Hi, I am writing to check in regarding my partner’s like of treatment post her neoadjuvant and lumpectomy surgery in January this year. The cancer was HER2+ and due to not having a complete pcr the doctor said my partner would be put through radiotherapy for 2 weeks, and be given Kladcyla infusions every 3 weeks. However now we have received a call from the chemo ward today saying that the Kladcyla is scheduled for tomorrow afternoon. The hospital had not even done any ECG or bloodworks since after the surgery and so we are very sceptical as to how is this possible. We are very well aware that before every infusion bloodworks need to be done as a protocol. Also the doctor had told us that radiotherapy would be the first line of preventative treatment and only then they would get to the Kladcyla 21 day infusions. We are very confused and don’t know what is the right thing to do. The BC nurses are not reachable and neither is the chemo unit. We want to know what is the standard procedure followed by the NHS that minimizes risk and ensures effective preventative treatment. Is it okay if radiotherapy and Kladcyla is given together or if they clash with each other’s proposed cycles? Is it ok to start Kladcyla without any bloodworks or ECG etc done? What are the standard tests done before starting radiotherapy. It will be really great if someone can explain this in detail, please.
I’m sorry this has happened to you and your partner, it does sound confusing.
I hope the BCN nurses can answer your question tomorrow as they are now closed for the day. It might be quicker to call after 9am on 0808 800 6000.
@naughty_boob That’s what we plan to do, we will sit down to track all the possible people starting early morning tomorrow. I hope this gets resolved in the best way possible. Thank you for your support as always
Please don’t worry. I suppose your partner’s blood results were ok before lumpectomy, and she has not been on chemo since then. It is probably the reason there’s no need to check it before the first Kadcyla infusion. I am sure her heart is going to be monitored. They are going to do heart echo ( scan) at every three, four months.
I am not that lucky. I had lumpectomy in the middle of December and I am still waiting for radiotherapy and Phesgo injections. I have already had 6, last injection 5th of December. Next one on the 13th of February and radiotherapy within three months.
I had only partial response to chemo and I haven’t been offered Kadcyla. I am going to continue with Phesgo. More side effects than Kadcyla gives.
Please don’t worry. I think you are on the right track. Sending hugs xx
Thank you dear @boz for the lovely words of reassurance. It means a lot. We will pray that your delay in radiotherapy and phesgo injections gets sorted soon so that you are not left waiting for longer. I understand how frustrating it can be to just keep waiting, although the days without any hospital or chemo ward visits are sort of a bonus, in this entire cancer journey, I’m guessing. But still the uncertainty of it all is confusing, I’m sure. Sending you strength and hugs
Is a blood test from 11 days before applicable for a Kladcyla chemo infusion? The chemo ward registrar is saying they have decided to administer the chemo based off of on that, but still somehow the situation feels quite odd. I am wondering if we should continue to push for a blood test before the chemo is administered today. A lot can change in 11 days , why are the doctors assuming that the blood works are the same as 11 days before. It’s pretty bizzare. Just so tired fighting this out since morning
Hello sms
Thanks for posting.
It sounds as though this is a very worrying time for you and your partner. It’s understandable that you have questions about your partner’s treatment plan after neoadjuvant chemotherapy and surgery for HER2+ve breast cancer.
Most women who have breast conserving surgery (lumpectomy) will have radiotherapy to the remaining breast tissue regardless of whether there was a complete pathological response or not. The only routine test required before radiotherapy is a treatment planning session. Treatment planning helps identify the exact area to be treated and the most effective dose of radiation, while limiting the amount of radiation to surrounding tissues.
Treatment planning is usually done using a CT (computerised tomography) scanner.
Kadcyla is often given to people with HER2+ve breast cancer who did not have a complete pathological response to neoadjuvant chemotherapy. You say your partner had a blood test 11 days ago, as @boz says if this blood test was satisfactory and she has not received any treatment since then, it is likely that this would not need to be repeated. It sounds as though you have spoken to a doctor this morning who has confirmed this.
As you are aware, one of the less common side effects of Kadcyla is heart changes. People normally have an echocardiogram or MUGA heart scan before starting treatment. It is likely that your partner had previous heart scans for monitoring during their neoadjuvant treatment, particularly if being treated with drugs like trastuzumab. If this is the case, they may not need another scan before starting Kadcyla but will continue to be monitored whilst having further treatment.
There is not usually a reason why radiotherapy to the breast and Kadcyla could not be given alongside each other, but do discuss this further with the team if you remain concerned.
Supporting a partner through their breast cancer diagnosis can be very difficult and talking to someone who has had a similar experience can often be helpful. Our Someone Like Me service can match you with a trained volunteer who’s had a similar experience to you. You can be in touch with your volunteer by phone or email and they can share their personal experiences to answer your questions, offer support or simply listen to how you are feeling.
You can ring the Someone Like Me team on 0800 138 6551 or email them at someone.likeme@breastcancernow.org, so they can then match you to your volunteer.
Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to more support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, If you have hearing or speech difficulties prefix our number with 18001 and the call will go through Relay UK. Our helpline has access to telephone interpreters if language translation is required.
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Best wishes
Mandy
Breast Care Nurse
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