MUGA Results - Herceptin on Hold

Hi Beth,
I have had the same problem off and on through treatment. I just now finished my last herceptin treatment (hooray!) I got all but my last 2 treatments in because my MUGA kept dropping. Last one was at 42% so my onc just decided to stop. I had to take many breaks and was on hold as long as 4 months during the whole "year" of treatments- but my heart always seemed to rebound to 50 or 55% and then I'd go back on. My history: I started with weekly herceptin and taxol for 12 weeks, then surgery, then epirubicin, cytoxin and flurourecil (sp?)then the herceptin every 3 weeks.
I too felt fine and still do so it's kind of weird. My onc had me see a cardiologist and he put me on Coreg to reduce the load on my heart.
Hang in there - i know it's frustrating! I have always been active: walking and rollerblading and such, try to eat right, am not overweight, etc. etc. so I too was shocked. I'm just glad they keep a close watch - it would be sad to be cured of cancer and then keel over of heart failure!
I will be thinking of you - let me know how you do! Mindy

A drop in your MUGA ,50% is an early sign of possible heart problems. Your doc will hold back the Herceptin until your MUGA improves.

You are right Debbie when you have CHF your heart is not pumping fluids effectively. Extra fluid puts added strain on the heart and will worsen the failure.

Sorry about your heart problems Debbie, it sucks that you have to suffer this added insult due to your treatment. With treatment your EF will likely come up although maybe not to normal.

Fists up!

I've been turned down for my herceptin treatment twice now, MUGA is at 47. I get another 4 week break and then he'll test it again, if no improvement he'll take it to rounds he says and discuss what options I might have. I've had AC, Taxol, radiation to left side after mastectomy, and had 4 treatments. Kind of disappointed but I see I'm not the only one.

Should I worry if I'm 52 or 53%? I feel fine. I've gone back to the gym and have started attending aerobic classes. Of course not as powerful as I used to after almost a year of treatments, but getting there. I'll have my MUGA mid-September. I started Herceptin after radiation mid-June. (My last MUGA pre radiation was at 52%; stopped during radiation).

Thanks.

Pardon my ignorance as I am newly diagnosed, but what is MUGA?

How often do your Onc. check MUGA scans? I had one pre-Herceptin (normal)about 3 mo's ago.

My cardiologist about had a cow when he found out that my onc was not doing regular muga's. Knowing what I know now about the damage chemo can do to your heart even years later, I would have demanded muga's at least every 6 months. I think if I had done that I could have caught my heart damage much sooner before my ejection fraction had gotten down to 24%.

Hi Gals,

I got the results from my ECHO today when I went for my Herceptin infusion. Bad news. My ejection fraction has gone from 67% to 36%. Just a wee bit alarming.

I am now off Herceptin and being seen by a cardiologist who is giving me a stress test, blood tests, and some meds to try to improve my heart function. He said no more Herceptin for me. I received three months of Herceptin total.

I also had Adriamycin and rads to the left side. My first ECHO was just before chemo started in March.

This is quite upsetting!

Miss S

After 12 weekly doses of Herceptin with Taxotere, I just had a MUGA (Multiple Gated Acquisition Scan) with results of 45. My previous MUGA (after Adriamycin and before starting Herceptin) was 72.

I've seen a cardiologist, who did an echo to confirm the results and put me on Altace to try to improve my heart function. She'll recheck the echo in 4 weeks, then we'll all decide if I can go back on Herceptin.

From what I understand in talking to my oncologist, cardiologist, and my husband (an ER doctor), MUGAs are primarily used by oncologists for measuring heart function because of the specific dangers of certain chemotherapy drugs (i.e., Adriamycin) and now Herceptin. MUGA's give a more precise measure of the ejection fraction (pumping ability) of the heart than a traditional echocardiogram. An echo gives more of a range (for example: 50-55%) rather than an exact number, but is still useful in determining heart function.

I can say this - it really helps to read, read, read! Get on the internet and read the information and results from the Herceptin studies (there are many). Be educated so you can partner with your doctor in making treatment choices and understand what's going on. The protocols for Herceptin treatment (and its complications) are still pretty new and some docs may stick more rigidly to them than others.

Beth, you posted this awhile ago and I was wondering if you were able to get back to the Herceptin?

I had to stop my Herceptin twice because my ejection fractions went a little lower than what they had been (never below 50%) originally and my oncologist wanted to be safe. Both times the fractions went up and I was able to resume. It meant that my treatment took a little longer than originally planned, but that was fine with me. I was on it for one year (just finished May '07) and had all 18 treatments. I am so pleased that oncologists and cardiologists are religious about scheduling these scans.

My cardiologist actually prefers echocardiograms to MUGA scans.

I have recently heard that even 6 months of Herceptin is considered a good amount which is good news for those who are unable physically to receive a full year.

I finished chemo and then a year of Herceptin 18 months ago. However, since I was on a trial for the chemo, I recently had a follow-up MUGA scan. It had dropped from the high 50s soon after finishing Herceptin, to 50 a year later. So my onc sent me for an echocardiogram which he implied was a better measure. I got 60 on that. So, I would suggest that if you have to stop Herceptin because of a MUGA score, you should ask your oncologist whether it can/should be confirmed with the echocardiogram.

  

Yes, there are studies that suggest that a few weeks of Herceptin is sufficient, plus with your hormone receptors, you have another option for treatment. I think celebration is in order!

Looks like this is a pretty old topic, but maybe we can get it started again. I am (was) HER2+, stage 2.5, and took a combination of Taxol & Herceptin. I'm all done with the Taxol, but need another 12 months of the Herceptin, but onc was waiting for better MUGA results.  My ejection fraction rate went from 44 to 62 - so all clear. But now I'm concerned about going through that same mess every couple of months.  Has anyone stopped the Herceptin mid-way, and still had good results?

Any feedback is helpful - not getting clear answers from onc or cardiologist

Zena,

They can put you on heart supportive medication to boost your LVEF. Also, exercising as hard as you can to increase the heart's pumping strength is helpful. It worked for me. Don't give up on Herceptin