Post #29-Where do we go from here!!!

After finding out the results of the pathology report, I was happy. Then of course the other shoe dropped. There has been a standard for chemotherapy in most breast cancer treatments and that is Adriamycin and cyclophosphamide(cytoxan) (AC).

The side effects of Adriamycin include:

an allergic reaction (including difficulty breathing; closing of the throat;
swelling of the lips, tongue, or face; or hives);
decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding;
black, bloody or tarry stools; or fever, chills, or signs of infection);
congestive heart failure (difficulty breathing, fluid retention, chest pain);
irregular heartbeats;
tissue or vein reactions near the site of administration;
liver damage (abdominal pain, yellowing of the skin or eyes);
severe nausea, vomiting, diarrhea, and loss of appetite;
inflamation and sores inside the mouth, throat, or intestines;
fever, chills, or other signs of infection;
numbness, tingling, or difficult movement of a body part;
seizures;
or increased levels of uric acid in the body (joint pain and stiffness).

The side effects of Cytoxan include:

Information on adverse reactions associated with the use of CYTOXAN (cyclophosphamide) is arranged according to body system affected or type of reaction. The adverse reactions are listed in order of decreasing incidence. The most serious adverse reactions are described in the WARNINGS section.

Reproductive System
See WARNINGS for information on impairment of fertility.

Digestive System
Nausea and vomiting commonly occur with cyclophosphamide therapy. Anorexia and, less frequently, abdominal discomfort or pain and diarrhea may occur. There are isolated reports of hemorrhagic colitis, oral mucosal ulceration and jaundice occurring during therapy. These adverse drug effects generally remit when cyclophosphamide treatment is stopped.

Skin and Its Structures
Alopecia occurs commonly in patients treated with cyclophosphamide. The hair can be expected to grow back after treatment with the drug or even during continued drug treatment, though it may be different in texture or color. Skin rash occurs occasionally in patients receiving the drug. Pigmentation of the skin and changes in nails can occur. Very rare reports of Stevens-Johnson syndrome and toxic epidermal necrolysis have been received during postmarketing surveillance; due to the nature of spontaneous adverse event reporting, a definitive causal relationship to cyclophosphamide has not been established.

Hematopoietic System
Leukopenia occurs in patients treated with cyclophosphamide, is related to the dose of drug, and can be used as a dosage guide. Leukopenia of less than 2000 cells/mm3 develops commonly in patients treated with an initial loading dose of the drug, and less frequently in patients maintained on smaller doses. The degree of neutropenia is particularly important because it correlates with a reduction in resistance to infections. Fever without documented infection has been reported in neutropenic patients.
Thrombocytopenia or anemia develop occasionally in patients treated with CYTOXAN. These hematologic effects usually can be reversed by reducing the drug dose or by interrupting treatment. Recovery from leukopenia usually begins in 7 to 10 days after cessation of therapy.

Urinary System
See WARNINGS for information on cystitis and urinary bladder fibrosis.
Hemorrhagic ureteritis and renal tubular necrosis have been reported to occur in patients treated with cyclophosphamide. Such lesions usually resolve following cessation of therapy.

Infections
See WARNINGS for information on reduced host resistance to infections.

Carcinogenesis
See WARNINGS for information on carcinogenesis.

Respiratory System
Interstitial pneumonitis has been reported as part of the postmarketing experience. Interstitial pulmonary fibrosis has been reported in patients receiving high doses of cyclophosphamide over a prolonged period.

Other
Anaphylactic reactions have been reported; death has also been reported in association with this event. Possible cross-sensitivity with other alkylating agents has been reported. SIADH (syndrome of inappropriate ADH secretion) has been reported with the use of cyclophosphamide. Malaise and asthenia have been reported as part of the postmarketing experience

DAMN I GET RID OF THE CANCER TO GET ALL THIS, LOL However, there is a twist for me... of course. Due to the fact that Iam Her-2 positive I need to take a drug called HERCEPTIN for a year in addition to my chemotherapy.

Herceptin's side effects include:

Common Herceptin Side Effects
Herceptin has been studied thoroughly in clinical trials, in which the side effects of a group of people taking the drug are documented. In these studies, the most common side effects of Herceptin included:

Pain -- in up to 47 percent of people
Weakness -- up to 42 percent
Fever -- up to 36 percent
Nausea -- up to 33 percent
Chills -- up to 32 percent
Headaches -- up to 26 percent
Coughing -- up to 26 percent.

Other common side effects (occurring in 2 to 25 percent of people) included:

Abdominal pain (stomach pain)
Back pain
Infections
Accidental injuries
Vomiting
Loss of appetite
Anemia
Bone or joint pain
Insomnia (see Herceptin and Insomnia)
Dizziness
Unusual sensations, such as burning or tingling
An irritated or runny nose
A sore throat
Sinus infections
Acne
Herpes infections
Urinary tract infections (bladder infections or UTIs).


Serious Herceptin Side Effects
Some side effects with Herceptin, while occurring infrequently, are potentially serious and should be reported immediately to your healthcare provider. These include, but are not limited to:

Depression (see Herceptin and Depression)
Signs of congestive heart failure, including difficulty breathing and swelling or water retention (see Cardiotoxicity and Herceptin)
Signs of an allergic reaction, including an unexplained rash, hives, itching, and unexplained swelling.

So we see two commonalities here Herceptin and Adriamycin both have the potential to cause heart damage. So because of this my Dr. wants me to participate in a clinical trial using Taxotere and Cytoxan both FDA approved as chemotherapy drugs for breast cancer along with herceptin. Taxotere is less harmul to the heart. Herceptin has been proven to be quite effective when used after chemotherapy in reducing breast cancer reoccurences. The test would be to see if it would improve chances even more if Herceptin was taken during chemotherapy and afterwards. Some test have already been done and it appears that Herceptin enhances the chemotherapy drugs. So the question is what road to take ???????????????????????????????????????????????