Taxotere is a nightmare

tracie23

Hi Girls, I went to Curves today. I loved it !!!! I was so out of breath by the time I was done... I had to take a lot of rests during the work out but I did it. The crazy thing is I have been trying to eat well  all week and I have gained 3lbs... uuugggghhhh On Monday I am going to have them weigh and measure me and start the week off right.

Lego: I am soooo craving chocolate.... but I am trying to restrain myself  sugarfree pudding with coolwhip is a good treat.

Survivorwoman

Thank you Tracie, Pejkug3, SAMayoFL, SpecialK, TonLee and Shooshoo for also welcoming me home from the hospital. I am really happy to have you all in my life. I thought about you all in the hospital that you are my family here, as I have none in the US. I was sure that some of you would be worried, too. Thank you all for making me feel good and loved.

Quick update: I am feeling much, much better. I even went to work for a few hours. And I still have a good appetite that I am very happy about b/c I lost a lot weight during chemo. I went form a size 10 to a 5/6.  I just did not feel like eating much, and as the cycles progressed, I was only able to tolerate soups practically. Besides raw foods gave me diarrhea all the time, so everything needed to be cooked. I had to eat canned fruits if I wanted friuts.I could not wait for the day to eat a raw apple or a pear. So, I am very excited that now, I am able to eat some raw things, too. I am slowly introducing them to my stomach.  Right now I am craving a spinach salad, but I don't think my stomach is ready. Maybe in a week or so.

Tracie- aren't you pushing yourself a bit too hard to do workouts? You just finished chemo not too long ago. Now, you are making me worry about you a bit, too.  

marjie

Yay Tracie!!  Good for you

I am going to my first practice of the season tomorrow morning.  I am so excited, but a little nervous too.

Survivorwoman - you sound like you are definitely feeling better, I am glad.

SpecialK

suvivorwoman - where are you from originally?

pejkug3

Glad that you're feeling better, Survivorwoman. 

All:  Hope you have a good weekend!

Beeb75

Hi Ladies,

Haven't posted on this thread before, but I just finished 3 rounds of Taxotere. (I started with Taxol, got a rash, and my onc switched me..) Taxotere is tough! Not my favorite. Taxol was much easier. Anyway -- my question for you is...when do I get my taste buds back? I miss them.

Trisha-Anne

I saw my Onc yesterday - he was on leave last time I was in and saw his registrar.  He has given me some great news.  Because I've had such a bad reaction to the taxotere I don't have to do my last treatment!  YAY!!  I'm so happy.  We did go through all the options, and I'm very comfortable with the decision.

He said the thing that is going to save my life is the Herceptin, and I'll be continuing with that.  He went to the conference in the States last year (San Antonio, I think?) and said that one of the things discussed there was the efficacy of 4 treatments v 6 treatments.  I've 5 out of 6 treatments, so he's confident that missing the last one won't cause any problems. 

I finally feel like I'm getting my life back - I'm doing Lago's happy dance too, and I can't stop smiling.  I actually feel like I've got a bit of a spring in my step now.

I'm so sorry to hear about you Surviorwoman - you have been through a nightmare - but glad you are feeling better now.

Hugs to you all

Trish

lago

Hey Beeb75 nice running into you here. Taste thing wasn't too bad for me although it did last longer each round. By the 6th round I had weird taste for about a week. It wasn't to bad for me though. Things just got really bitter tasting. Pepper really tasted crappy. I never got that metallic taste.

Trisha-Anne congratulations on finishing. Yes you too need to do the happy dance.

Anniemomofthree

Trisha-Anne - good news on your finish!  Congrats

Lago - how are the fingers today?  I think about your little nails every day.  You have done so much to educate us all on the process. So thankful!  When did you notice the changes initially? 

Hoping everyone has a great Saturday!

Omaz

Trisha-Anne - Congratulations on finishing chemo!!  I also did 5/6 because of neuropathy and I saw the abstract about 4 vs 6 afterwards (link to summary).  It is nice that your onc actually told you, mine left it up to me to decide.

Anniemomofthree

Omaz - THANK YOU for the link.  That is so interesting...anyone seen a similar study in TCH?

lago

Omaz I wish I had that article earlier. I would have loved to stop at tx4. I bet my nails & stiffness wouldn't be so bad and I know for sure the numbness in my left heel would be gone by now.

Anniemomofthree some nails I think are growing out. I do have one that is very lifted and another that might also start to really lift but the discomfort is getting better. I am starting to do more with my hands. My other large toe nail is lifting now but my podiatrist is keeping an eye on it. Hopefully we won't have to remove that one like we did the other. Thanks for asking.

Tracie congratulations. Happy Dance time!

Omaz

Anne, Lago - They also compared taxol (paclitaxel) as a single agent to AC but haven't reported those result yet.  For those of us who did taxotere/carboplatin I think taxotere is similar in effetiveness compared to taxol so the tax/carb regimen should be at least as effective as taxol alone.  Here is the full abstract:

*[S6-3] Four vs 6 Cycles of Doxorubicin and Cyclophosphamide (AC) or
Paclitaxel (T) as Adjuvant Therapy for Breast Cancer in Women with 0-3
Positive Axillary Nodes: CALGB 40101 ? A 2x2 Factorial Phase III Trial:
First Results Comparing 4 vs 6 Cycles of Therapy.*

*/Shulman LN, Cirrincione C, Berry DA, Becker HP, Perez E, O'Regan R,
Martino S, Atkins JN, Hudis C, Winer E, Cancer and Leukemia Group B. /*

*Background:* Four cycles of chemotherapy are frequently used as
standard adjuvant chemotherapy for patients with low-risk primary breast
cancer, though other regimens such as CAF, CMF, and TAC frequently are
given for 6 cycles. Using a phase 3 factorial design we attempted to
define whether 6 cycles of one chemotherapy regimen are superior to 4
cycles in patients with low-risk primary breast cancer. We also sought
to determine if T would be equally efficacious as compared to AC, with
reduced toxicity.
*Methods:* The study enrolled women with operable breast cancer and 0-3
positive nodes. Study stratifiers were ER/PgR, HER2, and menopausal
status. When the study was activated in May 2002, AC (60 and 600 mg/m2)
was administered every 3 wks for 4 or 6 cycles, and T (80mg/m2) weekly
for 12 or 18 wks. In 2003 (after 570 enrolled patients) treatment
schedule was changed to every 2 wks for both AC and T (175 mg/m2), each
given for 4 or 6 cycles. In 2008 accrual to the 6-cycle regimens was
permanently closed due to slow accrual, with 3173 patients enrolled. The
primary endpoint for this comparison was the superiority of 6 vs 4
cycles in relapse-free survival (RFS). The study was powered to have 567
RFS events. Data comparing AC with T are not yet available.
*Results:* This report describes the impact of treatment duration and
includes the 3173 patients randomized to 6- versus 4-cycles of
chemotherapy, 93% of whom had node-negative disease. At a median
follow-up of 4.6 years (2.5 - 8 yrs), the number of RFS events is 288
(with 138 on 4 cycles vs 150 on 6 cycles). The 4-yr RFS was 91.6% and
91.8% for 6 and 4 cycles, respectively. The Hazard Ratio of 6 to 4
cycles was 1.10 (95% CI = 0.87-1.39, p=0.42). Four-year OS was 95.3% and
96.4% for 6 and 4 cycles, respectively, with a HR of 6 to 4 cycles of
1.31 (95% CI = 0.95-1.82, p=0.097). Based on the present data the
Bayesian predictive probability of concluding superiority of 6 cycles [a
primary goal of the study] with 567 RFS events is only 0.001. There was
no interaction between the number of cycles and type of chemotherapy,
ER/PgR status, or HER2 status. In particular, the effect of number of
cycles on RFS and OS was similar for both AC and T.
*Conclusions:* For women with primary breast cancer and 0-3 positive
nodes, we found no evidence that extending chemotherapy from 4 to 6
cycles improves clinical outcome.

Omaz

Omaz

This is the study design.  I'll stop now!!!  I get a little carried away with the research stuff.

Anniemomofthree

Oh, I love it!  Thanks!  Any idea when the results will come out?

TonLee

I'm asking my Onc about this next week.

I've had 5 TCH and he's all about "standard of care" so we'll see.

christine47

Omaz,

This is something I have wondered about.  How great you have posted.  I am on TAC every 6 weeks, and thinking about asking to stop at 4-5 treatments.  Thanks for posting.

Omaz

Here is the link for the 4 vs 6 chemo study in Clinical Care Options - Oncology, that is where I got the figure.  You may need to sign up but anyone can use the website. The study is called

CALGB 40101

Survivorwoman

Hi Ladies -- Thank you all for sending me your good wishes. I really need them right now.  I am so happy to have you all in my life. Every day I  look forward to reading your posts. You can't even imagine how much strength I get from hearing from you regularly. Physically, I am a bit better, but I am still very much on an emotional rollercoaster. I guess, it will take time to "flush" that out of my body. I think I hit rock bottom on Wednesday with my hospital stay. Now, I hope, I will get better and stronger.

Trisha-Anne --- Congratulations! It is great to hear that you are done with chemo. You are like Rocky, too!  Here is a video for you, too and for all of us who are done with chemo!    http://www.youtube.com/watch?v=DCysXR92LpI

Marjie-- Good luck today with your practice!

TonLee

Survivor,

Glad you are on the mend.  Hang in there!

tracie23

Hey survivrwoman , I was so sore yesterday I could barely move and I swear walking and working out all week stirred up the chemo in me I felt like I had just done a round. I am a little better today. My back and arms felt like they are were going to fall off I had to to take a oxycodone last night.  Than my DH reminded me I have not worked my arms out since June (surgery) so you can imagine.

Marjie: Be careful rowing today take it slow......

I had a friend tell me that even a year out when she gets a massage or works out it is like the chemo gets stirred up do you think that is true... because yesterday I felt like it did???? I hope not. I am sick and tired of being sick and tired .... I HATE TAXOTERE !!!!! or just chemo in general 

TonLee

Tracie,

Chemo did a lot of damage to your muscles.  While on treatment if you weren't consuming enough protein for your body to replenish what the chemo was killing, and most women can't, (GI Tract, mouth, etc) then your body took that protein from muscle.  Essentially it ate itself, reduced your muscle tone, and made you weaker.

I'm not saying that to discourage you, but so you will not be so hard on yourself.  You're going to be weak and sore for a good long time.  If you do weight training 3 times a week, and lift heavy, in 4-6 months you may be getting close to your pre-chemo strength...just depends on how much muscle you lost during chemo.  I'm planning on 12 months.

As for chemo staying in the body after treatment.  I don't know.  But it makes sense doesn't it?  I've read other toxins can be stored in fat, be released with weight loss and massage, so why not chemo?

I have to say I am really impressed that you are already back at it after the especially rough time on chemo.....I haven't had half your problems with chemo and it takes everything I have to work out everyday....Hats off to you.

tracie23

tonlee, I think in my mind it is you are done with chemo you should be back to normal... WRONG !!!! last night my eyes were so blurry I couldn't even see it was awful. I think everyone else thinks when your done your done ????? You are right it is going to be a long recovery and I need to take it slow. My DH says my muscles are so sore because of the lactic acid that has built up over time and know I am releasing and it is down right painful. I was feeling good at the begining of the week and I thought no better time than the present to jump back in. If it makes you feel better when I am done in the morning walking or working out I am done for the day it's all over I am back on the couch I have a very small window to do things.

Omaz

Yeah, folks at work are wanting to celebrate my being 'done'.  I am not done with active treatment until next August!  Even family are surprised when I say I am still getting over chemo when my last one was end of Nov.  It appears to be a long process.

lago

Tracie you will start to feel better around week 5. I am definitely less stiff, no more tears for a while and I even thing my eyesight is a bit better. I'm 6+ weeks out. I am gently stretching every day now but it was really hard the 1st 4 weeks. Just a little at a time. (this is after 6tx)

motherofpatient

On your very nice graphic about the 4 v 6 tx with taxotere, what do they mean by low risk - is that referring to the grade? It is so confusing when they say triple positive is aggressive, say it's the better cancer ( really the first onc said this) to have.

lago

motherofpatient HER2+ is aggressive ( typically seems to be grade 3 with a high proliferation rate). Don't get all worked up about that because chemo does seem to work better on fast growing cancer. Doesn't matter how aggressive the cancer is because if chemo kills it or didn't spread then what does it matter.

You migth find this link interesting: Molecular Subtypes of Breast Cancer

There is Luminal A, Luminal B, Triple Negative, HER2+ (Best prognosis according to this information is Luminal A)

---------------------------- snipped from link -----------------------------------

Luminal B

Luminal tumors have cells that look like those of breast cancers that start in the inner (luminal) cells that line the mammary ducts. Luminal B tumors tend to be:

* Estrogen receptor-positive (ER+) and/or progesterone receptor-positive (PR+)
* Highly positive for Ki67 (have a high number of cancer cells actively dividing)
* HER2/neu-positive (HER2+)
* Lymph node-positive

"In general, women with luminal B tumors have fairly high survival rates, although not as high as those with luminal A tumors [26]."

--------------------------------------------------------------------------------------

TonLee

Tracie,

That is exactly how I was looking at chemo...when I'm done I'm done..until I started reading Lago, you and others.  Now I know to expect at least as long to recover as it took to break down.  I continue to work out everyday during treatment, (hoping this will help my bounce back time at the end, we'll see).  Except this last treatment I took off 3 days of structured workouts because I missed some steroids....and OUCH!  All I could do was walk (easy pace) for an hour those 3 days and even had to take a nap for TWO of them...(I've not had to do that before)...so discouraging

Today at 50 minutes of cardio I had to stop because my heart hurt and I felt like throwing up.  I wonder what my ejection fraction is right now...it can't be good.

Anyway, sorry, side tracked..lol...hang in there and keep at it....and if you have to budget your energy (I have too) and only use it to work out, then so be it...sounds like a good excuse to stay off the sweeper to me!! lol

Omaz,

I know exactly what you mean about people expecting instant snap back....I've had friends try to schedule a cross country trip/seminar for me 6 days after my last chemo.  And family telling me since I didn't get to do holidays fall/winter 2010..and they did, I should be doing them all in 2011.  Conversations often being with, "Tonya will be off chemo in April so she can...."

I expect a lot of myself, and others, but damn.  My heart hurts!

Maybe I should appear in public bald.  Lol.  That might make them remember it's a little bit longer to recover than simply having a last treatment.

Omaz

motherofpatient - Triple positive is good because it is treated with chemo, radiation, anti-hormone therapy and targeted therapy (herceptin).  Not all cancers can be treated with all these things.  Low risk I think is referring to 0-3 positive nodes and smaller tumors.  Most of their tumors were T1-T2 in size (1-2cm I think).  I don't know about the grades.  Her2+ is considered more aggressive but sometimes that is based on the pre-herceptin data when being Her2+ was not a good thing because they didn't have a way to fight it. 

This was their inclusion criteria:

Eligibility

• Operable breast cancer
  • 0-3 positive axillary lymph nodes
  • Any ER, PgR, and HER2 status