Med onc suggesting only 4 TCHP

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Girl279
Girl279 Member Posts: 3
edited July 2018 in HER2+ (Positive) Breast Cancer

Hi Ladies. Had my apt with onc and third TCHP this morning. My MO stated today that she thinks we should just stop at 4 and got to surgery based on her clinical impression of the obvious response that my tumor has had (locally advanced, three IDC tumors largest being slightly over 2 cm in a large bed of DCIS). I'm at a loss here, because while I would loveto get this over ASAP, I really don't want to cut any corners. Also, I already lost all my hair so why not go for all 6, am I right?

When I first met the onc, she told me she wasn't a fan of “overtreating" and I agree with that, but at the same I don't want to ever deal with this again.

I have an apt with my surgeon on the 16th (halfway betweeen rounds 3 and 4) and will definitely be asking lots of questions. Has anyone else had a similar experience where they stopped neoadjuvant TCHP at 4 based on the response?

Just a note- side effects have been a non-issue. I was really in great shape when I started treatment and have managed through so far pretty well. Thanks in advance for aharing

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  • carmstr835
    carmstr835 Member Posts: 388
    edited July 2018

    I can't comment on neoadjuvant chemo, but I have had concerns with my MO and decided to get a second opinion. My 2nd opinion suggested chemo and my MO suggested no chemo. My MO relented and finally gave in to m and my 2nd opinion and I got chemo. Good thing too,because my 2nd opinion was so concerned about my treatment he had all my pathology redone and found I was Her2+. Don't hesitate to get a second or third opinion we don't get a do over on this!

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  • rgail007
    rgail007 Member Posts: 7
    edited July 2018

    I just finished my neoadjuvant chemo 6 weeks ago. For me, after 4 treatments, they did an ultrasound on me and could no longer find the mass (9 CM when I was originally MRI'ed, 12-14 CM at physical exam 2 1/2 weeks later). Like you, (though not in "great" shape before hand) I did pretty well with side effects... until that 4th treatment. On treatment 5, my MO cut back the amount of Carboplatin by 30% because both the positive response and the fact that I had more persistent neuropathy side effects with my 4th treatment (my Taxotere dose had previously been cut back by 20%, I think after treatment 2 when I had an allergic reaction to it).

    Even if you're tolerating side effects well, the toxicity is real and the effects are cumulative, so she may just be hoping to quit while you're ahead since you're doing so well with it. In my case, with scheduling for the surgeon, it wasn't feasible to move surgery up, so I did have a 6th treatment (if surgery could have been scheduled sooner, I would have skipped it), but that 6th treatment was just THP, no Carboplatin. I had surgery 4 weeks ago and had pathological complete response! As my oncologist said, they plan 6 because that's how the protocol was tested in trials; it doesn't mean everyone needs it. Maybe you could discuss with your oncologist if there is a middle ground you both would be comfortable with.

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  • Giveityourall
    Giveityourall Member Posts: 71
    edited July 2018

    Girl279,

    Hey. I have a similar situation. I have become very anemic. As Rgail states.... this stuff is cumulative. Like u, I was in great shape. I worked out four to five times a week and thought this was going to be a cake walk. But.,after round 4..... that cake turned into cement and I could not walk as well and had to rest A LOT. I got really tired. Granted I am 53 and the anemia (hemoglobin of around 8.5 and RBCs at 3.21) did me no favors. I did push for my 5th treatment, on June 19th, but had to stop for two reasons. One- my tumor has shrunk but it is has not disappeared (per ultrasound) and surgery should occur three to four weeks after neoadjuvant therapy. As such, I only received Herceptin and Perjeta on July 10th (my scheduled 6th chemo treatment). My double mastectomy with reconstruction occurs, hopefully, on July 23rd. Personally, I want it out. I want to decrease the chances of metastasis. The longer it is there... the greater the opportunity for little rogue cells to find a new home. My humble opinion. Everyone is different and has their own thoughts, and I respect their thoughts and outlooks. This is not easy. There are too many unknowns.

    Giveityourall

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  • Giveityourall
    Giveityourall Member Posts: 71
    edited July 2018

    Girl279,

    Hey. I have a similar situation. I have become very anemic. As Rgail states.... this stuff is cumulative. Like u, I was in great shape. I worked out four to five times a week and thought this was going to be a cake walk. But.,after round 4..... that cake turned into cement and I could not walk as well and had to rest A LOT. I got really tired. Granted I am 53 and the anemia (hemoglobin of around 8.5 and RBCs at 3.21) did me no favors. I did push for my 5th treatment, on June 19th, but had to stop for two reasons. One- my tumor has shrunk but it is has not disappeared (per ultrasound) and surgery should occur three to four weeks after neoadjuvant therapy. As such, I only received Herceptin and Perjeta on July 10th (my scheduled 6th chemo treatment). My double mastectomy with reconstruction occurs, hopefully, on July 23rd. Personally, I want it out. I want to decrease the chances of metastasis. The longer it is there... the greater the opportunity for little rogue cells to find a new home. My humble opinion. Everyone is different and has their own thoughts, and I respect their thoughts and outlooks. This is not easy. There are too many unknowns.

    Giveityourall

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