THCP chemo side effect time line?

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I had my first round of THCP (taxotere, Herceptin, perjeta and carboplatin) yesterday and aside from terrible fatigue and feeling like I have an epic hangover, I’m feeling ok-ish. But I’ve also heard that SE’s can be delayed with this combo.

Anyone have any insight on when I could expect what?

Thank you!

Comments

  • HHPsych
    HHPsych Member Posts: 1
    edited February 2019

    I started the TCHP regime on August 2, 2018 and finished Nov 29, 2018. The fatigue continues to get worse each round. I had extreme nausea each round and diarrhea. I felt hungover pretty much the first 2 weeks. I did have to stop taking Perjeta after my third round because it was damaging my liver. I had my third round delayed for 6 weeks between round 2 and 3 (my side would get so painful I'd puke, and my liver numbers were extremely elevated). After stopping Perjeta, my liver numbers went back to normal.

  • Glittertits
    Glittertits Member Posts: 10
    edited February 2019

    Did the nausea and diarrhea start right away? Did you have any hair loss?

  • hapa
    hapa Member Posts: 920
    edited February 2019

    Glittertits - I love your username! I did TCHP and got through relatively unscathed. I did have lots of side effects but none of them were that debilitating, just like a hundred little indignities. I would do chemo on Wednesday and on Friday afternoon I'd be beat. Saturday and Sunday were spent with bone pain from the neulasta, Monday and/or Tuesday I'd be coming down from the steroids. This is when I'd get nauseous so I'd pop my anti-emetics for a few days to keep it under control. I had some constipation but no real problems with diarrhea. Usually the worst of the side effects were over in a week. The second week I'd just be dealing with things like mouth sores, bad taste in my mouth, maybe some nose bleeds. My hair fell out a few days after my second round. I started getting tired toward the end when my RBCs fell pretty low, but not low enough to need a blood transfusion. My WBCs held out pretty well. My liver tests spiked after a few infusions but came back down to normal by the end, I guess my body adapted. Also, toward the end (meaning the last 2 infusions), I was no longer beat on Fridays after my infusions, the bone pain was worse, and I started getting swollen which caused muscle weakness. The swelling started to dissipate to the point where I was able to work out normally again about four or five weeks after my last infusion. My hair started sloooowly creeping back up my scalp, but the top filled in last and that took until about 10-11 weeks after my last infusion and I ditched the stupid caps around 15 weeks after my last infusion. Over all, I think it wasn't that bad. Certainly not as horrible as popular culture had led me to believe it would be. I would tell people I felt "mildly crappy" for the first week after infusion and would tell them I still had some "lingering annoyances" for the second week. At the end I was complaining about being tired and swollen. Best of luck to you!

  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2019

    Glittertits - there are a couple of long running TCHP threads where members discuss all their SEs and the timing. And some neoadjuvant threads too. Also monthly chemo threads where members share their journey in real time. (such as Chemo February 2019)

    I found that the worst was 3 days after chemo, with an upswing after that. I continued to have diarrhea, but never had nausea. Had pretty consistent fatigue. Unfortunately I did not have pCR with the TCHP, so after surgery I had to go through AC. By the time I got to rads, I'd lost 60 lbs.

  • Glittertits
    Glittertits Member Posts: 10
    edited February 2019

    oops! Sorry to double topic then! Thank you for the directions!

  • BellasMomToo
    BellasMomToo Member Posts: 305
    edited February 2019

    I felt my worse day 3 - day 11 after my infusion. I was given 3 anti-nausea prescriptions so I took one at the first sign of nausea. (I never threw-up). I had the usual fatigue and alternated between diarrhea and constipation - - very difficult to control one w/o causing the other! I had pretty severe acid reflux so I took Prilosec OTC & Pepcid AC per my MO's recommendation. (I couldn't drink carbonated beverages because it felt like it was burning my throat. This issue went away a month PFC.) I didn't have any mouth sores, but there were times when it felt like the lining of my mouth was coming apart -- the baking soda/salt rinse was a big help then. Certain foods would taste really weird during my 'worse' days, but would notice a big improvement just before the next cycle.

    With each cycle the fatigue got worse. I felt so wiped out after the 6th and final round -- if there was a 7th round I couldn't do it.

    I'm almost 2 years PFC and that's what I remember. It wasn't pleasant, but was do-able. But I wouldn't want to do it again.

    Good luck!

  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2019

    No problem. I just got such good information from the monthly topics and felt like a bunch of us were going through it together. (you know - like holding hands & skipping through the daisys - NOT) I actually read through the entire month before I started chemo.

    There are some interesting HER2+ threads that you might fine useful too. We're all with you as you go through this mess.

  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2019

    Gilttertits - some of the TCHP threads or HER2+ threads don't seem to be very active. Hopefully people will jump into your new thread too.

  • WC3
    WC3 Member Posts: 1,540
    edited February 2019

    This is how it went for me.

    Day 1: Sleepy due to Benadryl. Bad taste starts due to Zofran.

    Day 2: Burning muscles starts. Mild nausea. Managed with Zofran. Acid reflux starts if I did not stick to reflux management schedule.

    Day 3: Face turns red and throat/esophagus becomes tender due to dexamethasone withdrawal.

    Day 4: Bone pain starts from Neulasta. Managed with Claritin and rest.

    Day 5: Bone pain peaks. Muscle burning and weakness peak. More nausea...not sure why it was always on day 5. Toughed it out to avoid prolonging the taste changes Zofran caused me.

    Day 6: Face no longer red, throat/esophagus tenderness is fading. Bad taste alterations due to Zofran is fading. Acid reflux, if present, is fading, but tongue is getting sensitive and tender. Food feels too rough.

    Day 7: Tip of tongue has enflamed taste buds. Food tastes partially normal. Stomach cramping starts. Managed with small portion sizes and Imodium but from this point on, restrooms must be nearby.

    Day 8 and 9: Much the same as Day 7.

    Day 10: Sense of taste starts to fade due to chemotherapy. Things start to taste bad again.

    Day 11: Same as day 10.

    Day 12: Can't taste much and most of what I can taste tastes bad.

    Day 13: Sense of taste starts to return. Tastebud inflammation going down.

    Day 14: Sense of taste improving. Getting strength back. Pulsating tinnitis develops.

    Day 15: Starting to feel like I'm getting back to normal except for the stomach cramping. (This gets pushed back with each infusion).

    Day 16 to until next infusion: Side effects continue to fade.

    Some notes: I was originally given Aloxi during my infusions for nausea and this controlled the nausea very well but altered my taste perception such that things, and particularly water, had a bad, linger taste and this lasted most of my cycle. I was switched to IV Zofran and Emend during the infusion. I had more nausea with this (the day 5 nausea) but it caused a far less lengthy taste alteration.

    Water tasted bad for most of the time I was on chemotherapy and I could only tolerate lime flavored sparkling water for most of it. I typically hate lime but my taste perception was altered by the Aloxi and Zofran such that lime flavored water tasted like unflavored water while unflavored water tasted bad.

    My urethra would get irritated and it would burn to pee. I think this usually happened around day 7.

    I got thrombocytopenia (low platelets) consistently and this would cause bruising/bleeding under my skin and any other place my blood vessles broke.

    Before I figured out how to get the stomach cramping under control, the cramping, plus the thrombocytopenia would cause me abdominal tenderness.

    I also developed pretty severe anemia and felt generally bad as a result. I am almost 4 months PFC and still anemic but recovering.

    I developed some vision issues probably from the anemia. Nothing major, just weird.

  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited February 2019

    I remember feeling pretty good the day of the chemo - just tired. I felt normal the next two days. By the third day I would start feeling achy (regardless of WBC stimulators) and really bad the following day. After that, it was a slow climb back up and I'd feel almost normal in time for the next knock down.

    I had steroids the day before, day of, and day after. The next day I would start taking Compazine twice a day for a few days as prophylaxis against nausea. Diarrhea from the Perjeta increased with each round and I ended up taking Imodium on a schedule for a few days as well. I was hospitalized after the first round for fever with low WBC count. After that, I got Neulasta or Neupogen with each round (took Claritin to help with bone pain). And I also developed really bad gastritis alongside the way which Omeprazole and Carafate helped immensely. My mouth was a mess when the WBC's were low so I had "Magic Mouthwash" by prescription.

    I'd advise keeping a journal of your symptoms - both to plan for what to expect in future rounds and also to share with your providers.

  • Bklynesq
    Bklynesq Member Posts: 4
    edited April 2019

    this thread is tremendously helpful to me as my first TCHP tx is tomorrow. I know there are other boards that overlap, but I’m really thankful these several accounts are here in one place. Thank you!!

  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited April 2019

    Bklynesq -wishing you the best for your first treatment. We'll hold you in our thoughts.

  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited April 2019

    Below is a 'tips' thread for chemo. You may have already seen it but just passing it along.

    https://community.breastcancer.org/forum/69/topics...


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