Stage 2a needs help with chemo decision

pennylane

Hi I am 4-years out and now am seeking help for my cousin.  She has just finished surgery and we are all so confused with the chemos being offered now just 4 short years later.  (I only had the A&C)...My cousin is Stage 2a, hormone+, her2-, grade 3, a small 11mm tumor, and yet 2 lymph nodes involved.  She has gone to several Drs and has heard about TAC, just T&C, and even some clinical trials...She is still pre-menopausal and is very vibrant and physically fit.  We would so appreciate any input on this and perhaps you can share how you made your final decision...Thank you all so much....P

cp418

For what it's worth I was dx 4/2006 same as your cousin stage 2A hormone +, Her2 -, with one positive sentinode.  I had lumpectomy followed by 4 DD A/C and 4 DD Taxol, then rads.  I recall visiting this site and my fellow 2006 sisters all got similar chemo regimens.  However, the medical reserach is always modifying these chemo regimens looking for the same or better efficacy with less toxicity.

A friend of mine was dx the following year 10/2007 with nearly identical dx as me - - the same medical center had now modified the chemo regimen and she recieved only 4 DD T/C followed by rads.  Frankly I was jealous that she only had 4 when I had 8, but I think in some instances they are moving away from Adriamycin due to the cardio toxicity.  Her medical hx may have been an issue as to why she did not recieve it.  However, the point I am trying to make is that I see more and more ladies getting an abbeviated chemo regimen.  You can probably do some google searches looking up the research for this revised regimen.

dlb823

pennylane ~ I went to 3 oncs and had 3 different opinions on what to do (AC+T, TC & no chemo).  I decided on TC x 4, which was UCLA's recommendation, after viewing a video presentation by my onc @ UCLA that reviews the history of chemotherapy for breast cancer and where we are today with it.  It's full of graphs and charts showing survival comparison stats from recent trials, and explains why Adriamycin may not be right for everyone.  PM me if you'd like a link to it for your cousin.   Deanna   

Marion

Hello pennylane,

Just like your cousin, I had a small tumor (1.3 cm), had lymph node involvement, was pre-menopausal, physically fit, and active.

I got 4 rounds of Taxotere and Cytoxan. I did fine while on this regimen but now I'm menopaused (or "chemo-paused")  and 15 pounds heavier. I would like to think that the steroids they gave me during chemo are to blame for my weight gain... My last chemo was on Nov. 27th 2009 and I still have a few pounds to shed and still no periods. I hope to get my fertility and my body back soon...

My oncologist also talked to me about clinical trials, especially the one about bone drugs such as Zometa that help prevent recurrences. I started taking Zometa 2 months ago. 

Good luck to you and your cousin!

ruthbru

Have her ask her doctor to go on www.adjuvantsite.com(a website for physicians) and type in her statistics with different treatment options. This computer program will calculate the risk of relapse and benefits of the various therapies based on her specific information. I am three years out (this month ), so things have changed, I'm sure. I had a bigger tumor (3 cm), but no lymph node involvement); did 4 rounds of AC, radiation & Arimidex. I didn't gain any weight, in fact lost a few pounds, due mostly to the fact that I exercised like crazy. Good Luck!

Marion

Just like dlb823 advised, your cousin should get a second opinion. Just like she did, I went to see another oncologist.

The 2nd oncologist I saw prescribed the same regimen (4 rounds of Taxotere & Cytoxan, no rads) based on my tumor and oncotype score. Both oncologists even talked to me about the same clinical trial (zometa) !

The fact that both oncologists prescribed the same treatment reassured me.

havehope

I had stage 2A, no nodes involved but grade 3 which is not good. I did 4 FAC and 12 Taxol (wkly). The higher the grade the higher chance for the tumor to spread in the body so I wanted the strongest chemo they could offer me. I was told I will reduce my change of recurrence with 40 %. I took the chemo. 

gofish185

Your cousins dx is the same as mine. I had a lumpectomy Mar. 12th. Drs. initially advised me to have ac and t, rads, and tamoxifan. Just received my oncotype dx results and scored a ZERO for distant recurrance. Now none of the Drs. or I know what to do. The test indicates no chemo but tumor grade and age say chemo. What a decision. Has your cousin been offered this test, it may help with her decision on chemo and what drugs. If anyone has had a similar situation please let me know. Good luck to you both!

pennylane

Hi Gofish...My cousin did the oncotype test, and as expected her score was not low.  Today she just finished her fourth round of AC and in two weeks will start the T part of the treatment.  She did great during these first four rounds (knock on wood) and I'm hoping the next four will be easy on her.  Four years ago I only did the 4 rounds of AC and had a miserable time so I'm glad someone in our family is doing this bc thing smart and cool and tough.  Sounds like you will have a difficult time making this chemo decision....some very conflicting information in your stats....Yet please remember you are early stage and so things should work out for you no matter what you decide.  And wow, that oncotype "zero" sure is encouraging for your prognosis...I guess at this point it is time to ask several of your Dr's what they would do if they were in your shoes....Stay strong and sure...Wishing you all the best, P.   

rainstormo

I'm 2 weeks post op from a lumpectomy 1cm tumor w 2 pos lymph nodes so I'm 2a  est. and pro positive and her 2 neg.  I'm 48 fit and premenapausal.  Today my oncologist suggested 2 routes one TAC 6x for 18 weeks (every 3 weeks)  The other option was DD AC-Taxol  8x every 2 weeks.  I have 3 kids 8, 10, and 12.  She said they were equal for me so now I have to figure it out.  She didn't mention not doing Adriamycin.  Should she have?  I'm worried about the chance of neuropathy with the DD but she said I'd feel better probably on that one because it affects the white blood cell count less.  So ok I'll lose my hair, be in menopause either way not sure which to do?  Also what is the oncotype dx test and how do I take it?  Thanks for all the discussion!

DiDel

The Oncotype DX test is a genomic test on your tumor. It looks for certain genetic markers and assesses the risk or recurrence and the likelihood that your cancer will benefit from Chemo.I had to sign a separate consent form before surgery to have hospital send sample of my tumor to them. My doctor ordered it and his office got all the insurance approval prior to remitting the sample. You can go to there website oncotypedx.com  to see how it works.