Herceptin

Hi. I will be starting Herceptin next week. My question is regarding blood work before Herceptin treatment. So far my course of treatment has included AC for 12 weeks, followed by Taxol for 12 weeks and I have just finished 25 radiations. Pre-chemo bloodwork was necessary each time, due to depressed immunity and white blood counts. I asked my onc about any pre-Herceptin blood work, and she said no, but agreed to do a "baseline" before I start.  Other women that I have talked to who are having Herceptin say they have blood work done about every three treatments (or 9 weeks). The chemo nurse said their protocol is blood work each time. Is she just being overly cautious? There seems to be some confusion here. What is standard? Should I have it done often and if so, what would be the rationale?  Thanks

[CCF-RN,MSN-rf]

Dear chirok17:  Herceptin is a monoclonal antibody that targets the HER2 antigen on the cancer cells.  It does not tend to cause damage to healthy cells the same way that chemotherapy does.  Chemotherapy affects the blood cells and can cause a person to be susceptible to infection (when the white blood cells are low) and other problems.  This is the reason that blood is tested so frequently when a person is getting chemotherapy.  The frequency of blood tests would likely be different for people who are getting herceptin without chemotherapy.  However, this is usually up to the doctor who is taking care of the patient and is based on the doctors preferences as well as the patient's individual situation.  

[Avidhiker]

I just had my second Herceptin yesterday. My oncologist's office does a CBC every week. I am very happy with that as I want to know where my levels are after 12 weeks of chemo and right now just about in the middle of radiation treatment.  I have a port so it is easy for me.

My first Herceptin infusion was for about 90 minutes. It was Halloween and I had to shut down the house to trick or treaters very early due to the fact that I had a fever from the Herceptin (about 40% of women will develop a fever from the first infusion).  Yesterday's treatment, the second, was for about 60 minutes, no fever, just tired from the Benedryl.  The next 22 infusions (six months for me) will be about 30 minutes each.

We are very fortunate to have this therapy as it has shown significant reduction in recurrence rates for HER2+. Good luck.

[chirok17]

Thanks, avidhiker, for your comments. It just seems confusing, with all the different protocol for treatment. My onc says 17 Herceptin treatments, once every three weeks, for a year. That appears to be standard here in Canada. Your regimen seems to be weekly. Wonder what the rationale for that is? Maybe that's why you have the weekly CBC as well? My chemo was finished Aug 21, started rads Sept 26 & finished Oct 31. I will be interested to see what my bloodwork looks like 2-1/2 months after chemo.
Take care.

[Montana girl 06]

I remember from a previous post that you had 7 benign biopsies and your 8th was cancer. Were your biopsies for calcifications or lumps? Also, did they catch your cancer early (with all your biopsies it sounds like you all kept a pretty close watch) or did they feel it had been there a while hiding in your dense breast tissue? Was your 8th biopsy for calcifications or a lump or both? I hope you don't mind the questions. I also have dense tissue and they are always sending me for a biopsy.

[Avidhiker]

I am sorry, you have me mistaken for another poster.

[boninclyde]

Was it under fourty pam or pam under fourty. I'll keep thinking. I went to the search engine here and typed in numerous biopies you may find some info there.

[boninclyde]

Sorry I typed in breast biopsies. I do believe it was Pam under fourty. If you go to that other site I believe you can click on search and type in her name and she will come up.

[Montana girl 06]

avidhiker - Sorry. I sure wish I could put a face with all of you and just maybe then I'd be able to keep your breast problems straight.

boninclyde - Thanks again for your help. It probably was underfortyPam.