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Maintenance Therapy | Top 3 Questions | Conversation Guide | Nurse Support
- Maintenance remedy is given to assist forestall breast most cancers from returning after preliminary remedy.
- Maintenance remedy for HER2-positive breast most cancers is taken long run, for months or years, however simply how lengthy is determined by your most cancers’s stage and response to preliminary therapies.
- Nurses are a key a part of your breast most cancers remedy crew and may present help throughout upkeep remedy
MyBCTeam members usually have fun ending their preliminary chemotherapy regimens and starting upkeep remedy. “Congrats on getting the chemo done!” supplied one member to a different. “The maintenance treatments go so much faster, and you will start getting more of your energy back.”
In HER2-positive breast most cancers, most cancers cells make giant quantities of a protein referred to as human epidermal development issue receptor 2 (HER2). This kind of breast most cancers requires HER2 to proceed rising, so it’s susceptible to therapies that concentrate on this protein.
HER2-positive breast most cancers has a excessive danger of recurrence (coming again) and metastasis (spreading to different components of the physique). But new focused upkeep therapies have prolonged each progression-free survival (time till most cancers worsens) and general survival (how lengthy an individual lives). This signifies that it’s essential to stay along with your upkeep remedy to get the very best outcomes out of your remedy. Your complete breast most cancers care crew, together with your medical oncologist, nurse navigator, and oncology remedy nurse, is there to help you thru this essential part of remedy.
People beginning upkeep remedy for HER2-positive breast most cancers naturally have questions on how lengthy this part of remedy will final and what to anticipate.
What Is Maintenance Therapy?
Maintenance remedy is given to assist maintain most cancers that disappeared after preliminary remedy from coming again. Initial remedy for HER2-positive breast most cancers could embrace:
- Chemotherapy
- Radiotherapy
- Surgery
Regardless of your stage at analysis, your oncology care crew will seemingly suggest beginning upkeep remedy proper after your preliminary remedy. Maintenance therapy could merely imply persevering with one or two medicines that you simply took for your first remedy.
The objective of upkeep remedy is to keep up remission — to stop or delay the most cancers’s return. Complete remission (additionally referred to as full response) signifies that after remedy, no indicators of most cancers stay.
Sometimes, most cancers reaches partial remission (partial response), which signifies that remedy decreased the tumor’s measurement or the most cancers’s unfold however didn’t kill all of the most cancers cells. In this case, upkeep remedy can be referred to as “continuous therapy” as a result of it’s used constantly to maintain most cancers from progressing. Another objective of steady upkeep remedy is to attenuate the usage of chemotherapy.
How Is Maintenance Therapy Given?
Maintenance remedy for HER2-positive breast most cancers often means taking not less than one focused drug designed to dam the exercise of the HER2 protein. The most typical of those medicines are trastuzumab (Herceptin) and pertuzumab (Perjeta). Both medicines are anti-HER2 monoclonal antibodies, a kind of laboratory-made protein that acknowledges HER2 and stops it from sending development indicators to the most cancers cells. These medication are generally mixed.
Targeted medicines may be given by both IV infusion right into a vein or an injection below the pores and skin. IV infusions can take hours, whereas injections are delivered extra shortly. Both infusions and injections must be given by an oncology remedy nurse, often at an infusion heart, however typically a nurse can do the injection at your home. Both the IV and injected types are usually given as soon as each three weeks. Your oncology nurse will help reply questions associated to remedy administration.
Nurses Are Key
Nurses are a significant a part of your breast most cancers care crew and carry out many essential roles. Nurse navigators will help you navigate a brand new analysis, make appointments, and aid you entry different providers you could require. Oncology remedy nurses administer upkeep therapies and supply help. Nurses may also reply a lot of your questions on upkeep remedy.
HER2-Positive and Hormone Receptor-Positive Breast Cancer
Some breast cancers which can be constructive for HER2 are additionally constructive for proteins referred to as hormone receptors. Hormone receptor-positive (HR-positive) cancers embrace estrogen receptor-positive and progesterone receptor-positive cancers. About half of HER2-positive breast cancers are additionally HR-positive.
Additional upkeep remedy choices that could be really useful for this HR-positive subgroup embrace neratinib (Nerlynx), a kinase inhibitor tablet taken as soon as a day, and endocrine remedy, a hormone-targeted remedy given as a every day tablet for as much as 10 years. Endocrine remedy could also be really useful as a substitute of trastuzumab or mixed with it.
How Long Do You Need To Take Maintenance Therapy?
Maintenance remedy is taken long run, however precisely how lengthy is determined by the severity or stage of your most cancers.
Early-Stage Breast Cancer
For circumstances of breast most cancers in phases 0 by 3, upkeep remedy is often given after a chemotherapy routine resembling paclitaxel (Taxol). After the ultimate dose of chemotherapy, upkeep remedy is often continued for one other six months, for a complete of 12 months.
A meta-analysis of 5 research with greater than 12,000 individuals discovered that stopping trastuzumab upkeep remedy after one yr was safer than stopping after six months. Taking trastuzumab upkeep remedy for longer than one yr, nonetheless, was related to elevated cardiotoxicity, or harm to the guts, a uncommon however critical aspect impact of trastuzumab. Talk to your oncology care nurse when you’ve got any considerations about your danger for coronary heart issues throughout upkeep remedy.
Advanced or Metastatic Breast Cancer
According to the American Society of Clinical Oncology (ASCO) tips, upkeep remedy is a lifelong remedy for superior or metastatic breast most cancers. If the most cancers progresses, you and your physician will focus on switching therapies. If uncomfortable side effects turn out to be tough to handle, discuss to your oncology nurse about choices.
Checking In With Your Health Care Team
To reduce the danger of congestive coronary heart failure related to trastuzumab, your physician could wish to do routine checks that verify your coronary heart perform. This is very essential in case you smoke or have a preexisting coronary heart situation. If you take sure endocrine therapies, which can contribute to bone loss, you may additionally want bone density testing. You can ask your nurse navigator for assist scheduling this testing.
How usually you’ll must observe up along with your physician or oncology nurse is determined by the stage of your most cancers, what therapies you might be getting, and the way effectively your most cancers is responding.
Complete Remission
An individual in full remission could proceed to have follow-up visits with their oncologist or most cancers care nurse. Yearly mammography is the one screening that ASCO and the American College of Physicians suggest for folks in full remission with no new or returning signs.
Partial Remission
An individual in partial remission or with new or returning signs of most cancers will want extra frequent follow-ups. Doctors will look for new or remaining tumors and decide the place they’re positioned and the way they’re responding to remedy. People who’ve simply accomplished therapies can even have extra frequent follow-ups for the subsequent 5 years.
Talk along with your physician or nurse when you’ve got signs that counsel your most cancers could have returned, resembling:
- A brand new lump
- New or completely different ache, usually involving the bones
- Lack of power
- Shortness of breath
The similar forms of checks used to initially diagnose breast most cancers — resembling imaging checks, blood checks for tumor markers, and biopsy — could also be achieved to substantiate whether or not the most cancers is again. Always converse along with your oncology care crew about your signs, remedy uncomfortable side effects, and considerations. Your oncology care crew can focus on your remedy choices and work with you to determine on the very best remedy for you.
Talk With Others Who Understand
On MyBCTeam, the social community for folks with breast most cancers and their family members, greater than 58,000 members come collectively to ask questions, give recommendation, and share their tales with others who perceive life with breast most cancers.
Are you or a cherished one residing with HER2-positive breast most cancers? Is upkeep remedy a part of your remedy plan? Share your expertise within the feedback beneath, or begin a dialog by posting in your Activities web page.
Maintenance Therapy | Top 3 Questions | Conversation Guide | Nurse Support
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