Download 786 sub cut herceptin final

786
Information leaflet on subcutaneous Trastuzumab
(Herceptin®) for breast cancer patients
This leaflet provides information for patients having
treatment with the drug Trastuzumab. Trastuzumab is also
known by the name Herceptin®. The leaflet will explain:
 what Trastuzumab (Herceptin®) is
 when and how it is given.
 common side effects that you may experience.
What is Trastuzumab (Herceptin®) and why am I having
it?
Your cancer showed a high level of a substance known as
HER2 (Human Epidermal growth Receptor- factor 2). HER2
is found on the outside of some cancer cells and it
stimulates their growth.
Trastuzumab (Herceptin®) is one of a group of cancer drugs
called monoclonal antibodies. Monoclonal antibodies are
sometimes called targeted therapies because they work by
‘targeting’ specific proteins (receptors) on the surface of
cells. Trastuzumab (Herceptin®) locks onto the HER2
protein. This blocks the receptor and stops the cells from
dividing and growing.
1
How often will I receive Trastuzumab (Herceptin®)?
For Trastuzumab (Herceptin®) treatment to be most
effective, it is given at 3 weekly time intervals. For patients
with early breast cancer it is usual to have Trastuzumab
(Herceptin®) treatment every 3 weeks for a total of 18
treatments over 12 months. For Metastatic Breast Cancer
patients the exact number of treatments you will receive will
be discussed with you by your doctor; however you will also
receive your treatment at 3 weekly intervals.
How is Trastuzumab (Herceptin®) given?
Trastuzumab (Herceptin®) is available in two types for
administration
 Infusion into a vein in the back of hand or arm
 Injection under the skin into the thigh.
Trastuzumab (Herceptin®) by subcutaneous injection is an
injection under the skin on your thigh. The administration of
Trastuzumab (Herceptin®) by subcutaneous injection will
take up to 5 minutes. The injection site will change from left
to right each treatment cycle. In order for the nurse to give
the injection to the leg it is advisable to wear comfortable
loose-fitting clothing for example a skirt or trousers to enable
access to your thigh for administration on the day of your
treatment.
How often will I see the specialist team?
Your doctor will let you know how often you will need to be
seen in the outpatient clinic. At each visit the nurse who
gives your Trastuzumab (Herceptin®) will check how you
are feeling and discuss any problems you may have with
treatment(s) or any other issues.
2
Where do I receive my treatment?
The first treatment will be administered in one of the day
case treatment areas at Velindre Hospital or the District
General Hospital closer to your home.
After the first treatment your Trastuzumab (Herceptin®) will
be given by VCC trained nurses in Velindre Hospital or one
of the Outreach Clinics.
Other information
You are welcome to bring someone to stay with you during
your treatment. Space is limited in the waiting areas and
treatment room so there is not usually room for more than
one person. Please be advised treatment areas are not
suitable for young children.
It is important you do not become pregnant whilst having
Trastuzumab (Herceptin®) treatment.
How long will my appointment take?
You will be required to spend a minimum of 2 ½ hours at the
hospital for your first cycle and a minimum of 30 minutes for
your second cycle of Trastuzumab (Herceptin®) treatment.
The reason for this period of observation is to ensure you
are tolerating the treatment without any initial side effects .
Side effects during the treatment
Most people tolerate Trastuzumab (Herceptin®) treatment
very well, with very few side effects. However, as with all
drugs, there are a number of known side effects which can
occur. Some of these are detailed below, the doctors,
3
nurses and pharmacists can give you advice or answer any
questions you may have.
Most side effects which can occur with Trastuzumab
(Herceptin®) occur at the time the drug is given. A nurse
will monitor you closely during the treatment.
If you experience any of the following during the treatment
or immediately post treatment please tell your nurse straight
away:







Feeling hot and feverish
Chills or shivering
Headache
Dizziness or faintness
Problems with breathing
Rash
Feeling sick or vomiting
Other common side effects you may experience in the first
few days after treatment include:






Diarrhoea
Weakness
Skin rashes
Abdominal pain
Joint pain
Muscle pain
These side effects usually only last a few days. Taking a
mild painkiller, for example whatever you usually take for a
headache, may help. If you feel very unwell or want further
advice please contact Velindre Cancer Centre –
Chemotherapy Pager.
4
Heart problems
Trastuzumab (Herceptin®) treatment may cause some
heart problems. This is rare and the risk of developing
serious heart problems is less than 1%. Any problems
which are caused by Trastuzumab (Herceptin®) will
usually get better when the completed treatment cycles
have finished. Your doctor will discuss this with you and
arrange for your heart function to be tested before you
start Trastuzumab (Herceptin®). Your heart function will
be monitored usually every 4 months for the first year of
treatment. We will also check your blood pressure and
monitor your weight regularly.
If you already have a heart condition or you take any
heart medication, please tell your Velindre doctor before
you start treatment with Trastuzumab (Herceptin®). If
you do develop heart problems whilst on Trastuzumab
(Herceptin®) it can be treated with tablets. It is very
important not to stop taking any tablets you have been
given for heart problems without discussing it with your
Velindre doctor or specialist nurse.
If at any time during your treatment you become breathless,
develop a cough, experience fluid retention (swelling) in
your arms or legs, or palpitations (heart flutter or irregular
heart beat) please contact Velindre Cancer Centre –
chemotherapy Pager immediately.
Is it ok to take other medication with Trastuzumab
(Herceptin®)?
Trastuzumab (Herceptin®) can remain in your body for up to
6 months after you finish treatment. During this time you
should tell your doctor and pharmacist that you have had
Trastuzumab (Herceptin®) before starting any new
medicines.
5
Who do I contact if I am unwell during my Trastuzumab
(Herceptin®) treatment?
If you are unwell at home and need immediate attention at
any time of the day or night phone Velindre Cancer Centre
029 2061 5888 ask for the chemotherapy pager
Sometimes cancer drugs can have very serious side effects
which rarely can be life threatening. It is important to inform
Velindre cancer centre if you are concerned about any sideeffects
6
Manufacturer’s patient information leaflets
This leaflet was written by VCC healthcare professionals in
line with the approved VCC protocol. The information
contained in this leaflet is evidence based. The leaflet has
been approved by a Velindre Cancer Centre group of
doctors, nurses, pharmacists and patient representatives. It
will be reviewed and updated every 2 years.
Copies of drug manufacturer’s patient information leaflets
are available from the Velindre Pharmacy, your treatment
centre or on the internet at www.medicines.org.uk These
leaflets provide detailed information on individual drugs. We
don’t give them out routinely as they can be difficult to read.
Please ask if you would like a copy
7
Contact telephone numbers
Velindre Cancer Centre
029 2061 5888
Ask for the chemotherapy pager if you are unwell at home
and need immediate attention at any time of the day or
night. For example you should phone if you:
 Are sick more than once in 24 hours
 Have a temperature of 37.5°C or above
 Have diarrhoea
Pharmacy department
029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your
medicines
Tenovus freephone
0808 808 1010
cancer helpline
7 days a week 8am – 8pm for general queries on cancer
This information is also available in Welsh
This leaflet was written by health professionals. The
information contained in this leaflet is evidence based. It
has been approved by doctors, nurses and patients. It is
reviewed and updated every 2 years.
Prepared January 2015
8