TRIPLE POSITIVE GROUP

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  • gooseberry
    gooseberry Member Posts: 61
    edited July 2015

    I was diagnosed in may with IDC and just completed a lumpectomy. My nodes were clean and my margins were clear. Tumor was 2cm. The her2 was a 2. I am to have chemo and the doc picked taxotere, carboplatin, and herceptin for 6 rounds and then herceptin for the rest of the year. I looked online and do not see many people using this now adays. The most common now seems to be taxol and herceptin for 12 then herceptin the rest of the year. I am going to ask the next visit but was wondering if anyone had any insight. I live quite a ways away so thought it might be to cut down travel time but surely they would not make a decision like that based on that and not ask/tell me????? Just trying to read up on it as much as I can and there is not much recent on that combo, or I have not found it yet. Thanks in advance.

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  • Cowgirl13
    Cowgirl13 Member Posts: 1,936
    edited July 2015

    gooseberry, I had Taxotere, Carboplatin and Herceptin (TCH) 6 years ago. I think it is possibly more of a West Coast thing.

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  • lago
    lago Member Posts: 17,186
    edited July 2015

    gooseberry I had Taxotere, Caraboplatin x6 and 1 year of Herceptin. That was 5 years ago. I agree that many are doing taxol x12 and 1 year of Herceptin but some still are doing what we were prescribed. The NCI still has that as one of the chemo cocktails on the stages I and II breast cancer pdf on pages 44- 45 in the chemotherapy regimens section.

    See phamphlets here: http://www.nccn.org/patients/guidelines/cancers.aspx#breast

    you will have to scroll down

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  • rosesrx
    rosesrx Member Posts: 458
    edited July 2015

    Gooseberry, that is the regime I am doing, I am/was grade 3 stage stage 2a started on 5/20 had #3 of 6 on July 1st. I am in NE TN, so it's not a west coast thing. Taxol and docetaxol are both Taxanes with similar s/e profiles. I am able to work the fatigue has been tolerable. Push myself at times and learning to pace myself. I am doing the cold mitts an booties during the T infusion to prevent nail loss and neuropathy. Wasn't fond of my hair before so not a great loss, too hard to part with too traumatic. I went to have the wig washed/refurbed today where I bought it and tried on a few new ones had some fun again. I do suggest trying on in person. My hair was slow growing in the past so I think I may be sporting a wig for at least a year. This is probably more of a post for Hair, hair, hair.

    The tastebuds enjoyed a filet today. Have a relaxing weekend.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2015

    I had TCH in FL, so east coast, in 2011. My understanding of the 12 weekly Taxol/Herceptin regimen is that it is used for stage 1, per this link:

    http://www.breastcancer.org/research-news/herceptin-plus-taxol-reduces-recurrence


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  • gooseberry
    gooseberry Member Posts: 61
    edited July 2015

    I am a stage 1, clear nodes and margins. Seems to be more aggressive chemo than I need??? I don't know, guess I will have to ask. I always have big questions after i leave the appt. Thanks for the info...

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  • debiann
    debiann Member Posts: 1,200
    edited July 2015

    Gooseberry, I had a 2cm w/ clear nodes and margins (bmx) and I had the taxatore, carboplatin and year of herceptin.  My MO would have liked to have added the perjeta too, and did the neo-adjunctive chemo, but I had already had the tumor removed by the time I was sent to him. I'm on 10 years of arimidex now.

    Unfortunately its an aggressive treatment for an aggressive cancer. 2 cm is the borderline between stage 1 & 2, so its been growing for awhile and you want to kill any cells that got out of the breast. Good luck to you.

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  • Gretagirl
    Gretagirl Member Posts: 182
    edited July 2015

    Gooseberry I too have TCH for 6 rounds then Herceptin for a total of one year and tamoxifen for 5 years. I am from south Louisiana. My MO said standard procedure. I will probably start treatment next week. My tumor was less than one 1 cm margins clear and no node involvement. Caught very early as well.

    Rosesrx where did you find the ice mitts and booties? I was told to bring bags of frozen peas and place on toes and fingers during the Taxotere infusion.

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  • lago
    lago Member Posts: 17,186
    edited July 2015

    Gooseberry your stage is one thing but there may be other reasons why they are going more aggressive. Might be age, family history, multi-focal. Ask your MD.

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  • Tomboy
    Tomboy Member Posts: 3,945
    edited July 2015

    I did taxotere, carboplatin, 6 times, with herceptin even though I was equivocal for her2, and did the perception for one year, 17 times i guess. The carboplatin is also a platinum drug, and you should ice you fingers and toes for that too, as platinum chemo also cause neuropathy.

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  • Gretagirl
    Gretagirl Member Posts: 182
    edited July 2015

    I need ideas please! Ok I am supposed to ice toe and finger nails during Taxotere infusion but unclear what/how to do this plus keep my hands available to eat ice chips. Also I was told infusion would take 1 1/2-2 hours. I have a small ice chest but really need to know how y'all handled this! Thanks !

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  • rosesrx
    rosesrx Member Posts: 458
    edited July 2015

    gretagirl, I just pulled one hand out of mitt to grab cup of ice. slide them in and out not using the velcro straps. Tried popcicles once and it was a disaster. If my sugar wasn't out of whack I would love to do a fruit slush. I haven't had any sores in my mouth, unfortunately it won't prevent the altered taste which may be due to the carboplatin.

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  • gooseberry
    gooseberry Member Posts: 61
    edited July 2015

    Thanks ladies, I better understand it now. The tumor size is probably the main reason. There is no cancer in my family anywhere and the BRCA was neg. but honestly from what I know about her2 positive, I would probable be a basket case if the chemo was not aggressive. So I will be getting a port and echo and all that these last few weeks and then beginning the chemo in aug. It should end very close to my bday baring any reactions or delays or anything. So that is going to be memorable, if I feel like even celebrating by then lol thanks again this forum is invaluable to me :D

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  • Gretagirl
    Gretagirl Member Posts: 182
    edited July 2015

    Roeserx what kind of mitts? How did you keep them cold/frozen? Did you do your feet too? I am getting confused because some people are doing the nails only and others are saying cover your whole hand and bottom and top of feet. Not sure how much I need to do.

    Gooseberry I am only a step ahead of where you are! I have been the las week-week and a half doing bone density heart echo and PET. See my MO Monday to go over tests and get a start date. And like you this forum is blessing to me!!!

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  • Tomboy
    Tomboy Member Posts: 3,945
    edited July 2015

    I got those 'soft' ice pack thingies, and kept them in an ice chest/lunchbox thing, and rotated them when they became uncool.

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  • rosesrx
    rosesrx Member Posts: 458
    edited July 2015

    gretagirl, I used Elasto-gel mitts and booties. I work next to the infusion center and we have a subzero freezer and use a styroform cooler. I do have to swap them out after 45 minutes. Start 15 minutes prior to start of Taxotere, thru and 15 minutes post infusion. Tomboy is right as well you can use gel packs or even bags offrozen peas. My first infusion I didn't use anything so the nails and neuropathy may not even be an issue. There is forum on this for the cold caps sorry I do notrecall the name but you can type it on search.

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  • gooseberry
    gooseberry Member Posts: 61
    edited July 2015

    That is another thing I wonder about. I am not getting any kind of scan to see if anything is anywhere else. Both the surgeon and the oncologist said with it not in the lymph nodes there is a very small rare chance it would be anywhere else so echo, port, chemo class then on with the show. I see a lot of her2 peeps getting pet scans and the bone density and I have neither... so I have put it in my notes to ask about :D

    Nice to have another triple positive close to where I am gretagirl :D I looked in the chemo threads and there are not many! We can get though it together :D

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  • debiann
    debiann Member Posts: 1,200
    edited July 2015

    I didn't get any scans either gooseberry. I think most MO's only order scans if there is something suspicious in the bloodwork or a worrisome symptom. 

    I think the bone density may only be needed if you are doing AI's, to get a baseline. I had one done just prior to my cancer dx. MO said we'll do another after I've been on AI for 2 years.

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  • rosesrx
    rosesrx Member Posts: 458
    edited July 2015

    gooseberry, when you gets chance update your profile and make your settings public.

    I had a scans post surgery the Monday before starting chemo on Wednedsay. Echo because the H can cause decrease in ejection of left ventricle. A bone scan to look for bone mets but be forwarned that arthritis and previous broken bones can show up as hot spots. CT scan looks at organs. A dexascan is the bone density test, used prior to starting AI 's. Done every 2 yrs. usually like Debiann said. Mine being followed due to thyroid and 4 yrs of Tamoxifen.

    Hope you get a nurse navigator who can help you sort out questions. Keep a binder with your results and dates and questions as well, it helped me.

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  • Suladog
    Suladog Member Posts: 952
    edited July 2015

    I was given 12 taxol/ herceptin and then herceptin for the rest of the year. It was what UCSF recommended for me since they were working off the results of the Dana Farber study that recommended that protocol for HER2+ Tumors smaller than 1 cm, (mine was 7mm) no nodal involvement and clean margins, it seems that the T/H is a good fit for patients in what used to be considered a grey area re : chemo. This dats came out in Dec right after I was diagnosed,

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  • sherry67
    sherry67 Member Posts: 556
    edited July 2015

    My tx consisted of carboplatin/abraxane/ herceptin than A/C. Finished. With Radiation.


    Sherry

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  • lago
    lago Member Posts: 17,186
    edited July 2015

    abraxane lucky you. Just a shot right? It's a more expensive chemo and usually reserved for advanced patients when they fail other drugs if I'm not mistaken. It's a good one.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2015

    lago - I think it is IV over 30 mins, usually used for advanced stage, but also given to those who are sensitive to the other taxanes and the solvents used.

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  • sherry67
    sherry67 Member Posts: 556
    edited July 2015

    Lago,


    It was part of the clinical trial I was in...

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  • lago
    lago Member Posts: 17,186
    edited July 2015

    I figured sherry might be sensitive to the taxanes. Cool that you are part of a trial.

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  • Blownaway
    Blownaway Member Posts: 760
    edited July 2015

    Has anyone heard of Brisdelle for hot flashes? My insisted onco that I see my gyno for a pelvic exam and she gave me a month and a half's worth of free samples to help with hot flashes - Effexor just can't seem to do the trick even at 225 mg., plus I had awful side effects at that high doseage. I took my first Brisdelle last night, along with a lower dose of Effexor (75 mg) than I have been taking. No noticeable improvement yet though.

    Gooseberry - I was stage 1, grade 2, HER2+++, no node involvement but margins were not clear - had to go back in, tumor size was .6 - .7 cm. I was suppose to have 6 TCH infusions, then finish the year with Herceptin every 3 weeks. I also had 36 rounds of radiation and will have to take Tamoxifen for 5 years. I couldn't continue with the chemo and Herceptin due to side effects (doctor stopped my treatment). I was told that it was standard treatment for my cancer but since I could not continue.......

    During the 4 chemo infusions that I did get, I was not allowed to use ice on hands, feet, head - onco said 'You are not to protect any part of your body from these drugs." I of course lost all hair, my feet looked like I had walked through boiling water and I still have very slight numbness to finger tips. I don't know when my fingernails will be normal again, if ever. Big toenails had turned loose but they look ok now.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2015

    blownaway - what anti-hormonal are you on? Brisdelle is paroxetine which is an SSRI anti-depressant (Paxil) and it is questionable if it should be mixed with Tamoxifen. Here is a link. I think per its own advertising it has not been tested on breast cancer patients, and it also carries a warning of bone fracture issues - could compound AI related risk.

    http://www.health.harvard.edu/newsletter_article/a...

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  • Gretagirl
    Gretagirl Member Posts: 182
    edited July 2015

    Went to MO today my PET was clear!!! Heart and bone looked good. If this bladder infection ever clears up I will start treatment. I go friday to do a urinalysis. MO said he doesn't think I will need the ice packs but if makes me feel good then use them. He has never seen the nails do anything but minimal color change with my dose and only 6 treatments.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2015

    gretagirl - there are a number of us on this thread who had nail issues, some of them permanent - I would do the ice. I took four bags of frozen peas in a cooler and used them during the Taxotere infusion. It can't hurt, can only help.

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  • Gretagirl
    Gretagirl Member Posts: 182
    edited July 2015

    Thanks SpecialK I am going to. I am hoping my nurses help me with changing the ice packs/frozen peas out.

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