Help with chemo tx plan!!!!

Tonya36

Saw oncologist for the first time today.  I am so confused.  His recommendation is Taxotere and Carboplatinum every 3 weeks for 6 tx.  He says recent studies have show that the "A" chemos are not as effective on her2 neu negatives.  Has anyone had this specific regimine?  If so how were the results?  He did tell me that I can take the dose dense but it will be epirubicin/cytoxan x4 then 12 weeks of taxotere but that it would be much harder on me, I won't be able to work, and that he thinks the T/C regimine is just as effective.  He also threw out there that since my tumor was 3cm that I should think about possibly having radiation on my chest wall just to be sure but that is a precautionary measure.  He has only been giving this Taxotere/Carboplatin for the past few months so cannot even tell me how well it works.  I don't know what to do.  I keep thinking that I need to be aggressive and take a shot at the dose dense but I have to work to keep my insurance because fmla only lasts 12 weeks.  Then again I don't want to choose the other cocktail just  because of money.  I don't want to die because I am poor.  Its hard being single and trying to make the right decisions.  I am not a doctor.  I want cold hard proof as to what has the best chance of keeping me alive and NED.  ITS MY LIFE and Lord willing I would like to keep it.  I sure don't want to make the wrong decision. If anyone has any advice or can help me in any way I would really appreciate it.  I am borderline tears and anger right now.  I wanted it to be cut and dry of what my treatment would be.  I assumed it would be like everyone elses.  I just want to live yet I feel like I don't know how anymore.  Thanks for listening.

jeanne46

Tanya,

Is it possible you can get a second opinion?  I don't know where you live, but if you can get into a major cancer center, medical personnel there tend to be well-informed on recent data and trial info. It might also make it easier for you to make a decision.  Like you said, you are not a doctor, and in order to make an informed decision, you need as much information as possible as to your options.

Best of luck to you

Jeanne 

FloridaLady

Hey Tonya,

I know you don't want to hear this, but...maybe you should get a 2nd opinion.  Most of us girl's do use Adrain. the first go around, but it is a harder chemo to work through.  Hey! but I did it all but the last two or three weeks I went part-time.  My thought for you for what it worth...Taxotere & Carbo are both good drugs, and if there good enough to treat a recurrence, than why are they not good enough for the first go around?  You can see other ladies on the "recurrence" thread that are using this combo for much more advance cancer than yours.  Praise God your's was found early.  About radiation...I have good and bad feeling's about them.  Just put it this way...the more I hear the less I believe and them. 

Here is finding the answer that you can live with...and work's best for you.

Flalady

chumfry

I've had triple-neg breast cancer twice, once in 2005 and once in 2007. For the first one, which was medullary, I had mastectomy and received four dose-dense AC treatments, followed by four dose-dense Taxol. I don't think anybody was using carboplatin in 2005, but I could be wrong.

In 2007, they found a second primary (IDC) unrelated to first tumor. Another mastectomy, but no more AC because of the cardiac risk. Had 12 weekly infusions of Taxol and Carboplatin. I tolerated the weekly treatments MUCH better than the every-two-week schedule.

Not sure if my info helps you much. I know they often use Taxol and Carbo for triple-neg mets. So I'd think it's a viable option for the first go-around. From what I've heard, the combo is potent. I had no nausea or pain, just incredible exhaustion. That may be less on the every-3-week schedule.

--CindyMN

LisaSDCA

Hi Tonya - Your tears and anger are certainly understandable. These decisions are really tough and there is probably no one right answer - we just don't get offered "cut and dried".

 I will just give you my opinion as someone with a diagnosis nearly identical to yours, also single. I had TACx6 (taxotere, adriamycin and cytoxan). This is known as a very difficult 'cocktail. If I had been offered the Taxatere/Carboplatin, I would have jumped on it - the 'platin' drugs have been shown to have good efficacy in triple negatives. Even though your oncologist has only been using this for a short time, it has good history and research behind it. It is a plenty aggressive treatment - a third generation regimen - though less toxic to your heart.

As far as working, this TC treatment may make that possible. Any therapy with Taxotere is going to be no party - it's a pretty debilitating drug for many women - but eliminating any Adriam. will make it far more tolerable, in all likelihood. OTOH, while some women make it through chemo only taking off a day or two on treatment weeks, others simply can't keep working after the cumulative effects set in. You won't know until you get those drugs into you -  neither does your MD or anybody.

Besides FMLA, you do have protections under the ADA, so your job should be secure even if you have to take a leave of absence. COBRA should also be available to keep you insured. You might want to have a discussion with your HR person to discuss your options. If you work in a small business, your protections may be different.

I am a bit surprised about your onc. mention of possible rads. Was your tumor right next to the chest wall? If your pathology came back clear after your bilat. mastectomies, with nice clear margins and no evidence of tumor, rads would not generally be indicated in node-neg. disease. I am concerned because it can make your ultimate recon. with implants problematic, dealing with irradiated skin. Just a thought... I know this is off in the future, if at all.

Best wishes to you as you make these decisions. These are some of the toughest days, psychologically. Once you get your treatment underway, you may find it a relief.

Lisa

Analemma

I know you have asked for information for your adjuvant therapy, but I'm one of the mets ladies whose 3neg was knocked into NED with 6 doses of carboplatin and taxotere.  Just wanted to chime in.  I had 4 A/C plus 4 taxol the first time around, in 2005, dose dense.

I found the second time (every three weeks carbo + taxotere) tougher than the first time.  Could be that I'm older, and have had some other issues in the interim, but it was hard.

I would suggest you hop over to tnbcfoundation.org and see what the ladies there are saying, too.

defeatbc

Hi Tonya.

Many more of us "newbies" are getting the Taxotere+Carboplatin combo.  Myself and CaNatalie, are to name a few members.  It is especially effective on Triple Negative type breast cancers.  Carboplatin is a platinum chemo.  If you read up on platinum, you'll see that there is research that shows those types of chemo's are great if you're tri-neg.  Also, this combo is less likely to give you other serious problems, such as heart damage.

I totally understand your frustation.  I'm 31 years old, want to live to see my toddler grow up, and to grow old with my spouse.  Cry every day about having cancer... currently taking Ativan to help with my anxiety and chemo.

Let us know which chemo you go on.  You will be fine.   We will beat this.

-- defeatbc