TCHP Chemo Regimen

By Contributing Editor, Madhumitha Sabhanayagam

When breast cancer first entered the spotlight, the most talked-about subject, other than cancer itself, was chemotherapy. Chemotherapy, though sometimes not the most common way to treat breast cancer, is often the first option that jumps into most people’s minds quickly followed by concerns of hair loss. The side effects of chemotherapy are notorious, and in its own league, and quite rightfully so. Many of you have experienced these side effects first-hand and the toll it takes, not only on your person but also on your mental and emotional health.

In recent days, I have come across several survivors discussing the aggressive side effects of the TCHP chemotherapy regiment for breast cancer treatment.

TCHP is made up of four different chemotherapy drugs. Each of these chemo drugs targets cancer cells and or slows down the growth of pre-existing cancer cells. TCHP chemo is usually administered before (to shrink the tumor) or after surgery (to eliminate any rogue cancer cells). The entire chemo regiment is designed to be given in several cycles and the treatment can last anywhere from 5 to 6 months. There are follow up medications to be taken, follow up treatments, and check-ups depending on each individual’s treatment path.

T - Taxotere (Docetaxel)

C - Carboplatin (Paraplatin)

H- Herceptin (Trastuzumab)

P-Perjeta(Pertuzumab)

Because of the four-way combination of the drugs, the regiment presents a slew of side effects that can wreak havoc on an individual and their day to day activities. Some of the common chemo side effects include:

· Diarrhea

· Hair loss

· Low white blood cells

· Nausea

· Fatigue

· Vomiting

· Anemia

· Upset stomach

· Constipation

· Decreased heart function

So why do we have side effects? It is usually because of the aggressiveness of the chemotherapy attacking cancer and in doing so, they sometimes also attack normal cells as well. For example; it may attack the cells that stimulate hair growth or the cells that release the hormone which stimulates hunger. This results in hair loss and loss of appetite.

The biggest overall side effect in most TCHP chemo survivors is weight loss. The regiment takes a toll on your appetite and the ability to find anything tasteful. You constantly have nausea and if you do get hungry, food tastes absolutely abhorrent. Many survivors see drastic weight loss and therefore have little to no energy to participate in their day to day activities. It is important to try and get in calories where you can, for example, nut butters are a great high protein and calorie dense option. Ask your oncology team if they can refer you to a nutritionist as well if you are having a touch time with food.

But there is a light at the end of the tunnel. Oncology teams are investing more time and effort into coming up with ways to reduce the severity of side effects and keep them to a minimum for their patients. For example, for those who are experiencing extensive hair loss, there is a new method called scalp cooling. It is a mask one can wear while undergoing treatment. It cools down the scalp and in doing so helps to minimize the damage inflicted on to their hair cells. It is still relatively new, but some oncology centers have seen some success with it as well as one of our very own SBC members who shares her experience with cold caps on our podcast Breast cancer Conversations.

The lack of appetite, nausea and continuous vomiting can result in dehydration and loss of protein in the body. So, when one does experience it is good to note that, drinking lots of liquids is extremely important. Water, electrolytes, and soup are some great resources. It is best to avoid intensive flavors, as those could trigger nausea - so keep to simple (bland unfortunately) food. Yes, that would include eliminating spicy foods, greasy and fatty foods, very sweet and sugary foods. For some, ramen, oatmeal, lemons, sour patches, and apple sauce were the only things that they could eat. Try eating several small meals throughout the day to avoid large size meals that may be too overwhelming while going through TCHP chemo.

Doctors do advise to consciously include protein into one’s diet. Focus heavily on milk or a plant based milk high in protein, eggs, beans, and cheese as they provide the protein to build back the protein you will need to replace the cells you might have lost. (Check out our short list of managing chemo side effects here and our recommendations on vitamin D and calcium.

There is also an emotional and psychological effect that is evident when undergoing, TCHP chemo. You tend to go through bouts of helplessness and extreme depression. This is normal and it is important to note that you are not the only person who is experiencing these effects. A good way to combat this is to invest in therapy and also to take some sort of control. Being out of control is the biggest stressor for most cancer survivors. Therapy can take on a variety of forms. Sometimes it is in the traditional sense of speaking with a counselor or social worker. Sometimes, it could be taking a walk with a friend or doing some light yoga and breathing exercises at home. It's important to carve out time for yourself.

Be in charge of all the knowledge your oncology team presents to you, have your medications ready and the aid tools you need to combat the side effects. At the same time, ensure that you do still bring a sense of normalcy to your life by engaging in hobbies and activities that bring you a pleasant distraction.

Battling cancer is a rough path and it is not a straight path either. It is filled with ups and downs and with several hurdles that we have to overcome. There are however tools to aid us. It is comforting to know that there are many support groups and forums at local oncology centers and online that offer great advice and programs to help soften the blow of cancer. Voice your concerns and do not be afraid to be heard. TAKE UP SPACE and BE SEEN.

Do not suffer alone..