Refusing Neulasta
I am suppose to go in for my first Neulasta shot today. Yesterday was my first treatment of AC and it went much better than everything I had been imagining in my mind for the last two weeks. I feel ok, except for more nausea feelings trying to creep in, but I have been on it with meds. All of my counts held up well through 12 weeks of Taxol and I don't want to take anything that is not necessary. I have heard about painful side effects of Neulasta and am also concerned about Leukemia. Would it be ok to take a watch and see approach? I have labs again next Tues, so I can see how I am doing on my own. Has anyone done this?
Comments
-
I never had neulasta.... My MO said he would give it to me if he saw I needed it. Apparently I did not.
-
I had it after every A/C, no side effects. If there are, it's recommended to take non drowsy Claratin for bone pain. It is to help keep your white cell count up, which helps your compromised immune system fight off infection. Your MO or nurse can address any other questions.
-
AC is nastier than Taxol (once the steroids wear off), but not everybody gets Neulasta after AC. I think a "watch and wait" approach is a good idea if you're healthy otherwise and are careful about germs. I taught while getting AC, and was happy to get Neulasta because students can be very germy.
-
I've had Neulasta after each AC treatment(just finished my fourth). I do take Claritin beginning the day before the shot until a couple of days after and I've had no side effects. I've had 2 infections so I can't imagine what could have happened without it.
-
I think Neulasta is given to those who are on 'dense' AC protocol - AC infusions every two weeks. It is not given to those who get AC every three weeks unless the blood counts get too low. In most cases however, blood counts recover enough during the last - third - week before the next infusion. -
If you have Ac every 2 weeks, you will have to have Neulasta. If you get it every 3, it'll probably be your choice. If you choose to skip it, be very careful to avoid infections. In 2013 when I did TC, my doc tried to see how I'd do without it. I ended up in the hospital for 4 days with a neutropenic fever. I'd take the Neulasta any day over a hospital stay. Even with Neulasta, on AC, my counts were sometimes really low (and they have been fine on Taxol with no shots). Like everything, it is an individual choice; just make it carefully.
-
I had Neulasta after each of 4 TC infusions. I had no bone pain or other side effects, and I did not take Claritin.
-
Mine was every 3 weeks. Before treatment they did a blood draw to check my count. Next day I was back for the jab. I guess I could have said no, but why should I? Felt crappy enough, didn't need a hospital stay.
-
There are no 'absolutes' on anything with how our bodies deal with any BC TX.
I did Neulasta the day after my 4 neoadjuvant DD A/Cs. The only issue I had with it was that I would go to sleep an hour after injection for an hour. Wake up fine. Did not take Claritin - no pain. Do not do it with my 12 weekly adjuvant Taxol.
For me, A/C was easy - did not slow me down at all. Taxol was nasty - completely and utterly EXHAUSTED during the entire 12 weekly infusions. From the posts of those who have done A/C and Taxo. - for the most part it seems that if A/C is not bad, Taxol will be but if A/C is bad, Taxol won't be. It is individual and how each body handles,what is going on - there are no absolutes that all will experience.
-
Thank you for the replies, I'm glad to read different experiences and views. I spoke with my nurse at the infusion center this afternoon. I decided to wait for the Neulasta. I hope I made the right choice, but she explained all the possibilities and what we need to do. I am on DD AC, and that was the only reason my MO prescribed it. I have my next labs on Tues. If they are low, they will do Neupogen, which is a daily version of the Neulasta. If they look good, I will go back in on Thur. and if they are low, Neupogen through the weekend. Worst case senario will be delaying treatment for a few days.
@Leighrh-Did you get dose dense AC or every 3 weeks?
-
Every 3 weeks!
-
I loved my Neulasta shots! I was teaching, and wanted to keep working during chemo. With them, I had one less thing to worry about (dose dense AC every two weeks....no claritan, no problems with it).
-
Nuelasta is MEGA expensive $8-9,000.00 per dose. Your insurance will not cover it unless you meet the criteria of low WBC and other white cell details.
I had it after each DD A/C after my blood count verified I needed it. I did the Claritin 24 the day before,of and after the dose. I had minimal bone pain.
-
>>Your insurance will not cover it unless you meet the criteria of low WBC and other white cell details.
Not necessarily true. My MO gave me Neulasta for TCx4 even though my counts were always good. I think they're able to make an argument for prevention (at least with some insurers). Most of the women in the March/April chemo groups who developed neutropenic fever cost their insurers more in hospitalization and medications than they would have for Neulasta (and certainly for Neupogen).
-
I had 6 TCH and my oncologist gives Neulasta without waiting to look at WBC - my insurance covered it without question. I suppose I could have refused it and waited to see if it was needed, but I followed his protocol. I also took Claritin and had no side effects that Tylenol couldn't handle.
-
I had mine after each infusion without any question from my insurance company......BECAUSE of it, my WBC was always good.
-
I had Taxatore/Carboplatin x6 and had the Neulasta each time. My wbc, did take a big drop, even with the shot, so I'm sure without it wbc would have been way too low. I did not take claritin and I did not have any pain.
-
<<Nuelasta is MEGA expensive $8-9,000.00 per dose.>>
I'm in Canada (Ontario) and each Neulasta shot was CAN$2,709.85 - I had to pay first and then was reimbursed by my private medical insurance. If I had needed, I could 'owe' the hospital pharmacy until my reimbursement came in but I just put it on my credit card. I don't know where the OP lives.
-
Never questioned neulasta. It was standard procedure and I'm glad it was. One week my counts were too low to have chemo...I can imagine what they would have been like with/out it. After all the slash, poison and burn, whats little shot!!
-
I got the neulasta after every infusion. No pain, and I did the Claritin just in case. My white blood cell count stayed high, and now two months after chemo is done, my white blood count is back where it was before chemo. I worked full time and have three grandbabies I see three times a week, so it was important to me to keep my white blood cell count high so I could live normally as much as possible. I don't know about the leukemia risk, but my MO told me it was a very, very low risk factor
-
I believe the leukemia risk is from the chemo itself, not the Neulasta shot.....and it is very low.
-
Despite Claritin, I had terrible bone pain and fever.
Told my doc. If this was it, I would rather go on hospice. He changed to just one dose of neurogen a week after taxotere with great results
-
I had Neulasta every week during my AC, every other week. I was able to work my full time very physically demanding job (retail sales manager)....it was even holiday season, everyone else was sick and I was healthy throughout, not even a sniffle! When I finished and started Taxol we tried the first week without the Neulasta and my counts dropped so low they wanted to delay my treatment. I went back on the shots and my counts were fine again. I took Claritin.
My insurance covered Neulasta. Also, my hospital had me fill out a form from the pharmaceutical company where they would pay whatever my insurance didn't cover
-
So, I decided to go back in for the shot a few hours later, I was worried about getting an infection and I want to stay on the DD AC. After the shot I went home and slept, today I also slept. Is this a common side effect? I took a 24 hour daytime Claritin, and no bone pain so far, but I am SO drowsy I cannot function.
-
Very glad you did the shot. The tired could be from chemo itself or more likely from the steroids wearing off.
-
Yep, there's nothing like the post-steroid crash. I always felt so energized on chemo day, but two days or so later, small tasks like putting away laundry seemed to take forever.
-
Sounds like steroid crash to me to. I truly hated the steroids, but MO said no way he'd give the chemo without them.
-
I never had neulasta but instead used chinese herbs from my practitioner that helped boost my immunity during treatment. There are studies in pubmed that refer to this though they aren't "gold standard". My own blood labs on the other hand I consider to be definitive as my WBC numbers went up round 3 much to the surprise of my oncology team and then went down post chemo when I stopped the formula temporarily.
Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: meta-analysis of randomized trials.
http://www.ncbi.nlm.nih.gov/pubmed/16421421
There is a lot they don't understand about the body.
Categories
- All Categories
- 679 Advocacy and Fund-Raising
- 289 Advocacy
- 68 I've Donated to Breastcancer.org in honor of....
- Test
- 322 Walks, Runs and Fundraising Events for Breastcancer.org
- 5.6K Community Connections
- 282 Middle Age 40-60(ish) Years Old With Breast Cancer
- 53 Australians and New Zealanders Affected by Breast Cancer
- 208 Black Women or Men With Breast Cancer
- 684 Canadians Affected by Breast Cancer
- 1.5K Caring for Someone with Breast cancer
- 455 Caring for Someone with Stage IV or Mets
- 260 High Risk of Recurrence or Second Breast Cancer
- 22 International, Non-English Speakers With Breast Cancer
- 16 Latinas/Hispanics With Breast Cancer
- 189 LGBTQA+ With Breast Cancer
- 152 May Their Memory Live On
- 85 Member Matchup & Virtual Support Meetups
- 375 Members by Location
- 291 Older Than 60 Years Old With Breast Cancer
- 177 Singles With Breast Cancer
- 869 Young With Breast Cancer
- 50.4K Connecting With Others Who Have a Similar Diagnosis
- 204 Breast Cancer with Another Diagnosis or Comorbidity
- 4K DCIS (Ductal Carcinoma In Situ)
- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team