If your cancer care team recommends TCHP chemotherapy (or chemo) as part of your breast cancer treatment regimen, you may wonder what impact the treatment will have on your day-to-day life. Reactions to this drug combination vary, but many people on TCHP chemo experience similar side effects, including anemia (low red blood cell count), mucositis (inflammation in the mouth and gastrointestinal tract), diarrhea, and general pain.

Knowing which side effects you may experience during TCHP chemotherapy can help you prepare to manage them. Read on to learn more about this treatment, how it works, what side effects you may experience, and ways to manage them.

What Is TCHP Chemo?

TCHP chemo is used to treat early-stage and local HER2-positive breast cancer. It consists of four chemotherapy drugs:

• Docetaxel (sold as Taxotere)
• Carboplatin (Paraplatin)
• Trastuzumab (Herceptin)
• Pertuzumab (Perjeta)

This drug combination is usually given once every 21 days for six cycles. Your cancer care team may add a medication to boost your white blood cells — called a granulocyte-colony stimulating factor (G-CSF) — to help prevent infection.

TCHP is given intravenously (directly into a vein) over a period of several hours. It is usually administered at a medical center such as a doctor’s office, clinic, or hospital.

TCHP Chemo Side Effects

Chemotherapy causes side effects because it damages healthy cells in addition to cancer cells. You might experience some side effects during or immediately after treatment, while others might take days, weeks, or months for you to feel.

Immediate Side Effects

TCHP chemotherapy side effects that might occur in the first few hours or days after your infusion are known as immediate side effects, and they may include:

• Allergic reaction
• Nausea and vomiting
• Headache
• Taste and smell changes
• Bone pain from G-CSF injection

Early Side Effects

Side effects you may feel in the first days or weeks after TCHP chemo are known as early side effects and include:

• Infections
• Thrombocytopenia (low blood platelet count) — Symptoms can include bruising, blood in your urine or stool (poop), fatigue, and heavy menstrual flows.
• Diarrhea
• Mucositis — Symptoms of oral mucositis can include swollen mouth and gums, mouth ulcers, thick saliva, and bleeding. Gastrointestinal mucositis can cause abdominal pain, nausea, vomiting, and blood in your mucus or stool.
• Fatigue
• Rash
• Changes in the sensations of your hands or feet
• Eye problems
• Palmar-plantar erythrodysesthesia (hand-foot syndrome) — Symptoms include pain, swelling, discoloration, and blistering of your hands or the soles of your feet.
• Fluid retention

Late and Delayed Side Effects

You may not experience late and delayed side effects of TCHP chemo for weeks, months, or even years, such as:

• Anemia — Symptoms can include dyspnea (shortness of breath), dizziness, pale or yellowish skin, chest pain, and irregular heartbeat.
• Hair loss
• Nail changes
• Menopausal symptoms — These may include hot flashes, mood swings, and vaginal dryness.
• Heart problems

Everyone experiences side effects differently, and some people may have more problems than others. You are unlikely to experience all of the side effects mentioned above. A 2022 study of 447 people who were treated with a TCHP found that the most common side effects were:

• Anemia (which affected 89.9 percent of study participants)
• Mucositis (85.2 percent)
• General pain (83.2 percent)
• Diarrhea (70.5 percent)
• Thrombocytopenia (29.8 percent)

As your treatment continues, you might experience immediate and late side effects at the same time. A MyBCTeam member wrote, “Just finished my second treatment four days ago. I did not realize the effects were cumulative. I have four more treatments, three weeks apart. I haven’t had terrible side effects — no taste, hair loss, a bit of diarrhea — but I wonder if things will get a lot worse. It’s hard to make any plans. Does anybody have some prior experience?”

Another member replied, “I was on the same treatment, and it is definitely cumulative. Treatment five took me longer to recover and six hit me fast and hard, taking almost two weeks before I felt better. Everyone reacts differently, but several ladies going through treatment with me had much the same recovery time.”

Which Days Are the Worst?

For many MyBCTeam members taking TCHP, the worst days were the first three to seven days after chemo.

One member shared, “I find days four, five, six, and maybe seven to be toughest. But then gradually it got better.”

You may find it easier to make plans after your TCHP chemo treatments if you watch for a pattern of how it affects you. One member’s suggestion: “Keep an eye for a pattern, days three to four may be your tough days. Knowing the pattern helps prepare for the next time!”

Many MyBCTeam members say they start to feel better between one and two weeks after each round. “I’m finally starting to feel better at day 11 after TCHP chemo round two,” shared one member.

Managing TCHP Chemo Side Effects

Several MyBCTeam members have shared tips for managing TCHP side effects.

Hydrate

Staying hydrated is one of the most commonly mentioned tips for managing TCHP chemo side effects. “As everyone here will tell you, HYDRATE HYDRATE HYDRATE!” commented one member.

Diarrhea caused by TCHP chemo can make you dehydrated if you lose more water than you take in. Everyone’s body is different, so talk to your doctor about how much fluid you need to drink per day.

Staying hydrated may make you urinate more often, which can be difficult to manage while you're getting your treatment. A MyBCTeam member suggested, “Wear pants to chemo that you can easily manage with one hand, like sweatpants. This way, you won't have to put much demand on the arm with the IV in it.”

Eat Well

TCHP can cause side effects that make eating difficult, such as nausea, mouth soreness, diarrhea, and taste changes.

Anti-nausea medication can help prevent nausea and vomiting. One MyBCTeam member suggested, “Take the anti-nausea meds that they prescribe to you EVEN IF you don’t feel nauseous; that was a mistake I made, and I paid for it unnecessarily.”

Preventing nausea can help you get the nourishment you need. Another member said, “It’s important to get as much nutrition in you as you can. Keep trying different things until you find what you can tolerate. Keeping your strength up is so very important.”

To help with mouth soreness and taste changes, another MyBCTeam member suggested, “I found chewing on ice chips during the carboplatin really reduced the side effects of my taste buds being so messed up this time around.”

Other tips for eating well during TCHP chemo include:

• Eating small, frequent meals
• Avoiding foods with a strong smell
• Trying bland foods
• Avoiding foods that are fatty, spicy, or sugary
• Ensuring you don’t lie down right after eating

Stay Active

Physical activity during TCHP chemo can help improve how tired you feel, allow you to maintain your strength, and reduce feelings of anxiety or depression.

A MyBCTeam member suggested, “Keep moving as much as you are able. A good walk every day helps so much. If the weather prohibits getting out and going for a walk, just getting up and moving around the house will be good for your energy and also lessen the G-CSF side effects.”

Talk to your doctor before starting a new exercise program to make sure you’re exercising safely.

Track Your Side Effects

You might find it useful to record your side effects from TCHP to help you talk to your cancer care team about them. A MyBCTeam member recommended, “Keep a journal of how you are feeling each day after treatment; you’ll find that your body will have its own patterns of ups and downs. It will help you know what to expect going forward.”

You can use a notebook, computer, smartphone, or tablet to record your side effects. To help you remember important details about your side effects, you may want to write down the following:

• What did it feel like?
• When did you feel it?
• How long did it last?
• Did anything make it feel better or worse?

Share that information with your oncologist so they can work with you to create the most effective side effect management plan.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 63,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you had TCHP chemo? Which days were the worst for you? How did you manage the side effects? Share your experiences in the comments below, or start a conversation by posting on your Activities page.