Acute Oncology Service
SACTCheck · treatment passport
TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab
A record of what you experience
One cycle per page. Each medicine has its own symptom table. Mark the worst symptoms since your last review, when they occurred and what they stopped you doing. Overlapping symptoms can be recorded under more than one medicine; you do not have to identify the cause.
These are patient-language severity prompts, not a validated questionnaire or a formal CTCAE grading tool. Your team assigns the clinical grade. Serious symptoms override the columns: call without waiting to decide a severity level.
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.
The four pages are reusable recording sheets, not a prescribed four-cycle course. Ask for additional sheets as needed.
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.
Ask for medical oncology
Other hospitals: use the numbers your team provides.
Your own hospital / contact instructions:
https://sactcheck.com/patient/00722/
Full patient information, sources and visual timeline. No identifiers are encoded.
Source reconciled; independent clinical, pharmacy and patient/PPI review pending
NCCP 00722 v2 · one cycle, one page
TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab
Cycle number: __________ Start date: __________ Next review: __________
Current regimen · reusable cycle record · copy this sheet for another cycle of the same phase.
Docetaxel · Taxane chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Numbness / tingling | □ None | □ Mild change; usual tasks unaffected | □ Limits buttons, writing or walking: call | □ Washing, dressing or walking difficult: urgent review | □ Sudden major weakness / paralysis: emergency help |
| Mouth soreness / ulcers | □ None | □ Mild soreness; eating normally | □ Painful; soft food needed: call | □ Cannot eat / drink enough: urgent review | □ Major breathing difficulty: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Carboplatin · Platinum chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Bleeding / bruising | □ None | □ New small bruise / brief bleed: report | □ Repeated bleeding: call today | □ Bleeding that will not stop: urgent help | □ Heavy bleeding / collapse: 112/999 |
Trastuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
Pertuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.
NCCP 00722 v2 · one cycle, one page
TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab
Cycle number: __________ Start date: __________ Next review: __________
Current regimen · reusable cycle record · copy this sheet for another cycle of the same phase.
Docetaxel · Taxane chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Numbness / tingling | □ None | □ Mild change; usual tasks unaffected | □ Limits buttons, writing or walking: call | □ Washing, dressing or walking difficult: urgent review | □ Sudden major weakness / paralysis: emergency help |
| Mouth soreness / ulcers | □ None | □ Mild soreness; eating normally | □ Painful; soft food needed: call | □ Cannot eat / drink enough: urgent review | □ Major breathing difficulty: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Carboplatin · Platinum chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Bleeding / bruising | □ None | □ New small bruise / brief bleed: report | □ Repeated bleeding: call today | □ Bleeding that will not stop: urgent help | □ Heavy bleeding / collapse: 112/999 |
Trastuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
Pertuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.
NCCP 00722 v2 · one cycle, one page
TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab
Cycle number: __________ Start date: __________ Next review: __________
Current regimen · reusable cycle record · copy this sheet for another cycle of the same phase.
Docetaxel · Taxane chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Numbness / tingling | □ None | □ Mild change; usual tasks unaffected | □ Limits buttons, writing or walking: call | □ Washing, dressing or walking difficult: urgent review | □ Sudden major weakness / paralysis: emergency help |
| Mouth soreness / ulcers | □ None | □ Mild soreness; eating normally | □ Painful; soft food needed: call | □ Cannot eat / drink enough: urgent review | □ Major breathing difficulty: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Carboplatin · Platinum chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Bleeding / bruising | □ None | □ New small bruise / brief bleed: report | □ Repeated bleeding: call today | □ Bleeding that will not stop: urgent help | □ Heavy bleeding / collapse: 112/999 |
Trastuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
Pertuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.
NCCP 00722 v2 · one cycle, one page
TCHP: docetaxel, carboplatin, trastuzumab and pertuzumab
Cycle number: __________ Start date: __________ Next review: __________
Current regimen · reusable cycle record · copy this sheet for another cycle of the same phase.
Docetaxel · Taxane chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Numbness / tingling | □ None | □ Mild change; usual tasks unaffected | □ Limits buttons, writing or walking: call | □ Washing, dressing or walking difficult: urgent review | □ Sudden major weakness / paralysis: emergency help |
| Mouth soreness / ulcers | □ None | □ Mild soreness; eating normally | □ Painful; soft food needed: call | □ Cannot eat / drink enough: urgent review | □ Major breathing difficulty: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Carboplatin · Platinum chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Bleeding / bruising | □ None | □ New small bruise / brief bleed: report | □ Repeated bleeding: call today | □ Bleeding that will not stop: urgent help | □ Heavy bleeding / collapse: 112/999 |
Trastuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
Pertuzumab · HER2-targeted antibody
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.