sure I keep the fluids coming in to balance.

  • bhd1
    bhd1 Member Posts: 3,874
    edited February 2013

    Scuttles. I was in a trial and had to wear depends around the clock. When I went out I took a backpack and always had to change at least once. Even Ito grocery store. We are not talking about D that bad are we?

  • scuttlers
    scuttlers Member Posts: 1,658
    edited February 2013

    Oh no. That would be awful! I "go" about 8-12 times a day. And can most of the time control it to the point where I have about 10-15 minutes to find a restroom. I always know the nearest one and how to get there quick!

  • bhd1
    bhd1 Member Posts: 3,874
    edited February 2013

    12 x a day is about once an hour. That sounds like slot to me. No?

  • Shaysmom
    Shaysmom Member Posts: 25
    edited February 2013

    Bhd for me it was like that. Maybe bc I have GI mets. This time last year I had C and then ended up with bowel obstruction. Went on Gemzar and had D once a day.

    On perjeta, herceptin taxotere . I wore depends, did not always make it to toilet , could go 8-20 times a day. Sometimes just water coming out. Had backpack, depends, lomotil, immodium and a powder meds. Nothing controlled it. The cycle we skipped taxotere it wasn't that bad. First cycle I had the Big D 18/21 days. I average 14-18 a cycle. It was bad for me.



    I hope I am the exception.

  • lilylady
    lilylady Member Posts: 1,079
    edited February 2013

     I too have had the D ever since starting tx[2 years now). Some days worse than others but can;t remember the last time I had a regular BM. I use WalMart brand Equate anti-d. I have it down to a science-I don't dose anything like the label says though. There are some days-usually 2-that there isn't anything in the world stopping it. I get my tx on a Tuesday and it is usually Sat or Sun when the worst hits-. I too know where every bathroom in town is. I stay on potassium all the time-I can;tkeep my level up on that bu everything else seems to be OK.

     Wierdest thing is now I have projectile vomiting. I did the PHT X 6 then just the PH. I got major progression once we stopped the Tax so now I am back on it. I have never had the pukes in anything i have been on so not sure where this is coming from. Strange thing is there is no warning. All of a sudden I get heavy saliva in my mouth then boom-huge puke storm-almost always 3 times then it is gone and I feel fine. So I am not sick to my stomach ahead of time and feel fine afterwards. Pretty mortifying when it has happened at work. I have started carrying a plastic grocery bag in my pocket. Bathrooms are spread pretty far apart in a factory. I can't believe the things we tell each other...BM and puking-glad we are all friends here. It is pretty certain my "in person" friends wouldn't want to know this. He gave me a drug called Reglan? for it-but you have to take it 4 times a day and it gave me a headache so I decided it wasn't worth it.

     Anyway I have 1 more tx with the Tax before we scan again. I am not every confident that this is going to work for me. I can't stay on Tax forever. My feet are going numb. I failed on Herceptin back in the beginning and failed on just the PH-I am figuring targeted drugs just are never going to be strong enough for me.

     I am glad this is working for so many-I just wish it was me.

  • bhd1
    bhd1 Member Posts: 3,874
    edited February 2013

    kelly, good luck on tdm 1.  where are you in pa?  i am at fox chase  .  barb

  • Bondgirl
    Bondgirl Member Posts: 140
    edited February 2013

    Lilylady, could your vomiting be acid reflux? I've struggled with GERD since I had my little girl 4 years ago. Mine didn't feel like heartburn. I'd have a burning in my gut, start salivating and then boom projectile vomiting. I have terrible heartburn now after infusions but the actual GERD is well controlled with prescription meds. It may be worth asking your onc about since not typical nausea symptoms.



    So I just finished my 4th cycle. Fatigue seems to be getting worse but at least I didn't lose my shit emotionally this time. Only one small crying fit from steroids but I don't even remember why now. Lol. Today is day 4 out and woke up with horrible headache and the Big D has made itself present. Missed church today and just lounging around house with hubs and my little one.



    Since we are all dealing with mets just curious if most of you feel pretty normal once the chemo side effects wear off (big D notwithstanding)? Besides occasional heaviness in my chest (from pleura mets) if it weren't for chemo I think I would feel normal.



    Anyway, rambling this am. Lol. Hope everyone is feeling as well as possible!



  • JillThut
    JillThut Member Posts: 1,470
    edited February 2013

    I have this thread in my favorites and read it all the time. I just joined your club as of this very minute..getting my loading dose of perjeta as we speak. My onc wanted it for me back when but Connecticare wouldn't approve it so I was on cabo/tax/ herceptin. I absolutely hated it..severe nausea two weeks out even...no qol. My last scan on it actually showed regression though which I know is great news especially since I've had nothing but progression to the liver for over a year and was really thinking I was real close to the end. But I found it hard to celebrate since the treatment was taking so much out of me. When my onc called the day of the scans to report the regression I asked her if it might be a good idea to try getting perjeta approved through Medicare since I am Medicare eligible as of January and no longer have Connecticare. Got it approved! I know many of you are finding this combo tough..especially with the severe diarrhea but I'll take it over nausea given a choice. Now I feel like celebrating :). A 6 cm liver lesion shrunk to 4cm, a 3.7 to 2.9 etc etc. Best report I've seen in a long time! And looking forward to more quality of life.



    I know many of you have reported less severe SEs with subsequent doses after the loading dose so I'm hoping. Planning a trip to Florida which didn't seem possible the past couple months. I'm hoping to at least have manageable diarrhea by the third week. I know everyone is different but isn't it better for most of you the third week out from treatment?

  • Kaelia
    Kaelia Member Posts: 163
    edited February 2013

    Lilylady & Bondgirl, hopefully all these SEs will give us all good scan results! I have the same SE as far as the "no warning extra saliva" in my mouth followed by a sudden need to vomit. Usually I will rush and take a Zofran pill and that has worked for me so far. I vomitted once because I couldn't find the Zofran. And when I did vomit, it was projectile vomitting. I have had 5 chemos on this combo so far; at the beginning of it, I had the big D constantly but that has sort of been replaced by the big C every now and then.  As of right now, my toes and fingers have more of that bothersome tingling sensation; I have frequent nausea but Zofran is the miracle pill for me, and the runny nose is non-stop. The fatigue is what is taking a toll on my body.

    Jill, congrats on getting the perjeta approved and on your scan results! To answer your question: I have treatment every 3 weeks and I am usually feel my best starting 10 days post treatment. 

  • kingcour
    kingcour Member Posts: 93
    edited February 2013

    Jill, I remember my second one being bad too, but they got better. I can predict to the day what is going to happen to me now after 9 treatments. I go for treatment on Thursday, and my worst days for D are Tues through Thurs after that. Then things get fairly normal. Lomotil has helped a lot too! I am going to Disney World Sunday. My D isn't enough to wreck my normal life. I still go to the gym too. I have had maybe five random days throughout the past six months where I just stayed in because the D was so frequent. I am so glad to hear of your regression. Praying that this works for you!

  • SPAMgirl
    SPAMgirl Member Posts: 1,470
    edited February 2013

    The treatments have gotten easier. They sucked the big one at the beginning. I started taking the taxotere weekly instead of 1/3 weeks. Now I'm a 3 weeks on taxotere, one week off, Perjeta at the start of a tax cycle, so 1/4 weeks. Of course I got hit Hard by the

    hIt "D" on my week off and that stupid cold my first week of the new cycle. Blech.

  • pearlady
    pearlady Member Posts: 882
    edited February 2013

    Ladies I have to say that I've been living with the Big D since I've been on this combo starting in July.  It's been a real learning experience.  As I mentioned previously, for me it's unpredictable.  I can be good the first week and then the big D or I can have the D for a week after treatment and then it gets better.  No matter what, it's usually very bad 48 hours after.  I've recently had to start taking Potassium pills since the D was depleting the potassium.  I have to say that the potassium does give me back most of my energy.  I also just had an injection for the big D called Sandostatin.  It seems to have provided some relief, so I am very excited about that and hope that it continues to work.  The injection is once a month.  I still take lomotil which does help a little, but when it's a bad day it's a bad day no matter what I do.  I get my next treatment tomorrow, so I'm anxious to see if the Sandostatin will help lessen the usual bad day which usually occurs 48 hours after treatment.

  • ango74
    ango74 Member Posts: 255
    edited February 2013

    Hi Ladies,

    I was suppose to start Taxotere, Perjeta and Herceptin today but came into the office to find out insurance isn't covering it.  That wasn't a surprise to me as this is my 5 chemo combo.  How did you guys get it? I know it's first line for some of you but not all of you on here.  Today I am getting Abraxane, Herceptin and Tykerb.  My oncologist is trying to get it through some foundations and is hoping to just replace the Tykerb with Perjeta when we get things set up. 

    Thanks.

  • Shaysmom
    Shaysmom Member Posts: 25
    edited February 2013

    Barb,



    I grew up near FCC. I'm in Bucks county now. I go Univ of Penn and Aria Torresdale. FCC was not a good fit for me.



    I've had the Big D like pearlady, no rhyme or reason. Fine days 1-3 then anyone's guess. I followed brat diet, take lomotil two and a time every 3 hours plus immodium for break through diarrhea and still needed depends. It was worst chemo side effect ever. I spent almost all waking hours in our tiny bathroom. I have some big d with tdm1 but once or twice a day. I normally have warning so time to find bathroom. I went two days without any. I'm not as malnourished.



    I had vomitting on perjeta, taxotere and herceptin but I had dairy which normally did not agree with me. Do foods trigger it? I had vomitting everyday with stomach mets but mostly after eating and at the end of the day bc my stomach wasn't able to digest the food. I just switched to less effective reflux drug due to insurance and had more nausea. Back on Prilosec and its working.



    Hang in there.

    Kelly

  • bhd1
    bhd1 Member Posts: 3,874
    edited February 2013

    Angie I am sorry to hear you r having insurance problems. I hope this tx is good for you. Prayers being sent.

    Kelly I had no D on tdm1. Maybe you just have leftover prob from perjeta and it will stop soon. Good luck w tdm1

    I have scans a wk from fri. If tdm 1 fails I am not sure I want to do perjeta. I had D with another tx and it was horrible. No qol

  • aic
    aic Member Posts: 417
    edited February 2013

    Congrats Jill! Awesome news!

  • JillThut
    JillThut Member Posts: 1,470
    edited February 2013

    Thanks, aic. But I feel like crap. First infusion this past Monday. Bad sore throat, off and on fevers, every joint hurts, I feel like throwing things at his point. Called to report the sore throat and fever and the APRN wanted me to come in for a CBC to see if I need intervenous antibiotics. I declined..not up for driving 50 minutes for a blood test..I don't feel good! Had the blood drawn locally..waiting for results. Just getting so tired of feeling sick! Just venting a little here. I'd rather be posting on the "What are you doing for fun" thread but nothing has been fun in a long time! Ok...I'm done.

  • Bondgirl
    Bondgirl Member Posts: 140
    edited February 2013

    So sorry you are feeling so cruddy Jill. Did you get a neulasta shot? That could be the source of your symptoms more so than the chemo. I usually take Tylenol for the joint pain but I think Claritin is often recommended. Its good you called though as they always want to know about fevers. First dose is loading so hopefully future rounds won't be as bad. Rest well.

  • SPAMgirl
    SPAMgirl Member Posts: 1,470
    edited February 2013

    Be ready for at least the next 3-4 rounds to suck too. I had a week and a half of ick and a week and a half where I felt normal. You will enjoy life at the end of next week. After 4 rounds, I moved to a weekly dose of taxotere. I feel king of icky all of the time now. I think I might want to try the 1/3 weeks again.



    My scans were stable the first time and my TMs are going down.



    My most annoying SEs right now; runny nose/sore throat and watery eyes. I look like I'm crying all of the time. My shirt always has tear spots on it.



    The "D" is more than annoying. Get some pepto and Imodium now! Don't wait any longer before you pick it up.

  • JillThut
    JillThut Member Posts: 1,470
    edited February 2013

    Thanks all for your input. White cells were ok so I didn't need to leave home. Just took advil and Ativan and went to sleep. Woke up with a fever. Still waiting for the promised diarrhea. On carbo/tax I was taking lots of stool softeners and senna which I stopped doing expecting diarrhea. Instead I got very constipated and have been using enemas and suppositories. My eyes are always tearing and burning since on tax. When I wake up in the morning they are stuck shut with goop until I wash them out with warm water...annoying but not major compared to the rest. I am hoping to at least have one good week before the next treatment. And also hoping that subsequent

    doses are more gentle.

  • fujiimama
    fujiimama Member Posts: 800
    edited February 2013

    Jill it gets better. My load dose I felt like I'd been run over. It hit hard,but it was so worth it. I hope it works for you too.

  • aic
    aic Member Posts: 417
    edited February 2013

    Hang in there Jill. It does get better. I felt the exact way the first few and then certain se eased up.

  • JillThut
    JillThut Member Posts: 1,470
    edited February 2013

    Thanks..hangin in..a bit better today...finally got the promised diarrhea which was relieving..sore throat..no more fever...looking forward to better days.

  • SPAMgirl
    SPAMgirl Member Posts: 1,470
    edited February 2013

    My eyes water so much, I feel like everybody thinks I'm crying. Especially with the runny nose. I've only cried at work 2 times in 16 years. Once when I got the call that my grandmother passed away and the second one the day before my mastectomy. So this is awful.

  • Lorijo6600
    Lorijo6600 Member Posts: 51
    edited February 2013

    I had my furst dose on the 21st. Days 1-4, not too bad, fatiqued, horrible aching joints and bones, no terrible side effects; day 5-6, almost felt normal; day 7, tired and running a low grade fever; day 8, neupogen shot, still had 100 fever, day 9, neupogen shot and doc started me on Leviquin but ended up with 103 fever, went to the ER where I was not seen after 2 hours of waiting and decided to go home since my onc's office would open in a few hours anyway. My fever broke in the morning, had another neupogen shot; Thursday, labs said everything was good. Felt cruddy the next few days and was still running a 100 fever on and off. Monday while shopping with my girls I started feeling bad and went to wait in the car. Long story short, by the time I got to the doc's office, my fever was 104.7! Doc did a direct admit to the hospital. I was put on IV antibiotics and the fever broke Wednesday morning. I was released Saturday at noon and back in Saturday night by 10:30 with vomitting, D, and high fever. I was released Wednesday the 13th. They never did find the cause of either fever and settled on influenza-type illness for the first one and stomach bug for the second one. My next treatment was supposed to be the 11th but they moved it to the 25th. I feel great now, of course, and am definately NOT looking forward to round 2!

  • JillThut
    JillThut Member Posts: 1,470
    edited February 2013

    That doesn't sound good at all, Lori. :(. Glad you feel better now at least. Hoping round two is much milder.

  • lilylady
    lilylady Member Posts: 1,079
    edited February 2013

    Lorijo

     Welcome and sorry about your first round. I have been on this stuff since it came out last summer and my loading dose wasn;t pretty either. 5 day hospital stay with high fever-continuous IV antibiotics-they finally decided the chemo made me sick. Very few problems since so hopefully you will be OK next time.

     I go tomorrow for #13 then a scan in 2 weeks. Sometimes that 3 weeks goes by so fast and other times it seems to drag-I just know that even with it being tolerable I have really come to resent tx day!

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