I am 57, with metastatic HER2-positive BC. How to manage it?

Question

Hello doctor,

I am a 57-year-old woman with metastatic HER2-positive breast cancer, spread to my liver and bones. My initial treatment with Trastuzumab, Pertuzumab, and Docetaxel reduced the tumor burden, but recent scans show new liver lesions. My liver enzymes (Alanine aminotransferase 65, Aspartate aminotransferase 72) and CA (Cancer Antigen) 15-3 (120) are elevated.

I am fatigued and have mild abdominal discomfort. My doctor is considering switching to T-DM1. I am worried about side effects and whether it will help. Are there other options, and how can I manage the fatigue and liver symptoms?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

T-DM1 (Trastuzumab emtansine) is an antibody-drug conjugate that combines Trastuzumab (Herceptin) with Emtansine, delivering chemotherapy directly to HER2-positive cancer cells (Human Epidermal Growth Factor Receptor 2) while minimizing systemic side effects.

Common side effects include fatigue, nausea, thrombocytopenia, and elevated liver enzymes, so regular blood tests and close monitoring of liver function are essential during treatment.

Light exercise like walking or stretching is recommended to manage fatigue and maintain energy, along with frequent meals rich in protein and complex carbohydrates. Iron and vitamin supplements may also help, but avoiding heavy or greasy foods and focusing on easily digestible options is important.

Clinical trials and additional therapies, such as stereotactic body radiotherapy (SBRT) for liver lesions or bone-strengthening agents, can be discussed with your oncologist to optimize disease control and quality of life.

I hope this helps you.

Thank you.