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HER2+ Breast Cancer Discussion Guides — Herceptin for adjuvant treatment of recently diagnosed breast cancer

Here are some questions to ask your health care team about Herceptin for adjuvant treatment of recently diagnosed breast cancer. Print these questions and take them with you to your doctor's office.

Questions for Your Doctor

About your diagnosis:

What kind of breast cancer do I have?
What stage is my cancer and how does it affect my treatment plan?
How is adjuvant breast cancer different from metastatic breast cancer?
Has my tumor been tested for HER2? If so, is my cancer HER2+?

About treatment:

What are my treatment options?
How soon should I start treatment after my diagnosis?
What medications should I be considering? Should I be on multiple therapies?
What is the difference between chemotherapy, hormonal therapy and biologic therapy?
How long will I need to stay on these treatments?
How will I know this treatment is working?
What are the chances my cancer will come back after treatment?

About Herceptin:

What are the benefits of adjuvant Herceptin therapy in HER2+ breast cancer?
How do Herceptin treatment regimens differ? What is the difference between TCH and AC → TH therapy?
What other therapies can I take with Herceptin?
How long will I need to be on Herceptin?
How will I know if the treatment is working?
What side effects can I expect to have?
What types of things can I do to help cope with any side effects that I may have during my treatment?
Are there any symptoms or problems I might have during my Herceptin treatment that I should immediately tell you about?
How often will my oncology nurse follow up with my oncologist about my Herceptin treatment and my progress?
Why is my heart being tested? Is there a treatment option that is safer for my heart?

Questions for Your Oncology Nurse:

Can you tell me more about the medications I should be considering for my HER2+ breast cancer? Should I be on multiple therapies?
If I go on a new treatment, what will your role be in administering the treatment?
Are there support groups that you can recommend for me? Could you also recommend information about support groups that may be helpful for my friends and family members?
Can you provide me with information about how diet and exercise can affect my treatment?

Who is Herceptin for?

Herceptin is approved for the adjuvant treatment of HER2-overexpressing, node-positive or node-negative (ER/PR-negative or with one high-risk feature)^† breast cancer. Herceptin can be used several different ways:

As part of a treatment regimen including doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel
With docetaxel and carboplatin
As a single agent following multi-modality anthracycline-based therapy

† High-risk is defined as ER/PR positive with one of the following features: tumor size >2 cm, age <35 years, or tumor grade 2 or 3.

What important safety information should I know about Herceptin?

Herceptin treatment can result in heart problems, including those without symptoms (reduced heart function) and those with symptoms (congestive heart failure). The risk and seriousness of these heart problems were highest in people who received both Herceptin and a certain type of chemotherapy (anthracycline). Your doctor will stop or strongly consider stopping Herceptin if you have a significant drop in your heart function.

You should be monitored for decreased heart function before your first dose of Herceptin, and frequently during the time you are receiving Herceptin and after your last dose of Herceptin. If you must permanently or temporarily stop Herceptin due to heart problems, you should be monitored more frequently. In one study with Herceptin and certain types of chemotherapy, an inadequate blood supply to the heart occurred.

Some patients have had serious infusion reactions and lung problems; fatal infusion reactions have been reported. In most cases, these reactions occurred during or within 24 hours of receiving Herceptin. Your Herceptin infusion should be temporarily stopped if you have shortness of breath or very low blood pressure. Your doctor will monitor you until these symptoms go away. If you have a severe allergic reaction, swelling, lung problems, inflammation of the lung, or severe shortness of breath, your doctor may need to completely stop your Herceptin treatment.

Worsening of low white blood cell counts associated with chemotherapy has also occurred.

Herceptin can cause low amniotic fluid levels and harm to the fetus when taken by a pregnant woman.

The most common side effects associated with Herceptin were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, shortness of breath, rash, low white and red blood cells, and muscle pain.

Because everyone is different, it is not possible to predict what side effects any one person will have. If you have questions or concerns about side effects, talk to your doctor.

Please see the Herceptin full Prescribing Information including Boxed WARNINGS and additional important safety information.