The word cancer brings a lot of fear to many of us. So, when the doctor tells you or a loved one has breast cancer, I know it's hard to put into words what you feel. But you are not alone in this journey. Thanks to the advancements in medicine today, there are many good treatments to fight cancer. So, being properly informed about those treatments will bring great strength to your mind. Today, we are going to talk about a very important drug used in the treatment of breast cancer. That is the combination of injections called Trastuzumab and Hyaluronidase.
What is this Trastuzumab and Hyaluronidase vaccine?
Simply put, this is a combination of two drugs. Together, they fight cancer cells. Let's look at what these two drugs do separately.
1. Trastuzumab
This is the main hero of this treatment. Trastuzumab is a targeted therapy . That means this drug doesn't just attack every cell in the body. It specifically seeks out cancer cells and attacks them.
Think of cancer cells as a bunch of bad doors. Some breast cancer cells have a special protein (a protein called HER2) on their surface that helps those cells divide and grow quickly. This is like a special key that is locked to those bad doors. If you have this key, the door opens, and the cancer cells divide quickly.
Trastuzumab works like putting something in the keyhole and blocking it. Then the cancer cells don't get the signal that makes them grow. So the cancer cells stop dividing and spreading or become very sick. This drug belongs to a group called ``monoclonal antibody''. That means it's a protein that's made in the lab specifically to target cancer cells, just like parts of our body's immune system.
2. Hyaluronidase
This is the main hero's sidekick. We don't inject this vaccine directly into a vein, but under the skin. Then the large protein molecule called Trastuzumab needs a little help to be absorbed well by the body.
The drug, called Hyaluronidase, temporarily loosens the tissue under the skin where the injection is given. This allows the Trastuzumab to pass through it more easily, enter the bloodstream, and quickly reach the cancer cells where it needs to work. It's like clearing the traffic on the road and allowing an ambulance to get there.
This medicine is usually marketed under the brand name HERCEPTIN HYLECTA .
Things you need to tell your doctor before starting this medication
Before you start any treatment, it is very important to tell your doctor your complete health history. Because that information will determine the safest and best treatment for you. In the case of this medicine, it is important to tell the following things.
| Your health condition | Why is it important to inform about it? |
|---|---|
| Heart disease or heart failure | Trastuzumab can sometimes affect heart function, so your doctor will be especially careful if you have a pre-existing heart condition. |
| Lung disease | This medicine can sometimes cause breathing difficulties, so it is important to inform your doctor in advance if you have a lung condition such as asthma. |
| Various allergies (Allergies) | Be sure to tell us if you have any allergies to Trastuzumab, other medications, foods, or dyes. |
| If you are trying to get pregnant or are pregnant | This medicine can be very harmful to the baby in the womb, so you should make sure you are not pregnant before starting treatment. |
| If the baby is breastfed | This medicine can pass to the baby through breast milk. Therefore, breastfeeding should be avoided during and for some time after treatment. |
How will this treatment be given to you?
This is not a medicine you can take home. This vaccine is given in a hospital or clinic by trained medical staff.
The vaccine is given under your skin (subcutaneous injection) , usually in the thigh. This process takes a few minutes.
Important: This medicine is not approved for use in children. Also, this medicine is prescribed for you only. Do not share it with anyone else for any reason.
What if the medication dose increases?
This is given in a hospital setting so the chances of this happening are very low. However, if you think you have taken too much of this medicine, inform the medical staff immediately. Otherwise, call the National Poisons Information Centre at the National Hospital , or go to the Emergency Department (ETU) of the nearest hospital.
What do you do if you miss a dose of medication?
It is very important for this treatment to be successful to take the medicine on the scheduled date and time. If you are unable to go to the hospital/clinic on the scheduled date, call your doctor or clinic immediately and let them know. They will tell you what to do next. Never change the date on your own.
Other medications that may interact with this medicine
Some types of chemotherapy, especially daunorubicin, doxorubicin, epirubicin, and idarubicin, may increase the risk of heart problems when used together.
But remember, this list is not complete. So it's important to tell your doctor about all the medications you take, including vitamins, herbal remedies, and supplements. Also tell your doctor if you smoke or drink alcohol.
Things you should be especially careful about during treatment
It is important to pay close attention to your body during this time.
General discomfort and well-being
It's normal to feel a little tired and uncomfortable during cancer treatment, as it can also affect healthy cells. This happens to many people. But tell your medical team about any side effects you experience. It's important to finish the course of treatment, even if it's uncomfortable, until they tell you to stop.
Be careful about infections.
This medicine may weaken your immune system a bit. This means you are more likely to get sick and get infections. So if you have symptoms of a cold like fever, chills, sore throat, or cough , don't take it as usual . Call your doctor right away for advice. Don't go out alone to take your medicine. Avoid crowded places as much as possible and stay away from people who are sick.
Be careful with painkillers that suppress fever.
Unless your doctor specifically tells you to, do not take pain relievers such as aspirin, acetaminophen, ibuprofen, or naproxen. These medications can suppress your fever. The first and most important sign of an infection is a fever. If it is suppressed, you may not know until you have a serious infection in your body.
Pregnancy and breastfeeding (very important)
This is a matter of great concern.
- Pregnancy: You should avoid getting pregnant while taking this medicine and for 7 months after your last dose . This medicine can cause serious birth defects in an unborn baby. You will need to have a pregnancy test before starting treatment. Talk to your doctor about birth control that is right for you during this time.
- Breastfeeding: Avoid breastfeeding your baby while taking the medicine and for 7 months after the last dose .
Side effects that may occur with this medicine
These things can be scary to hear, but not all of them happen to everyone. Also, most of them can be controlled. The most important thing is to let your medical team know if you feel anything is different.
| Side effect/symptom | Description and what you need to do |
|---|---|
| Serious side effects that should be reported to your doctor immediately | |
| Allergic reactions or angioedema | Skin rash, itching, swelling of the face, eyes, lips, tongue, hands or feet, difficulty swallowing or breathing. If you have any of these, it is an emergency. |
| Difficulty breathing | Dry cough, shortness of breath, difficulty breathing. |
| Heart failure symptoms | Shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, feeling unusually tired or exhausted. |
| Changes in heart rate | Feeling like your heart is beating fast or irregularly, dizziness, fainting, chest pain. |
| High blood pressure | Your blood pressure will be monitored regularly, but be aware of things like headaches and dizziness. |
| Signs of infection | Fever, chills, cough, sore throat. |
| Common side effects that should be reported to the doctor if they persist or are bothersome: | |
| Diarrhea | Drink fluids like water and Jeevani. If it persists, tell your doctor. |
| Hair loss | This is seen in many cancer treatments. Hair grows back after treatment is complete. |
| Headache | Rest. Drink fluids. Tell your doctor if it is severe or persistent. |
| Muscle pain | Rest and a lukewarm bath may help. |
| Nausea | Instead of eating large meals at once, eat small meals. The doctor will prescribe medication for nausea. |
| Unusual weakness or fatigue | It's normal to feel more tired than usual during this time. Get as much rest as possible. |
Take-Home Message
- Trastuzumab and Hyaluronidase are targeted therapies for breast cancer that stop the growth of cancer cells.
- Before starting treatment, tell your doctor all your health information, especially about heart and lung disease.
- This vaccine is given in a hospital or clinic by trained staff. It is not a take-home medicine.
- During treatment, be very careful about things like fever, difficulty breathing, and swelling in the legs. If you notice any changes, tell your doctor immediately.
- It is very important to avoid getting pregnant completely while taking this medicine and for 7 months after finishing treatment.
- Don't be afraid to talk to your medical team about any discomfort you're feeling, no matter how small. They're always there to help you.
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