TRIPLE POSITIVE GROUP

thanks, Twiggy. Very informative article...

Dannajae - some of the worse is not knowing what comes next. The TP really threw me for a loop. I was already done with surgery and brachytherapy before my final path report came back. Did 8 sessions of Taxol and Herceptin until the SE of the Taxol did me in. Have been on just Herceptin since April and started AI in May. Get your profile posted and make it public so folks can help you even more. Good luck and welcome to this club we didn't want to join.

Thank you, T-Sue!

Dannajae - I saw you got it (looks like on the first try although I needed some coaching attempts.) Good luck with your MO. Being HER+ you probably will need chemo. Look for other threads on BC.org as you know (and want to know) more. The group that "started chemo in Feb. 2017" has a private Facebook account and it has been fantastic. We've watched hair fall out and come back in and had both lots of tears and laughs.

Thank you twiggyOR, I have not taken any yet, they told me to take it 30 min before the infusion, I get nauseuous easy. I will only be given cortisone before the infusion. I hate all this stuff and that this is happening, could not sleep much at night

TwiggyOR,

I am already in the August chemo group, everybody here has been so helpful. I have to go to the clinic now

I went the day after for the shot.

The conversation with the Oncology Nurse was extremely important (to me) in understanding what to expect and how to manage those side effects. These Nurses really kept me motivated to move, eat healthy, and they answered everything they could. I was never rushed.

May be different for others.

Vicky

Vicky, Did they do labs before they gave you the shot every time?  Did you end up needing Neulasta every time?  I've run in to a lady who never needed it per her lab results.

Thanks,

Melanie

Moddy Blues,

My order was:

Labs day of treatment.

Met with Oncologist after he reviewed labs.

Treatment after Nurse went over labs and dosages.

Next day, shot, no matter what my labs were.

The only change was an iron infusion in between two rounds when my saturated iron dropped 50 points.

Vicky

moody - the nadir (low point) from chemo doesn't occur until 7-10 days afterward, so having a CBC the day after chemo would not accurately indicate the need for Neulasta. The CBC done the day of chemo usually is the test that is most indicative of your current WBC and neutrophils, and whether your counts are high enough to safely receive chemo. Because Neulasta has dosing restrictions - must be given within 24 hours of chemo and no sooner than 14 days before the next infusion - some oncologists give it in a prophylactic manner because if they wait for 7-10 days to check WBC during the nadir, it will be too close to the next infusion to administer Neulasta. Some oncologists do wait to see if Neulasta is needed, and some insurance companies won't pay for it without demonstrated need, but trying to remedy low WBC is problematic mid chemo cycle

hap - I know, just explaining it in terms of breast cancer treatment and the decision making rubric. Others reading may need the explanation

HapB, yes now I understand it, I have just red SpecialK's post on it, twice.

SpecialK, you are truly a Wikipedia, how do you even know all this stuff. Reading it online is one thing but you also have to systemize it, and your vocabulary is very is not scientific dry, it is like reading popular science. I am reading its Swedish equivalent but hey they take a lot from the bigger papers and journals.

SpecialK.  Thanks for the explanation, makes total sense!

cherry - the hardest thing to know in the early stage is what sources to read from - particularly in terms of being Triple Positive - some of the information on the web is outdated and more scary. Determining which info is as up to date as possible, and credible, is key. As far as understanding why some people get certain regimens, I believe it comes down to geographic location, center policy, and oncologist philosophy. It is also important to understand that when it comes to cancer treatment, more is not always better. Our natural inclination is to want to take the strongest drugs, do the most complete surgery, etc. to eradicate the cancer, but the problem with that approach is that there is a lot of collateral damage. For you - with your stage, your oncologist is offering a newer regimen that has been shown to be effective in stage 1, or less than 1cm and node negative breast cancer. This is a more forward thinking approach than giving someone with those same stats the old school regimen of AC-TH. To me that is somewhat reactionary and potentially signifies an oncologist that perhaps has not kept up with current studies, or is older and has only given this regimen, or is at a center that gives this regimen to all of its Her2+ patients, or AC-T to all breast cancer patients. For a stage 1 patient with no positive nodes it is the equivalent of shooting a fly with a cannon - it may take care of the cancer, but it subjects you to the potential for some nasty side effects, possible permanent heart disease from the Adriamycin, and cumulative issues from a combination drug regimen. With a single agent regimen like your oncologist is using you have far less possibility for problems, and great chance for effectiveness because it is combining the targeted therapy with a taxane. My oncologist does not prescribe AC-TH(P) for his Her2+ patients, he uses TCH(P) because of the cardiac issues that can come with using Adriamycin, then Herceptin. Even though the two drugs are not infused at the same time, due to the potential for permanent heart issues from the first dose dense combo, closely followed two weeks later with Herceptin, he agrees with Dr. Slamon, the doctor who brought Herceptin to the market, that TCH is the better choice, wile still offering efficacy. Depending on where some docs went to school and practice you will see regional differences here in the US - a lot of east coast oncologists use AC-TH, west coast use TCH, newly out of school versus docs who have been practicing for a long time, there are lots of reasons different choices are made, but don't let it worry you.

cherry - lita makes a very important point, I assumed that the member you referred to also had a TP diagnosis, and my comments were based off that assumption. AC-T, plus targeted therapies would be a standard of care choice for a patient with Her2+, but negative hormonal receptors. Regimens are chosen with the entire clinical profile in mind, not just stage or tumor size.