Kadcyla and Radiotherapy treatment clash

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Hi, I am writing to check on my partner's radiotherapy and kadcyla treatment plan. My partner has received neoadjuvant chemotherapy for HER2+ primary breast cancer , post which she has had her lumpectomy in early January. There was a very small residual cancer of 0.7mm and the nodes were all clear. Due to this the doctor has suggested to start with 14 kadcyla infusions for her post radiotherapy for 2 weeks.  However we haven't heard back from radiotherapy regarding the treatment plan yet. Yesterday we received a call from the chemo unit saying that they are starting the kadcyla infusions today and will then we pausing the treatment when we hear back from the radiotherapy unit regarding the dates/ treatment plan. We are slightly worried about the break in the Kladcyla plan when radiotherapy happens. Is it alright or will this pose greater side effects and also disrupt the preventative treatment plan. We are quite confused and have not received any logical or clear cut answers from the medical teams and nurses. It will be great to get an idea on this. Thank you in advance! 

  • Hi SMD,

    Thanks for getting in touch, and welcome to the Online Community. My name is Ursula and I’m one of the cancer information nurse specialists here at Macmillan cancer support.

    I am very sorry to read of your partner’s breast cancer diagnosis. It is understandable to have questions around her treatment plan and the timings of these proposed treatments.

    Here at Macmillan, we are independent of the NHS and do not have access to medical records or information. We are therefore unable to give personalised advice or comment on your partner’s treatment plan. I am sorry that you are feeling confused and feel you have not been given any logical or clear-cut answers from the medical teams and nurses. I’m wondering if your partner has a breast care nurse specialist she could speak with, who may be able to offer advice or support with your concerns? Or can your partner contact her consultant’s secretary to see if she can speak with her consultant directly about this?

    Information from Cancer Research UK states that if you are having radiotherapy as well as Kadcyla your treatment is usually spaced to reduce the risk of having radiation related side effects – but this needs to be discussed with the specialist team.

    This study from 2022 looks at acute skin radiation toxicity with concurrent Trastuzumab emtansine (Kadcyla).

    Another study also from 2022 looks at cardiotoxicity risk with adjuvant Kadcyla plus concurrent radiation.

    I have been unable to find any specific information on pausing Kadcyla to deliver radiotherapy so would suggest speaking directly with the treatment team about the reasoning for this, and any potential clinical significance of this for your partner.

    Supporting someone with cancer can be an emotional time, and there can be a lot to think about. It is important to know there is support available.

    You may also find it helpful to chat in more detail with one of our nurses, by giving our support line a call. We often find we can talk through things in a bit more detail over the phone, giving you the opportunity to ask more questions if needed. Also, the breast cancer forum and family and friends forum on our online community can often offer support from others going through similar challenges.

    I do hope you find this information helpful, but please do not hesitate to get back in touch with us if you need any further support. 

     

    Take care, 

    Ursula

    Cancer Information Nurse Specialist 

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.  

    Ref: UH/HeP