Taxotere, Carboplatin and Herceptin

minivan -- I'm not sure if there are answers, but my MO is sending me to an opthamologist because he said some people get eye problems-- either weepy eye or dry eye... and I've got a bit of dry eye. Even if there is no answer, at least I feel better getting it checked out. When my heart was beating fast, they gave me an echo-cardiogram to be sure, and had a cardiologist see me. She reassured me that it didn't look like the chemo was causing any heart problems... but that dehydration could cause the rapid heartbeat. BUT you know chemo can cause heart problems--so you should at least get an echo to have a look. At the very least, it can rule stuff out and that might reassure you a bit.

People were telling me that MOs have to know a lot about everything because there are just so many SE of chemo and other treatments. My MO is always asking about things (like whether I'm having eye problems, or mouth problems). Sometimes he'll send me to another doctor to check it out (as with the eyes), and other times he have me do something, like take l-glutamine powder, for mouth tenderness.

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MUSCLE TONE -- I'm in my 5th cycle and I've definitely got very bad muscle tone. Sad to hear that this can continue after chemo... I was hoping to try and be better after chemo... but I do know that the effects can last longer.

Maybe I really will need to look into getting a stationery cycle... Walking is a bit tricky for me. I hurt my ankle (I think the chemo messed up my muscles and I caught my foot and twisted it-- I told my MO (after weeks!) and he's sending me to a foot doctor to get it checked out because it's now numb and I'm experiencing foot-drop! -- I think I need to be a bit more pro-active with my health... but chemo was really taking up all my attention...).

I've got a gym membership, but haven't gone since starting chemo... and am not sure I can manage to do much there even after chemo... I'm kind of lying about a lot these days, doing not much... more puts me out of breath, unfortunately!

WEIGHT LOSS -- I have never in my life had a problem putting on weight! But I've been yo-yoing during chemo-- up and down by 10 lbs. each cycle! I know this can't be healthy... but so far I'm at least glad I can make the lbs back up at the end of the cycle. But I do worry that these last two cycles will be worse...! So far I've almost got back to normal at the very end of the cycle... So I was hoping this would be true at the end of chemo... I guess I can only hope!!!

Did you all have a tougher time through the last sessions??? Or were they the same as the others???

NAILS -- When did you all start having problems with lifting? I'm just wondering what to expect. Was it AFTER chemo ended??? Or did it just continue afterwards?

--I'm set for Radiation and Herceptin and something else--femara? afterwards... Need to know what i might expect...

5th cycle and no nail lifting yet--- BUT I have those white bands showing... My fingertips are a little numb. Sometimes my nails hurt, but not always. Sometimes my feet are tender, but not all the time... *sigh*

Welcome SpriteB and sorry you're here.  While I've heard of some doing the weekly herceptin, I don't know the rational is for doing it that way. You should ask the MO why he recommends that schedule.

I did the herceptin every three weeks. I believe many, if not most of us on here did it that way. 

Good luck to you. Join the Chemo in April thread, its a good support to be able to talk to others going through the same thing.

I believe the initial studies did herceptin weekly, then later they changed it to every 3 weeks and found it was just as effective (and easier for scheduling, controlled costs, etc., etc.). I chose to do my herceptin weekly. I preferred getting a smaller dose weekly, as I tend to have bad side effects to drugs. I don't think other than that that there is a big difference in terms of effectiveness. It will be interesting to hear if your doc thinks otherwise.

I think most of us have the Herceptin every 3 weeks with our taxotere/carbo. You can reduce the side effects by slowing the infusion. Mine started at 60 with the TCHP, which was OK. Then they wanted to move it to 30 minutes for the balance of the 17 doses. I had them increase it to 90 minutes and had very few SEs.

I had the 3 week schedule also.

I have a question for a colleague/friend of mine who is not on this site. She is getting Taxotere/Carbo/Herceptin/Perjeta. Did her 6 TCHP, and now the doc says she needs an ADDITIONAL FULL YEAR of the H/P part, every three weeks.

I have always only heard of getting the H or HP up until a full year from the beginning (including chemo) - 17 or 18 infusions, not a year AFTER the chemo portion is done, which would be 23 or 24.

She asked about it and he insisted that is the protocol for her. I have been on this board for six years and never heard of that. Have things changed since back when I went through this, or is this unusual?

Thank you so much for your answers and feedback. I am worried about her a bit.

Amyls - So many people talk about Herceptin for year, but really mean the balance of the year. Maybe that's the confusion? But I wouldn't have minded 24 doses. I'm ER/PR negative & there are not really other ongoing options for HER2+. My MO wanted me to continue with both H&P. I think it depends on the degree of positive HER2, the size of the tumor, was there a pCR, etc. My heart was doing OK but I don't think Perjeta effects that, only the H. All the docs swore that P doesn't cause or aggravate neuropathy and that it's only listed on their site in case it might happen to someone, somewhere, sometime. Since I already had serious neuropathy from the Tax & Carbo and since I have been lucky enough to be that 'someone' who's gotten all the things "no one ever gets", I opted out of continuing Perjeta. Now I think I'm sorry since it was available to me & as Special says, it usually isn't offered. Oh well we make the best decisions we can as we go along. Let us know what your friend decides.

Hi KathMcD. My RBCs dropped below normal after my fourth infusion and never came back to normal ranges for the remainder of my infusions. My hemoglobin was low almost the entire time and is still just barely below normal. My platelets dropped below normal after my second infusion and stayed below normal for the duration, but have since bounced back. I never had a treatment delayed. I'm sure it varies from person to person, but those were my experiences.

I wonder if some treatment centers have you come weekly for the Herceptin during chemo because of time constrictions.  When I went weekly the Herceptin was only 30 minutes, but when it went to every third week, after chemo, the infusion lasted 90 minutes.  Adding that extra 60 minutes to an already really long chemo day, would have been exhausting. 

Debiann - I believe you're correct that the centers want 30 minutes when it's Herceptin alone. There are a lot of people on these threads who have opted to push for 60 or 90 minutes when it's H only and have pretty much eliminated their side effects, as I did.

Mine was 90 minutes when given with chemo every three weeks, and it was a very long day.The first H only they infused over 30 mins. I had horrible hip and leg pain, so every subsequent infusion was done over 90 minutes.

My herceptin was 90 minutes the first round and 30 minutes beginning round 2, even with the other chemo drugs. My MO believes in spending as little time as possible at the infusion center. 

I had my Herceptin infusions every week for the duration of a year.  My onc said he felt the every 3 week dose would be too hard on me.  My EF from the echos kept going lower to where it was close to where I couldn't do Herceptin anymore.  But doing the weekly dose made it possible to continue the Herceptin.  I did have my chemo every 3 weeks.  I had every bad side effect of the chemo (carboplatin and taxotere).  There is a cumulative effect so each round of chemo was harder and harder for me.  My blood counts kept going lower after each round and bottomed out after my 6th and thankfully final chemo.  I, too worried about losing my hair.   Sometimes thinking about it is actually worse than when it does happen. 

Mine gave the herceptin over 30 minutes, weekly for the first 18 weeks, then it went to every third week, and they took 90 minutes to infuse it. I'm pretty sure that is still their same protocol.

I asked my oncologist the question about how Herceptin doses are decided and she said that generally 12 are given in addition to the ones given as part of chemotherapy. That will total 18 for me. I had to stop for a number of weeks last fall after an echocardiogram showed possible heart damage. After tests and a visit to a specialist, I was cleared to start Herceptin again.

It is good to know others are dealing with issues getting your strength back. I have so little stamina compared to this time last year. I lost a little weight during chemo ( a good thing as I am overweight), but several weeks after that last chemo, food started to taste good again and the big D cleared up and I put that weight right back where it came from!

My hair is coming in slowly.....mostly white!.......and curly. I lost all my toenails but they are back except the pesky big toes. No spring pedicure yet:(

Minivan......I had the eye situation you describe and did see an opthamologist to make certain my tear ducts were open. She blamed Taxotere for my problems, made sure my tear ducts were open, and suggested lubricationg eye drops when my vision is fuzzy, etc. it was about 2 1/2 months after chemo ended that one day I noticed my eyes were back to normal! Neuropathy of my feet and fingers has also slowly gotten better. Hang in there!