How bad are side effects with just Herceptin and Perjeta after chemo?

Congratulations on reaching the halfway point with TCHP treatment! Many patients find that side effects often become more manageable when transitioning to just the targeted therapies without chemotherapy. While experiences vary from person to person, the fatigue and taste changes commonly associated with chemo often improve significantly during the Herceptin and Perjeta portion of treatment. This community has many members who have been through similar treatment journeys, so hopefully others will share their experiences with the targeted therapy phase to help give you a better sense of what to expect.

Hi Melissa. A lot of people say the herceptin and perjeta are a walk in the park compared to active chemo. I didn’t have any real problems during active chemo aside from fatigue and diarrhea. I got the phesgo shot (herceptin and perjeta in a shot form as opposed to the IV). I had a horrible reaction to it and wind up in the hospital over the weekend. But the fatigue and diarrhea are still there because of the perjeta. I am now only doing herceptin because the diarrhea was too much. It’s been ok. Still have the fatigue. They should be monitoring your heart, I think every three months because those drugs can cause heart issues. Good luck to you!

Thanks Kim! That gives me hope 🩷 I have been getting scheduled echo cardiograms before and during chemo. Guess that will continue for awhile then. I cannot wait to cross the finish line!

I have four more treatments of the herceptin and my revision surgery. Prayerfully, I’m done after that. So, I know what you mean about can’t wait until you cross that finish line. I’ve had hiccups along the way and should have been done but it’s ok because you also go through the “what do I do now and am I going to be ok” when there’s no more doctor visits, x-rays and scans. You’re definitely glad it’s behind you but you also feel a little like that. Everyone is different, but if you can tolerate TCHP, you should be ok with HP.

Starting TCHP this week. I was told to stay on top of fluids and protein, take Claritin the day before my injection (that will be chemo day) and for a few days after. Told not to take Imodium until diarrhea starts. It was suggested by an oncology nurse (not my own oncology nurse) to gargle with baking soda, salt and warm water daily to help offset any muscle sores. Wondering if anything worked to prevent the side effects?

Hello Laura! As much as I think TCHP stinks. And I do my share of complaining ): I do feel like I’ve been pretty lucky with my side effects. I take a steroid the day before treatment and then days 2-5 after. Usually Day 6 I feel rough. But I think part of that is coming off the steroid. I take Claritin the day of my infusion and then for 7-10 days after. I was told that helped with the white blood cell booster shot I get the day after my infusion. Because that usually causes bone pain. Honestly after each cycle of chemo I had different experiences. The 1st round, I felt heavy. If that makes sense. But I was good for day 1-5. Day 6 is when the diarrhea started. But it wasn’t too bad for me. I probably only took maybe 3 Imodium out of the whole 21 day cycle. My mouth never gets sores. It is just my taste buds are gone. Like I burnt my mouth on hot soup kinda feeling. Nothing tastes normal. My mouth gets watery but I can’t say it makes me nauseous. I’ve only taken anti nausea meds one time. And that was like Day 7 of cycle 1. I haven’t taken anti nausea meds since then (: I will say heartburn was a big thing that I have had with each cycle. My Dr has me on prescription meds for that. That has been a constant. Cycle 2 my diarrhea was much better. But the taste thing had me upset and frustrated. I felt like it took longer for my taste buds to heal for round 2. I also get a metallic taste in my mouth. I switched out my metal water tumbler and tried a totally glass one. Still didn’t help. The heaviness feeling has been getting worse with each treatment. Cycle 2 I was super tired. But it’s a tired that sleep doesn’t help. So for round 3 my doctor lowered my chemo dose by 15%. I think that helped because cycle 3 was better than cycle 2 (as far as side effects and how long they lasted). My iron is low and my activity level really decreased in cycle 2 compared to cycle 1. Which is why the Dr suggested lowering my dose. And I am glad he did. After cycle 2 we could no longer feel the lump in my breast!! I try to drink water as much as I can. I should do better but this mouth thing is rough. And I hate electrolyte drinks. Even with a good mouth! I have been trying to stay as active as I can. If it is nice outside I will walk a mile or two. When it isn’t I do the elliptical for 20 minutes. I do red light therapy too. I wear the cold mitts and socks during my treatments. I also use a vibration plate at home. The dr said that can help with any tingling and/or numbness in my feet! I think that has helped! During week 3 of my cycle I have been getting chemo acne on my head. This round it has been terrible. It itches and hurts. Oh sorry one more thing, I did shave my head week 2 of cycle 1. It was slowly started to fall out more and more. When I would shower I would have to clean up the shower floor because of the hair that was left behind. It was almost a relief when I shaved it. I didn’t have to stress about keeping it any longer. I think that’s it. lol. It has been a ride. And I will be glad when I’m done. But overall I think I have been doing pretty well! Oh and I do get hydration infusions the week after chemo. It is rough getting there and sitting through it but I think after I’m done it kick starts the downward slope to feeling better. By week 3 I feel ok. Just to start the whole thing over again. Another thing I’ve experienced is digestion issues. I don’t know how else to describe it. I keep saying it feels like an apple peel is stuck in my throat. Like I always have a lump in my throat. And it feels like my stomach isn’t digesting my food. So I have tried smaller meals and eating slower but that doesn’t seem to help ): geeezzzz after typing all this I guess I do have some issues 😂 Good luck to you!! You got this. I can’t say it will be easy but we are tough!!

Hi Laura. Everyone is different and will have different side effects. I didn’t have too many during chemo except for diarrhea, thrush and my appetite being a little off, hair loss and some fatigue. I worked through the whole thing, in-person. I drank a lot of water and would not eat a lot the day before but have a vegetable smoothie and one the day of. I took a Tylenol before my treatments and I took Claritin when I got home from my treatment. Wishing the best for you.

Melissa, something I read said it was the steroid that causes heartburn. I had it too. I found the HP to be super easy compared to the TCHP. I started Kadcyla yesterday because my surgery biopsy had residual cancer cells (tiny!) I'm wondering how this will go...

Thanks Lynn!! It’s encouraging to hear that HP might be easier!! I have an appt tomorrow with my dr. I want to ask him about the possibility of reducing how long I have to take the steroid. I hate when I’m on it ):