It is used all the time here in Boston, the major barrier is getting
insurance to cover.  Sounds like she is being offered top notch treatment.
I hope she responds well to the herceptin, I also posted a link to a second
generation drug in clinical trials which is a pill. It is posted in living
beyond breast cancer.

Hi,  Allan,  My best friend is receiving dose dense sequential
chemo..adriamycin q2weeks..taxol q2weeks...cytoxan q2weeks. She gets
neulasta on day 2 of each treatment.  The idea was to give less
medication at more frequent intervals.  Giving each one individually
does draw the chemo out but her side effects have been minimal.  The
neulasta brings the white count back up in seven days following the
injection.  It does cause some flu-like aches but nothing intolerable.
It has kept her count up to 7.0 (she's had 2 treatments thus far..s/p
lumpectomy/node dissection for stage 2 ductal Ca). I wish Carol
strength and faith during the challenge ahead.  Denise

I had Neulasta after every chemo treatment excpet the very first one
{1/10/03}. My onco wanted to see what my response would be if I didn't
get it.
I was on AC for 4 rounds {1/10/03-3/14/03} and Taxotre for the last 4
rounds {4/4/03-6/6/03}.
I had no problems with this.I didn't have the "flu like" symptoms that
others have talked about. I had my treatments on Friday's, and went in
for my Neulasta shots on Monday's. The only reason there was 2-3 days in
between is the onco area wasn't open on the weekends., otherwise I'm
sure I would've had it sooner then I did.
My counts were very low last time {8/99-1/00} I was on CMF and they
dropped to a very low level a few times during that time. They did
rebound prior to the next treatment, but it took most of the 3 week
interval to do that. There was only one time that I had to be retested
within a a couple days to make sure that I was going to be ready to have
next treatment.
I always had my bloodwork done on Friday's in bwt treatment days, and
the onbe time I'm speeaking of, I had to repeat the test again on
Monday.

I hope this helps. My thoughts and prayers go out to your friend.
{friends relative?}
I also hope Deb is doing well, and please let her know that I'm thinking
of her. Well, you too dear. ;-))
My thoughts and prayers are with you both. Take care/God bless
annie    

Ultimately.....we know deeply that the other side of every fear is a
freedom.

"Courage"...is *fear* that has said it's prayers.

I forgot to mention that I was told that if that one blood test when
repeated was no better then I'd be given Neupogen. As it turned out it
came back up and wasn't needed.
This last time {2003} I approached the Onco about the Neulasta shots. He
told me that he would order them, and I'd get them afer my treatments. I
presented the arguement that my counts were very low last time all
through treatment, and I really didn't want to take the chance of having
treatments stalled because of low blood counts. I was in NO moo to be
told "sorry you have to wait" NOT! This was my second dance through
cancerland and didn't want _anything_ to halt thr progress of this
treatment schedule. That and I told him that "if I feel better, I'll do
better" He agreed and I got them like I said after ech one, except for
the very first AC.
Someone mentioned the cost an they are for sure very costly, but our
insurance picked up the cost of ll of them.
I had 7 all together and it was told to me that they cost $4,250 PER
shot. Whew!
Thank God for the HMO...although I don't always feel that way. {lol!} As
in recently, but this too shall pass....
Take care there my friend and give my best To Deb.
God bless you both
annie

Ultimately.....we know deeply that the other side of every fear is a
freedom.

"Courage"...is *fear* that has said it's prayers.

-----------
That's what I'm getting too.  Does she have a very large tumor?  That was
the rationale with me.

I just had my 2nd treatment yesterday (and coincidentally lost my hair).  I
was able to walk out of the treatment session and take care of some
important personal business.  I was able to eat supper last night but this
morning I'm nauseated as hell and have to go take my pills .

So my point is that the two-week interval may not be as rare as you thought.

Eva

Allan wrote << I have a couple observations - first, the two-week interval
between
treatments.  They've decided to go dose-dense for her and this looks
like it might be kinda tough chemo.  You don't see that real often.

Has anyone had experience with Neulasta?  As an alternative to
Neupogen it looks pretty attractive - one shot per cycle instead of
eight or nine daily injections.

Anyway, observations are welcome.  What do y'all think?

hugs to all -

allan >>

About a month or so I wrote about my colleague who was recently dx'd with bc.
She had a 2 cm tumor and felt a very large axillary lymph node --it was 3 cm.
She opted for lumptectomy and surgeon removed 30 axillary nodes.  He/they were
surprised that only one of the nodes was positive.  The tumor was ER- and high
grade (as well as Her2-).
Recommended treatment which she has started included dose dense chemo and she
is also being given Neulasta.
She seems to be having it a bit rougher than those who had chemo every 3 weeks
but not "too" bad.  She threw up the first time--not alot--only once with the
Zofran.  However, her 2nd dose of Zofran was delayed because by the time she
got out of chemo (on a  Thursday night) the pharmacy was closed.  I think she
went into work the next day for an hour or two and then did so again the
following Monday.  She also worked from home and during treatment whenever she
could (writing reports).
She had her 2nd treatment last Thursday and said they switched the anti-nausea
medication to Amend (sp?).  She said she read the insert and it said that it
should be given with Dexamethasone at given intervals.  She showed that to
either the nurse or dr. and they prescribed some Dexamethasone but told her
that wasn't usually done.  She did not get any dexamethasone with the Zofran.
I am wondering if that contributed to the greater difficulty with nausea that
she reported.  I recall having to take Dexamethasone for a day or two after
each chemo along with the Zofran.  I wonder if the Zofran may have worked a
little better if she had the Dexamethasone?
I don't have any experience with Neulasta but think it is a single shot rather
than series (Neupogen) and it is automatically given with dose dense chemo.