Patient treatment portal · TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab

Your complete treatment reference

Understand the plan. Find what you need.

Medicines, schedule, tests, side effects, daily life, with sources and practical actions.

Open complete patient reference → Explore your 21-day timeline →

Source reconciled; independent clinical, pharmacy and patient/PPI review pending · prepared 2026-10-21

All four medicines are given by infusion on Day 1 of a 21-day cycle, for six cycles before surgery. Surgery findings guide the postoperative treatment. There is no routine take-home chemotherapy pump.

How your medicines work

Taxane chemotherapy

Docetaxel

Disrupts the cell’s division machinery

Microtubules stabilised→Division disrupted→Cell growth affected

Docetaxel stabilises tiny structures called microtubules. Cells need these to separate their chromosomes during division; disrupting the process can stop cancer cells multiplying. Healthy dividing cells are also affected.

Take prescribed steroid premedication. Report fever, lasting numbness, swelling, sore nails or infusion symptoms.

Platinum chemotherapy

Carboplatin

Damages DNA inside cells

Platinum enters cell→DNA links form→Copying is disrupted

Carboplatin creates links in DNA, making it harder for cells to copy and repair their genetic instructions. Its dose depends on kidney function as well as the intended regimen.

Keep blood-test appointments. Fever, unusual bleeding, repeated vomiting or infusion symptoms need prompt advice.

HER2-targeted antibody

Trastuzumab

Targets HER2 growth signals

HER2 on cell surface→Antibody binds→Growth signalling reduced

Trastuzumab binds to the HER2 protein on cells and helps reduce HER2-driven growth and recruit immune activity. HER2 testing identifies the cancers for which this approach is used.

Attend planned echoes. Report breathlessness, ankle swelling, rapid weight gain or infusion symptoms.

HER2-targeted antibody

Pertuzumab

Blocks HER2 pairing with other receptors

HER2 pairing→Pertuzumab blocks pairing→Growth signals reduced

Pertuzumab binds a different area of HER2 from trastuzumab. It limits receptor pairing, so the two antibodies act together at different points on the same growth pathway.

Report diarrhoea early, especially with poor fluid intake. Keep cardiac checks and report infusion symptoms immediately.

Baseline → treatment → follow-up

Tests and milestones through treatment

Columns show sequence, not equal durations or appointments. A test is only complete when performed and reviewed. Echo timing and cancer-imaging timing are different. Symptoms can bring any check forward.

Check	Before starting	Cycles 1–4	Around cycle 5 / week 12	Surgery / next phase	Ongoing / follow-up
Blood tests	Baseline FBC, renal and liver profile	Before each cycle; additional dose checks as prescribed	Continue the required pre-dose checks	Use the selected active regimen’s blood-test schedule	Investigate symptoms / persistent abnormalities
Echo / cardiac assessment	Baseline cardiac assessment	Earlier for symptoms / concern	Echo during neoadjuvant treatment, around cycle 5	Surgery does not restart the echo clock	Agree follow-up for the active medicine and cardiac risk
Cancer imaging / markers	Baseline disease assessment	Clinical response; imaging if concern	Response review as planned; not tied to echo	Before surgery / pathology	Breast surveillance after early treatment
Surgery / radiotherapy	Agree indication and sequence	No automatic concurrent radiation	Coordinate with both teams	Local treatment as indicated	Review recovery and late effects
Endocrine / bone health	Check hormone receptors / fracture risk	Plan endocrine therapy if indicated	DEXA when relevant to bone-risk plan	Endocrine timing by the treating team	Individual DEXA / bone follow-up

The whole treatment journey

TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab: the whole pathway

HER2-positive early breast cancer · before surgery

Read from left to right. Columns show stages, not equal lengths of time. This is a general plan: no dates or personal information are needed. Your team confirms which steps apply and arranges appointments.

On a small screen, swipe the map sideways. The checks below give the same timing in words.

Treatment, tests and reviews across the course
Care / check	Before starting	Cycles 1–4	Around cycle 5 / week 12	Surgery / next phase	Ongoing / follow-up
Cancer medicinesNCCP	Confirm diagnosis and exact regimen	See the dose-day map: use the current regimen and active phase	Echo due; treatment review	Surgery/pathology select postoperative medicine	Review benefit / tolerance and next plan
Surgery / radiotherapyEARLY	Agree indication and sequence	No automatic concurrent radiation	Coordinate with both teams	Local treatment as indicated	Review recovery and late effects
Blood testsNCCP	Baseline FBC, renal and liver profile	Before each cycle; additional dose checks as prescribed	Continue the required pre-dose checks	Use the selected active regimen’s blood-test schedule	Investigate symptoms / persistent abnormalities
Echo / cardiac checksNCCP · ESC	Baseline cardiac assessment	Earlier for symptoms / concern	Echo during neoadjuvant treatment, around cycle 5	Surgery does not restart the echo clock	Agree follow-up for the active medicine and cardiac risk
Scans / tumour markersEARLY	Baseline disease assessment	Clinical response; imaging if concern	Response review as planned; not tied to echo	Before surgery / pathology	Breast surveillance after early treatment
Endocrine / DEXABONE	Check hormone receptors / fracture risk	Plan endocrine therapy if indicated	DEXA when relevant to bone-risk plan	Endocrine timing by the treating team	Individual DEXA / bone follow-up

What each check is for

1Blood testsFBC, kidney and liver profile at baseline and before every 21-day cycle. The team reviews the necessary results before a planned dose.

Check safety before the next dose.

Ask / act: Agree the booking owner, result reviewer and action if overdue.

Sources: NCCP

2Heart testsCheck heart pumping function before starting HER2 treatment. Repeat echo or MUGA every 12 weeks: around cycle 5, then cycle 9 if 21-day cycles stay on time. Earlier checks are needed for symptoms or abnormal findings. Count elapsed time from the first HER2 dose; changing phase or route does not restart the clock.

Monitor pumping function and relevant rhythm risk.

Ask / act: Agree the booking owner, result reviewer and action if overdue.

Sources: NCCP · HERCEPTIN · ESC

3Cancer imagingBaseline breast and nodal imaging, with staging tests appropriate to the diagnosis. Review response during preoperative treatment and before surgery. After local treatment, arrange breast surveillance; routine CT, PET or tumour-marker testing is not the usual screening plan for someone without symptoms.

Assess response or follow-up needs.

Ask / act: Agree the booking owner, result reviewer and action if overdue.

Sources: EARLY

4Bone healthIf the cancer is also hormone-receptor positive, endocrine treatment may form part of the wider plan. Bone-density testing is linked to aromatase inhibitors, ovarian suppression and fracture risk; it is not automatically required because a HER2 medicine is prescribed. Agree baseline DEXA where indicated and individual follow-up.

Assess fracture risk where relevant.

Ask / act: Agree the booking owner, result reviewer and action if overdue.

Sources: BONE

At the next review, ask

Which treatment phase am I in, and what happens next?
Which test is expected next, who arranges it, and who explains the result?
Who should I contact if an expected appointment has not arrived?

This map does not show whether a test has been ordered, booked or completed. Do not wait for a scheduled test if you develop new symptoms.

Open whole-treatment map Printable journey and checks

Day 1 → Day 21: a general pattern

This is a visual orientation, not a prediction of your personal cycle. It shows when some effects often emerge and which effects are not tied to a particular day.

Day of cycle123456789101112131415161718192021

All regimen infusions · Day 1IV

Blood counts / infectionTests and symptoms guide review

Energy and bowel symptomsTiming varies; report changes early

Numbness / tinglingCan accumulate with taxane treatment

Heart symptomsAny time; attend planned echoes

Planned treatment: All four medicines are given by infusion on Day 1 of a 21-day cycle, for six cycles before surgery. Surgery findings guide the postoperative treatment. There is no routine take-home chemotherapy pump.

Heart checks: Check heart pumping function before starting HER2 treatment. Repeat echo or MUGA every 12 weeks: around cycle 5, then cycle 9 if 21-day cycles stay on time. Earlier checks are needed for symptoms or abnormal findings. Count elapsed time from the first HER2 dose; changing phase or route does not restart the clock.

Next phase: After surgery, the pathology helps select the next HER2 medicine. The plan usually aims to complete about one year of HER2 treatment from the first dose. Residual invasive disease may change the treatment. Blood tests and supportive medicines must follow the selected postoperative regimen.

Why these bands stay broad: Treatment markers show the planned schedule. Symptom bands are broad possibilities, not measured risk curves; serious symptoms can occur at any time. Band length does not show likelihood or severity, and the chart cannot tell you whether it is safe to receive treatment. NCCP 00722 v2 · official regimen ↗

There are no guaranteed “safe days”. Fever, shivers or suddenly feeling unwell require immediate contact. Serious symptoms override the timeline or diary.

Practical treatment guide

Your practical treatment plan

STEP 1

Before the first visit

Confirm blood tests, heart assessment, active medicines, route and the consent discussion.

STEP 2

Plan venous access

A cannula, PICC or implanted port may be used. If a port is chosen, a trained team inserts it in a separate procedure with local anaesthetic and sometimes sedation; the team explains fasting, blood-thinner and wound instructions.

STEP 3

Infusion day

Trained staff check and access the line, give the prescribed premedicines and infusions, and monitor for reactions. Tell the nurse immediately about pain, burning, rash or breathlessness.

STEP 4

Home and next review

This regimen does not routinely need a take-home infusion pump. Staff disconnect the infusion; a port is de-accessed when appropriate. Keep line-care and next-visit instructions.

Port insertion and removal

The line team explains placement, dressing care and when normal activities can resume. A port is accessed with a special needle during treatment. Removal of the implanted device is a separate planned procedure when no longer needed; do not remove or adjust it yourself.

PICC care and urgent line symptoms

A PICC usually needs regular dressing and flushing appointments even between treatments. Fever, redness, swelling, pain, leakage or damage requires prompt advice. Your hospital supplies the exact care instructions.

Visit time and transport

First visits can take longer because of loading doses, premedicines and observation. Ask the unit about expected time, transport and any escort needed after sedation or line insertion.

Open practical treatment guide · Printable practical guide

Sources: NCCP 00722 v2 · official regimen · eviQ · implanted port patient information · eviQ · PICC patient information. Source reconciled; independent clinical, pharmacy and patient/PPI review pending.

Regimen-specific symptoms

Recognise symptoms and act early.

A picture of side effects

Numbered symptom boxes connect to the anatomical illustration. The medicine responsible may be uncertain; report the symptom.

1Hair / scalp

Docetaxel

Hair loss is expected with docetaxel. Discuss scalp cooling where appropriate and hair / scalp support.

3Breathing

HER2 treatment

New cough or breathlessness needs prompt assessment.

5Bowel

Pertuzumab / docetaxel

Report diarrhoea promptly, especially with poor intake, fever or dizziness.

7Blood / infection

Chemotherapy and the whole regimen

Fever, shivers or suddenly unwell: contact oncology immediately.

Full-body anatomical illustration with numbered symptom locations

12345678

2Mouth

Chemotherapy

Painful ulcers or difficulty eating and drinking need advice.

4Heart / circulation

HER2 treatment

Fainting, chest pain or severe breathing difficulty: urgent help. Keep scheduled cardiac checks.

6Nerves / joints

Docetaxel

Report numbness, tingling or difficulty with buttons or walking before the next dose.

8Skin / liver symptoms

Treatment medicines

Severe rash, blistering or yellow skin/eyes needs prompt advice.

Selected effects, not every possible effect or a prediction. Blood-count, skin and line markers are schematic. Number and text carry meaning; colour is decorative.

Docetaxel

Low blood counts, infection and sepsis
Hair loss, mouth soreness and fatigue
Numbness / tingling; sometimes lasting
Fluid retention and nail changes
Allergic infusion reaction

Carboplatin

Low blood counts, infection and bleeding
Nausea, vomiting and fatigue
Allergic reaction, sometimes after previous exposure
Kidney or electrolyte changes

Trastuzumab

Heart pumping-function reduction / heart failure
Infusion or allergic reaction
Diarrhoea and fatigue
Rare serious lung effects

Pertuzumab

Diarrhoea and dehydration
Infusion / allergic reaction
Heart pumping-function reduction
Rash and fatigue

Support around treatment

The correct supportive prescription

Follow the script for the active medicine, route and treatment day. Do not carry chemotherapy anti-sickness medicines automatically into an antibody-only phase.

Tests before treatment

FBC, kidney and liver profile at baseline and before every 21-day cycle. The team reviews the necessary results before a planned dose.

Keep heart checks on the plan

An echo every 12 weeks is separate from blood tests or cancer imaging. Ask who books and reviews it.

Plan for symptoms

Keep your agreed contact numbers and instructions. New symptoms can need assessment before a routine appointment.

Do not wait for the next appointment

Emergency: 112 / 999. Severe breathing difficulty, collapse, seizure or severe chest pain needs emergency help.

Contact oncology immediately for temperature ≥37.5°C or ≤36°C, shivering or suddenly feeling unwell, even with a normal temperature. Follow your own hospital’s instructions. If you cannot reach the team, seek urgent medical assessment.

Your oncology team · daytimeInsert numbers here

Acute Oncology Service

Your oncology team · out of hoursInsert numbers here

Ask for medical oncology

Evenings / overnightYour out-of-hours pathway / nearest ED

Other hospitals: use the numbers your team provides.

Report new breathlessness, chest symptoms, severe diarrhoea, dehydration, jaundice, unusual bleeding or sudden illness promptly. Do not wait for the next planned test.