Breast cancer, chemotherapy and radiotherapy, Herceptin?

Question

My mum was diagnosed with breast cancer in june. She's had the operation to remove and reconstruct her breast. It's been about 4 weeks now since the operation and she's received her results back that it's spread from the breast to 2 out of the 4 lymph nodes that they removed.

She's been told that she'll need 6 cycles of chemo with a 3 week break in between each dose. It's a chemotherapy treatment known as FEC (Flurouracil, Epirubicin, cyclophosamide). But then she has a choice whether she wants to change to a trial regime after 3 weeks. This is where she'll have chemo every week for 3 weeks to complete the 6week cycle. Has anyone heard of this "trial" regime? Cos my mum's pretty sketchy on the details as she was upset. She's pretty worried that she's going to lose her hair, just because it's an outward sign that she's got cancer. Does anyone who's had this treatment not lost there hair? We've been told about a cold cap that can reduce the chances of hair loss as well.

I just wondered what to expect from the overall treatment. Cos there's a lot of explanations of the possible side effects, but i just wondered if anyone has had this FEC treatment? What it was like for them? and if there's anything i can do for my mum to make it a bit easier for her to cope?

After the chemo she'll start radiotherapy. But again, i don't really know what to expect of it? I've read all the leaflets but i think personal experience makes it more believable.

And then after the radiotherapy, she'll begin herceptin for a year. I know this is a relatively new drug, but has anyone been on it or know someone who's been on it?

That was rather long, but i just want to settle some questions. Thanks.

Answer 1

Hi. Yes, I had FEC. I don't know anyone who's currently having it, so I don't know about the trial.

She will lose her hair on FEC. The cold cap is an option but,as well as the concerns Inverse has mentioned, there are other disadvantages. It extends the time for each chemotherapy session as you have to wear it for some time before and after the chemo. I was glad I'd decided against it when, during my first chemo session, I saw a woman crying with the discomfort and pain of the cold cap she was wearing. It can be very painful. One woman I know gave up using it after two chemo sessions because she just couldn't face it again.

All of which might be considered worth it if your hair all stayed the same as it was, I suppose, but it usually doesn't. Most people lose some hair anyway, up to half in some cases. And the hair that remains is usually in such bad condition that people often end up cutting it very short anyway.

Chemo isn't easy, but side effects do vary from person to person.

It's unlikely she will escape nausea, but as Inverse has said anti-sickness drugs are very good these days - I didn't vomit once. I'm guessing from your spelling of mum and use of the word radiotherapy that you're in the UK - these drugs will be prescribed automatically.

Typically, people are exhausted and feel very nauseous for a week or so after each chemo, then feel a bit more like themselves for the following two weeks. Some people manage to work throughout chemo with just a few days off each cycle - but don't bank on it!

This could get very long; if you'd like me to list some more details and possible side effects please email me

For me radiotherapy was a walk in the park after chemo. The  only side effect for me was fatigue.

Herceptin was still being trialled when I had my treatment, so I didn't have it and don't know anything about it.

One thing you and your mum might benefit from is visiting these two sites if you haven't already. As well as information they have forums where she - and you - can talk to other people who have been through or are going through the same thing. I don't know what I would have done without internet support forums in the dark days following diagnosis and during treatment

http://www.breastcancercare.org.uk

http://www.breastcancer.org

Best wishes to you both

Answer 2

Please see Google search for more details on FEC treatment.

FEC: 5-fluorouracil, epirubicin and cyclophosphamide given 3-weekly for 6 cycles

Answer 3

I did not have FEC, but it is a well-established protocol for treating breast cancer. You can find more information about it at breastcancer.org.

Sorry, I'm not familiar with that trial. So the FEC is once every 3 weeks, a total of 6 treatments? Is the trial also FEC, or a different set of drugs?

She will lose her hair on those drugs. Most of the effective drugs for treating early stage breast cancer have hair loss as a side effect. More than 99% of people lose most of their hair. It's a scary prospect, and it's unsettling at first, but it's do-able. Really. After a while, you almost don't miss it. Showering and getting ready each day is so much easier without all that ...hair.

She may have some gastrointestinal upset from the FEC, that's very common. There are great drugs to prevent vomiting and nausea, so she should be sure to have the oncologist prescribe them. They aren't cheap, but they ARE effective, and even if I had to pay for them myself, I would have.

I do NOT recommend a cold cap. There is some belief among much of the healthcare community that this can prevent the chemo from reaching areas of the scalp/head where the drug may be needed. It's not worth keeping some hair to compromise the effectiveness of the treatment. No one ever died from losing their hair. People DO die from cancer. Let the drugs do their job.

Radiation can be easy or difficult, it just depends on the person. I will have my 29th of 33 radiation treatments this afternoon. My skin is a little bit pink and occasionally itchy, but those are the only side effects that I have had from radiation.

I receive Herceptin treatments every 3 weeks. I have a bit of joint pain from that, a little bit of leg swelling, a slightly upset digestive system for a couple of days (very minor), and some tiredness the day of the infusion. I'm about 6 months into the Herceptin, 6 more to go.

Answer 4

I was diagnosed with breast cancer February 2007 and it had spread to 3 of my lymph nodes.

I had 6 rounds of Taxotere/Carboplatin/Herceptin every three weeks.  During that 18 weeks, I had Herceptin every week.  After...I continued on Herceptin every three weeks until this past June.  I didn't have any problems with the Herceptin.  I had MUGA scans every three months to make sure my heart wasn't being affected.  

Unfortunately, losing hair is a common side effect to chemotherapy.  I lost all my hair, including eyelashes and eyebrows.   I agree with the other answer, I wouldn't try using a cold cap to avoid hair loss.  A few weeks before chemo started I cut my hair short.  Then I shaved it down to stubble.  After the first treatment when the stubble started falling out, I shaved it bald.  I tried wearing a wig but hated it, I wore it only once.  I wore bandanas and caps I found at http://www.tlcdirect.org  I wouldn't spend alot of money on a wig until she knows she's comfortable wearing one.  I hear many women say they ended up not wearing their wigs.  A soft cap is a good idea for the evening because your head does get cold.

I know it can be difficult for your mom, but she shouldn't worry about looking like a cancer patient.  She needs to do what is comfortable for her.  And I understand her wanting to keep some type of normalcy.  I had "down weeks" during chemo treatments and then I would have a good week before the next round.  That's the week that I'd be out doing as much of my normal activities as possible.  And there was always people asking how I was doing and I would say doing good, thanks for asking.  Most didn't get into more questions.

There are so many different chemo drugs and everyone reacts differently.  All the side effects they go over with you can be overwhelming....they cover every last thing that could possibley go wrong.  She will most likely be tired and she needs to listen to her body and rest and not worry about the things that need to be done.  That may be where you can help her.  I know many people told me to let them know if I needed anything.  I felt uncomfortable asking, so I never did.  The most help came from those that just brought cooked food over and straightened the house, or offered rides for my three kids to activities.

I had 7 weeks of radiation and I did get very tired midway through treatments.  I did burn, but they give creams for each stage.  

The treatments are temporary.  My hair, eyelashes and eyebrows are all grown back in now.  The burns healed.  Life is more back to "normal" now that I'm not running from treatment to treatment.  There are still the follow up appointments and scans...but I try to always remain positive and am so more appreciative of life nowadays.

I wish your mom the very best during her treatments.  And I wish you comfort and courage to help her go through this journey.