Cytoxan and Taxotere ?

OtraVez

My onc has given me benedryl with every Taxotere treatment. I haven't had any allergic reactions, but it puts me right out everytime. I figure that sleeping is a good thing, as the decadron that I begin taking the day before - or maybe, it's just nerves, I'm not sure which - keeps me awake the night before. I guess my sleep quotient gets evened out that way!

yankeedownsouth

I had TC when I went through chemo. Four rounds, 21 days apart. My onc recommended it due to my early stage and the lack of cardio issues. It was hard, my doses were high, and my side effects were difficult. But I made it through and feel great now.

I've since switched oncs to a great breast cancer specialist, and she confirmed this was the correct treatment for me. She said triple neg especially responds to this treatment. Yeah!

MelanieW

I am curious as to why AC and then after that is done Tax is given. Why not do it all at once like I am doing (6 rounds). I intend on asking my onc the same thing, but I won't see him again until next week right before my 2nd chemo. Just curious...

ghw123

yankeedownsouth, you give me hope. I have two TC treatments to go, the next one this Friday, 02/23/07.
Gayle

yankeedownsouth

Quote:

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yankeedownsouth, you give me hope. I have two TC treatments to go, the next one this Friday, 02/23/07.
Gayle

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You can make it through!!!

hockeymomfl

Hi Ladies,
Just back from TC treatment number 2.
When I got treatment number 1, I had a reaction to the Taxotere, normal they said as it is a highly allegenic drug. They stopped the transfusion and gave me steriods, saline etc and it went fine after that.
In prep for today's transfusion I took 3 steriod tabs last night, 3 this morning, Then had more steriods at the onc office, zofran, benedryl and then they started the Taxotere. Well within a minute I had a worse reaction than the last time. My neck, face and ears went bright red and I could not breath well. They stopped it and immediately my color started to go down. They gave me more steriods and saline and said that they would stop for the day and the Onc will revisit my situation on Wednesday.

Any one else have such a severe reaction?
Would love your input?
G.I. Jel

NOLONGERREADINGORPOSTING

Sorry you had to experience this!!!!!

Allergic reactions do happen to some people. I was lucky and got no allergic reaction, but it sounds like you got a severe one. I think they're going to have to find another combination for you. I think AC is used interchangeably with TC and has about the same success rate.

Good luck!

hockeymomfl

Thanks Mizsissy,
Yes it was very scary...... They said people get it the frist time, but generally not the second.
I really don't want the AC as I have heart issues on both sides of family and am concerned about the effects of the A.
Will see what they say on Wednesday.
Thanks,
G.I. Jl.

hockeymomfl

GHW1,
Have you had any other reactions to the TC??
Or have you not yet completed the second on?
Would love to hear how you are getting on.
G.I. Jel

ghw123

hockeymomfl, my first treatment was uneventful, but I was given the steroids in my IV. I was given a steroid script for the second treatment, one tablet in the morning and one at night beginning the day before chemo, then for two days afterward. The reaction happened right after they began the Taxotere. I heard my onc say to one of the nurses that the dosage I got from the tablets was not strong like what I had been given previously in the IV. I don't know why they changed it, anyway when I go in on Friday for my third treatment I'm going to ask about it, if they won't give me the strong dose in the IV, then I will tell them to knock me out with Benedryl. Here's hoping for uneventful again this time. Hope everything gets settled for the best for you.

Gayle

NOLONGERREADINGORPOSTING

Hi Hockey Mom,

I do hope your second round goes better. Maybe if they prep you with lots of intravenous benadryl. A calm emotional state helps too. Taxotere has been working great for me and I am a very *allergic* person.

I understand your fears of AC...I was almost ready to forego treatment rather than deal with heart problems; I've already had an ablation and I'd rather have BC than go back to a constant fear of arrhythmia.

You could also consider CMF, that is a good regimen that is easy on the heart, if the taxotere does work...good luck!!

Mizsissy

hockeymomfl

Thanks Gayle and Mizsissy,
They prescribed three steriods tablets the night before treatment, 3 tablets the morning of treatment, IV steriods the morning of treatment, with benedryl, zofran and saline and I still had a reaction. Then after it they gave me more steriods. I had 4 doses of steriods within a 12 hour periods. I feel like Aronold today.
I thought CMF also caused heart issues?
Will see what the onc has to say tomorrow.
Thanks again for your support.
Will let you know how I get on.
Jel.

LisaSDCA

It's looking like I'll be having a TC schedule prescribed beginning in early March, so I am grateful for the experiences you all have shared. For those who have had oral steroids, was it Decadron? Dexamethasone is the generic name.
hockeymomfl- looking forward to hearing what your onc. says about this. So sorry you had to endure such troubles - as if the chemo itself were not enough!?!
ghw123 - isn't it amazing about the $8000 per shot for the Neulasta?!? I mean, I know pharm companies need to make back their investment on research for new drugs, but dang, this is criminal!
Lisa

NOLONGERREADINGORPOSTING

Yes, I had decadron. It actually charges you up and make you feel ready for anything, even chemo.

It's actually $3700 per shot for neulasta; that's was I was billed. Or you can having daily Nuepogen shots given a nurse or yourself at home for $237. Usually 6 x 237. The advantage of the Neupogen is that isn't doesn't give you the severe muscle acches that Neulasta does.

ghw123

Lisa, my script is for the generic of Decadron. I start with it again tomorrow morning.
It sure is criminal how these drug companies charge such ridiculous prices. I call Neulasta "liquid gold".

Gayle

mamak

Hey, Spiffy Iam new to the board. But i have had my taxotere 4 cycles first than the a/c. on the 26th of feb will be my last treatment and boy will i be glad. the A/c was much harsh on me than the taxotere. Iam just glad to be through that and to move on to the next phase. SURGERY. don't know what to expect can anyone help me. We are trying to save my small breast.

Lynn12

Lisa,

I have the generic for Decadron, take 2 the night before and 2 the morning of my TC treatment. My IV premeds are Decadron and Zofran. I don't have Naulasta or other shots because my treatments are 3 weeks apart so my body recovers the blood counts without the shots.

Good luck!

Lynn

hockeymomfl

Hi,
Have not heard from Onc yet, but I had Decadron before treatment.
Will keep you updated on what's next.
Jel

irelandmb

I had the mastectomy. Just as a peace of mind thing for me.
It is doable. Just have to take each step at a time.
Best of luck with your decision.

JeanLouise

The package insert says that the steroid should be started the day before taxotere, but my onc never had me do that. Even when I specifically questioned him about it. I had lots, lots of sinus problems from my taxotere treatments and will always wonder if they could have been lessened if I'd received the steroid like I was supposed to (to reduce inflammation).

I also had lots of muscle pain throughout my chemo months. The chemo nurse was very familiar with that as a side effect but my onc acted like I was imagining it.

NOLONGERREADINGORPOSTING

I amazed that your oncologist never told you how to prep properly. The Decadron really builds you up and prepares you for chemo....it helped me a lot.

The quality and variation of medical practice in this country is shocking, especially when you consider all the risks you take with chemo!!!

Glad you survived!

Anonymous

I'm new to board since yesterday. I'm scheduled to have my 1st TC chemo on 3/15 and want to be informed before I start. I had a lumpectomy on 2/8 with sentinel node biopsy. The tumor was larger than originally thought (2 centimeters vs 1.1), Grade II. No cancer in lymph nodes or surrounding tissue. Also results came back that I'm ER Positive, PR Negative. Oncologist did not want to do Oncotype testing due to size of tumor and that I'm PR negative. He wants to do 4 treatments of TC (one every 3 weeks) followed by 7 weeks of radiation. He also explained that I would be giving myself an injection the day after treatment. The HER2 results were not back when I met with him this Monday. I was disappointed that I need chemo but he strongly belives that as a healthy postmenopausal woman of 58, treating this aggressively is important. I have been taking Effexor 75mg for the last 3-4 years. Has anyone been on this med while taking chemo? What should I expect for my first chemo treatment? I hope to continue working during all of this but do have available sick and vacation time if needed. There is no history of cancer in my family and this is all new to us. I do live alone but have family and friends close by. Thank you for any info you can provide.

Bernadette

ghw123

Bernadette,
I am doing TC also. I know it's rough thinking about your first treatment, but after you get the first one down, it really does not seem as scary. I work, and while some days are not so good, most are.
Wishing you the best,
Gayle

mkl48

Hi,
Do most people get neulasta for both AC and T? Beth

OtraVez

I got neulasta and arenesp shots(for red cells) for AC and T(with Herceptin), along with Emend and Zofran (IV premeds and pills for home). For tax, I take 2 decadron pills twice a day for 3 days, beginning the day before,
along with the Emend, and get decadron, benedryl, and zofran by IV before the tax and herceptin. My onc also has all of his folks on IV for a second day, with additional anti-emetics and saline. He said that cytoxin sometimes causes kidney or bladder trouble, and the extra IV is more effective at flushing our systems than depending on patients to drink enough water.:)

NOLONGERREADINGORPOSTING

Hi Bernadette,

Most people get AC, which is about $300 per infusion, vs $2400 for TC...so count yourself lucky!

My diagnosis was almost identical to yours in terms of tumor size, aggressiveness, clear lymph nodes; mine was ER+ and weakly PR+.

I am taking 4 doses of taxotere + cytoxan, two weeks apart, dose dense. According to research, this is I think the most effective regimen for our type of cancer, and results in the fewest recurrences. It is also gentler than AC and some of the others. I've had 3 infusions, one more to go, and I'm doing fine.

I am also taking an SRI (prozac), it is not an SNRI like yours but closely related. Many women take SRIs while on chemo; in fact, many are presribed SRIs to get through chemo. They will also be prescribing short-term sleep aids like Ativan, anti-nausea drugs. Generally, chemo is much more of an advanced art than it used to be, and they'll keep you in good shape.

My advice to you is to keep yourself in the best physical shape as possible during chemo. Drink LOTS of water. Exercise every day if possible, even if it just a short walk. Eat only healthy food (fresh meats, fish, veggies, etc.). Avoid junk food...you probably will lose your taste for it anyway. Getting your blood circulating is good. Days 3 and 4 will be the worst. On those days just pamper yourself, sleep, watch TV, take bubble baths, don't try to cook or do anything productive. Just rest and heal, and then you'll recover quicker. By Day 5 or the second week after infusion I felt pretty good.

Get exercise, but stay rested and don't overdo, and it will be overwith before you know it.

One other thing: have you considered the OncotypeDX test? This is a predictor of recurrence that is supposed trump all other factors--tumor size, grade, etc. About half of the women who take this test get a low score and can forego chemo; unfortunately I didn't. I highly recommend you have this test before you undergo chemo, because chemo isn't really good for you unless it's necessary.

You can find more about the oncotype test elsewhere on this website or at www.genomichealth.com

Good luck!!!

Mizsissy

Anonymous

Thank you Gayle and Mizsissy for your replies. Its comforting to know that I'm not in this alone.

Mizsissy, my oncologist told me that the OncotypeDX test was not for me due to the size of the tumor and the PR Negative status. I've since checked info on the web and found that there is a clinical trial TAILORx that would be available to me except that I do not meet their parameters as I'm PR negative. I really wanted to have that testing just to validate the need for chemo. I believe with the clinical trial that you have to score below 11 for not to need the chemotherapy. My daughter is helping me with questions to call the doctor before my 1st treatment. What is so unsettling is that I look and feel much younger than my 58 years and my health has been excellent up to present. Sometimes wonder how many of us were on hormone replacement therapy for a number of years. I took them for about 8 years and stopped in 2002 when they had the scare regarding the heart.

Thank you again for your valuable comments.

Bernadette

NOLONGERREADINGORPOSTING

Hi Bernadette,

Wow, we have so many similarities. You know, I also took HRT and I think this may be why I got the beast. My mother was DES too. Do you know that I am also 58 years old!!! Also, I happen to feel a lot younger than my age. Where do you live?

OK, maybe you do have to do chemo, but the TC regimen is a good one and it adds some insurance.

Keep me posted on you progress, send a PM if you like, makes it easier to stay up to date with you.

Mizsissy

ghw123

Yes! I got thru my 02/23/07 TC a-ok. I took Emend (wonderful drug) then was given steroid via IV, then Benadryl, also via IV. Only a very slight reaction from Taxotere this time, felt a little flushed for just a minute. Got my Neulasta (liquid gold) the next day. Got my 10 day after chemo blood work done yesterday, and the Neulasta (liquid gold) is doing its job. My CBC is fantastic!
Now it's on to 03/16/07, my 4th and final TC. Praise the Lord!

tarap3

Wow,Just read through this thread and had lots of questions answered. Just found out today that this is what my onc is prescribing for me. I am stage 1, grade 2 with no node involvement, but IDC,DCIS,ILC and LCIS so many things going on in there. I had my bilateral mastectomy on 2/20, so will be starting the chemo on 3/02. Any body else starting at this time? THe thing I am most worried about is the continuing pain from my tissue expanders and not being able to take any pain meds with tylenol or ibuprofen. My onc won't let me take these b/c of the risk of masking an infection.
Any other tips or advice will be greatly appreciated. I will be having 4 cycles, every four weeks.
Thanks,
Tara