Perjeta is my friend, and cutting edge meds. I admit to having Big D, awful at times BUT it was mainly what I was puttin in my talk hole! It can be controlled with diet and meds, right? Still better to have some D than cancer. Now, the first 3x, I also suffered crippling nausea, which sucked like nothing else...BUT. I still would keep Perjeta, as it can also me managed. Full disclosure, not sure my issues were all due to Perjeta, could be any of the other three.