Anyone else doing TAC neoadjuvant chemotherapy

lisa224

I'm headed into round five (of six) of TAC neoadjuvant chemotherapy and am having a hard time finding others who are doing this.  I still have to have surgery, reconstruction and raidation.  I'm finding the TAC rough with a lot of fatigue, chemo brain, and other side effects. 

Would love to hear from others regarding the neoadjuvant chemo.  It feels like everyone else had surgery first.  

Momine

I had FEC before surgery and taxotere after. At first I found it difficult, because I just wanted the thing OUT, but as the tumor shrunk it got easier. The chemo after surgery was harder in a way, because I didn't have the encouragement of a shrinking tumor.

Hang in there, just one more. 

Karina121293

Hi Lisa, I had neoadjuvant FEC too, then taxanes. FEC was a lot easier for me than the latter. Yes, It goes with fatigue, hair  loss, nausea, but quite doable. The first week after each round is the worst for most of us.I never really dwelled on how it made me ill or tired. If I was sick , I would stay in bed, sleep, eat what I fancied at that moment. If I was well, I would go to work and lead a usual lifestyle. You just need to take care of yourself and concentrate on your treatment with one step at a time. Once you start it , you will know how to manage. Alltogether I had TEN rounds, but survived and you WILL too, I promise !!!!

Good luck to you and come here with any questions you like. Girls are just awesome on these forum!!!!

Kay_G

I had 4 DD AC then was supposed to get 4 DD taxol neoadjuvantly. Due to an allergy, I had to switch to taxotere. There were several in my March chemo group though who had the TAC all together. I am not sure if that's based on your age and other health or just the onc's preference. I was 48 and in good health other than BC. It did seem to me that the women getting TAC all together were younger than me. But that's just a general feeling, I didn't look it up or ask my onc about it. Good luck with your treatments. At least it will be over twice as quickly for you.

jennyboog

I did chemo before surgery.  I did DD ACx4 then DD taxoterex4, BMX/ALND, rads, oophr.  No, it's not easy, I had chemo brain and fatigue as well.  I'll be 2 yrs out in July and just got to where I feel ok again.  I had a large tumor & IBC they were trying to shrink it before surgery so they could get clean margins and it worked and they did.  I was 34 at dx, maybe age does factor in the dr's equation. 

lisa224

I'm 50 so I'm not sure about the age thing.  My surgeon and oncologist are all about saving the nodes and the neoadjuvant TAC may do the trick.  I just get frustrated going to support groups because I'm the only one who hasn't had surgery.  My first round of TAC was the hardest as I was told I would sail through it.  HA!  Between the TAC and the neulasta shot, I'm a mess for 7-9 days.  After the second round, I started getting hydration two days after the infusion.  This does help a lot.  I live in Santa Cruz, CA and will be having my surgery at Stanford.  I will meet with the plastic surgeon on Friday and see what my reconstruction options are. 

I'm currently on short term disability as my job in medical billing doesn't work with chemo brain.  I'm also finding it tough to drive and sometimes even walk.  Anyone else have shortness of breath and hot flashes?  I was given three chemo options, but it was strongly suggested that I do TAC due to the aggressiveness of the tumor and lymph node involvement.  

The oncologist's office warned me that it would be hard to motivate myself to do round 5 & 6 and yup it is.  I hear the surgery will be a lot easier than this!

mccrimmon324

Lisa, I did TAC but after Surgery.  I have to say round 2 & 3 were probably the hardest, 5 was a breeze for me compared to the other rounds.  6 wasn't so bad but I was so excited to get done I think that helped alot.

Kay_G

It is strange and sometimes unnerving that we don't all do the same thing.  I am assuming since you're getting 6 txs, you're not getting the dose dense treatments?  I had 4 txs of each, but they were dose dense, so I think the equivalent of 6 regular txs.  But I think there are women who did the TAC all together at once as dose dense txs.  I guess a lot depends on your onc and cancer center's usual practices.  I was told it's cumulative and every tx will get a little harder on you.  To tell you the truth, to me they all seemed about the same, although taxol was much easier than AC for me.  I also didn't have the neulasta with the taxol, just the AC. 

mccrimmon324

KAY, I'm not sure TAC can be given as dose dense yet.  Maybe not enough research. 

The treatment is A, C & Taxotere all in the same day, like AC was.  I believe it's a bit more harsh so that's why is only 6 treatments. 

lisa224

Kay, you're right it is strange.  I'm doing the TAC every three weeks.  I started at Stanford but the oncologist was way too aggressive for me not to mention it's an hour away.  It's hard to explain to people who have had the surgery first how different it is to do the chemo first. 

NancyD

Like Sherri, I had four TAC before surgery and two afterwards, before rads. I have to say, the worst SEs I had (aside from the loss of hair which was a given) were constipation and change in taste. I worked through the first four, took off for four weeks to have surgery, and then came back to work right after #5 and worked through #6.

I don't have a very physcially demanding job (all on the computer), and there was a seasonal lull when I was out, so it wasn't too hard to do. I also used "intermittent disability" which gave me two days off for treatment every three weeks. I scheduled that for Thursdays and Fridays so I also had the weekends to recuperate.

I did have a touch of chemo brain, but I hid it pretty well at work. I used a LOT of post-it notes to myself. My computer monitor looked like it had sprouted yellow leaves.

I did not have excessive fatigue. I was just my normal indolent self. Still am, lol.

wildrumara

Hi there - I just finished T/C X 6, neo-adjuvant.  I think the "adriamycin" is what really kicks ya in the butt, from what I've read heard, although T/C was not a walk in the park.  I honestly feel that in the future, most women in the states will be having neoadjuvant chemotherapy.  Seems to be that if you have a large tumor, you are going to have neo too, or if your cancer is more on the aggresive side.   Its not a bad thing.  My surgeon said in Europe this is the standard protocol now for most women who need chemo.  There are quite a few threads on this forum you can find information regarding neoadjuvant so take some time and read up on it.  Don't worry.  It is tough.  I'm so sorry.  There are things that your oncologist can do for you to help ease your symptoms.  It's not easy, but you don't have to suffer.......hand in there.  Be sure to ask more questions if you have them. 

khegidio

Lisa - I decided on chemo before surgery.  I did 6 X TAC 3 weeks apart.  I just had my last TAC treatment on 01/04 and i have surgery (BMX) next wednesday.  It was a personal decision I made because my oncologist and breast surgeon recommended it for a couple of reasons:

1. If I wanted to do a lumpectomy the tumor would hopefully be smaller

2. Doing chemo with the tumor in place would allow the drs. to identify if the chemo was working

3. It would give me more time to decide on my surgery

There is essentially no difference in the prognosis.  Its a personal decision. 

msmouse

Lisa224, I did TAC x 6 every 3 weeks starting around the 1st part of July thru mid Oct. I also had a node disection surgery before chemo; 4 nodes excised and none were positive.  Rounds 1-3 were pretty easy; round 4 kicked my butt with crushing fatigue but 5 & 6 were not quite as hard. I drank coffee for the brain fog. Some side effects from the Neulasta shots but my MO let me use a long acting NSAID with the Claritin & that helped with the bone aches. White counts on the last round were ugly & I ended up w/ prophylactic antibiotics for a week and I stayed home. I was never "sick" or ran a fever. I had a  almost complete response with only .1mm left of an almost 7CM lump & cyst. lumpectomy 2nd week of Nov w/ a re-excision 1st week of december for better margins for some DCIS they found during the 1st lumpectomy. Now in the 2nd week of IMRT radiation. I was able to maintain my weight & lose 6 lbs during my chemo w/ the MOs blessing. I started an exercise plan Nov 1 & have been able to continue it except for surgery days. I tried to walk every day during chemo but it was hard. Most days I just had to rest. I worked 32 hrs a week until chemo 3 and had to go out on disability. Working on call now. My surgeries were EASY compared to chemo but again, I was exercising & eating again & felt SO much better. Being stronger is also making the radiation go easier, at least so far since I am only on week 2 of 6.5 weeks (28 IMRT w/ 5 boosts. 33 total) Its a personal choice but I'd do it the same again even knowing what I know now. You will bounce right back after the last chemo. 6 weeks later you will start seeing hair again!

karen1956

Lisa224.....I did TAC chemo following my bilat.....there is a great thread that was active when I was going through chemo.....something like "starting TAC chemo March/April 2006...I am 10 days shy of my 6 years from hearing those dreaded words....TAC is tough, but it is doable....I was turning 50 when I going thru chemo....Wishing you and easy time

mom2twins34

Hi Lisa, I also had neoadjuvant chemo.  I was told that the reason was two-fold.  1) I was considered inoperable because of the size of the tumor area & because I had chest wall invasion and 2) because of extensive lymph node involvement.  

I did dose-dense AC and then Taxol before I had my BMX (followed by more Taxol, rads, herceptin, tamoxifen after surgery).  I had a great response to the chemo, but I can definitely relate to your feelings of how rough it is.  I know not everyone has the same side effects, but I thought the chemo itself was going to kill me.  The fatigue was overwhelming, I had to do daily Neupogen injections because my counts were so poor, and I was very nauseous and vomiting so much that after a few emergency trips I ended up requiring home IV hydration for the length of the treatment.  I know you asked about shortness of breath--this was a big one for me.  The shortness of breath coupled with a great deal of leg and abdominal swelling actually gave us a congestive heart failure scare--my MOs were almost convinced that I had developed CHF and that we'd have to stop treatment.  Thankfully, we learned this wasn't the case, just that this was how my body reacted to the A & C especially, but it was a scary time.  

To be perfectly honest, there were days when I didn't think I'd survive the chemo.  I only tell you this because I did make it through...  And it was a really effective protocol for me & prepared me well for the surgery (I'm hoping it is just as effective for you!).  It did take a long time to recuperate (I still struggle with fatigue and chemo brain), but I started to notice a big improvement in side effects even weeks after finishing.  

Hang in there...  You are almost there...  I know it's tough, but we are all here for you... 

Big hugs!  

P.S. You asked if anyone else had hot flashes--yes!  And lots of night sweats, too.  This also improved for me within a couple of months of finishing chemo.  

tmetz1616

I had neo-adjuvent treatment.  4 rounds of A/C then 12 weekly Taxol completed 12/8/11.  I just had my BMX Jan 20 and I am starting rads in a couple weeks.  If you have any questions, feel free to send me a message.

Good luck with your treatment

lisa224

I feel like a boxer about to climb back into the ring to get pulverized.  Ding ding round five today.  I think the steroids are adding to this.

 Thanks for the info and support, it really helps. 

 XO, Lisa

mccrimmon324

Only 1 more!!  Good luck. 

mamabee

Good luck today Lisa! I know a bit how you feel - I'm 6 days out from my 3rd treatment with TAC. I'm also doing my chemo before surgery. I was a bit frustrated after my first TXs that my tumor didn't seem to be having a huge response, but after this treatment, I swear it shrunk significantly overnight. I needed that response too because this last treatment really wore me out - I'm huffing and puffing after taking a basket of laundry upstairs. 

 Hang in there - only 1 more after this! 

GeorgiaRai

Hi, ladies - I'm one of you! I'm 2 weeks out from #1 of 6 neo-adjuvant TAC infusions (every 3 weeks).  The lobular features of my tumor made it "too extensive" to remove prior to chemo, so I had SNB then straight to TAC.  I'll have scans after #2 or #3 to see how well the tumor is responding, but I swear I could feel it being "attacked" after treatment.  Has anyone else felt pain in their tumor after chemo, or am I crazy -- wait, don't answer that!

Chemo brain has definitely been the worst SE for me.  I need to keep working as much as possible, so I came back to the office on Day 7 but it took longer than that to feel 100% mentally.  This has been a good week, though, so I'm grateful. 

Best of luck to all of you - and congrats to those who are done (or almost)!

libraylil

Georgia, I too had slight "pain" sensations in the tumor during chemo. After lumpectomy the path report showed 65 per cent of the cancer cells were dead. The MO considered this a good response. Of the 4 sentinel nodes removed 3 had evidence of dead fibrous cells. I m glad I went with the chemo first as it got the show on the road quickly.

sloblr

Lisa - By now you are definetely on the home stretch.  I was diagnosed in November 2006 and had surgery first, six rounds of TAC, followed by radiation.  I waited almost four years for reconstruction.  But, the chemo was by far the worst of the whole process.  So - you will be done soon with the hardest part of it!  It gets much easier after this.  Good luck to you!

sloblr

Lisa - By now you are definetely on the home stretch.  I was diagnosed in November 2006 and had surgery first, six rounds of TAC, followed by radiation.  I waited almost four years for reconstruction.  But, the chemo was by far the worst of the whole process.  So - you will be done soon with the hardest part of it!  It gets much easier after this.  Good luck to you!

Momine

Georgia, I swore I could feel the tumor dying, and most of it did. If it is huge and then shrinks, it makes sense to me that you should be able to feel the change, although my onc told me I was nuts.

mamabee

Georgia - I'm between treatments 3 & 4 right now, but I definitely felt pain in my tumor - an aching feeling - especially after my first 2 treatments. I've only had that feeling once after #3, but it seems that my tumor has shrunk the most after this one. It does make chemo a bit easier to take when I can actually feel it working.

jenlee

kehgidio,

Glad you mentioned the reasons for adjuvant chemo.  For some people, it doesn't work -- imagine going through after surgery for nothing, and you'd never know.   In addition, if it doesn't work, we Adjuvant Ladies have the benefit our docs being able to change the chemo to a different cocktail. My logic is that if it's working on the tumor, we know it's working on any little nasties that may have broken loose from our breasts and are floating around in our bodies!  I had varying opinions from several MO's & surgeons and choose one who was 100% convinced that adjuvant was the way to go.

I'd doing TAC x 8.  It was originally TAX x 6, but my MO changed it based on good results after round 2, at which point we saw approx. 65% shrinkage of tumor  (see study below)...  So I would have been 2/3 of the way done by now (just had # 4 last week), but now I'm only 1/2 done.  I hate it, it sucks and I'm an emotional wreck, but it is working.  My side effects aren't as horrible as some of you have experienced -- the worst ones so far are psyschological. 

 My MO was really excited about this... German (GeparTrio) study on Neoadjuvant Chemo was released at the 2011 San Antonio Symposium...  Apparently the study showed that if after two rounds of TAC, there was a significant response (50% or more reduction in tumor); they then found that those who were given six more cycles (for a total of eight) had even better outcomes than those receiving four more cycles (for a total of six).  MO is very interested in this and has spoken to the investigators.  

Note: Significant developments for those who were initially lower responders as well.  

http://www.medscape.com/viewarticle/755590 

mamabee

Jenlee, Thanks so much for sharing that study. I'm going to bring it up to my MO when I see her next week - although I would have mixed feelings also about having to do 2 more treatments.

lisa224

I finished round six of six of neo-adjuvant TAC on 2/21/12.  Went through the usual hell and now 11 days out still extremely weak and wondering how much longer until I bounce back?  I'm scheduled for a single mastectomy (left breast) on Monday 3/26.  I was hoping to be stronger and to have taken off the 10lbs I put on from chemo by then. 

Did anyone else struggle with this much weakness?  Also it's such a strange feeling to have the cancer still in me.  The MRI and ultra sound did show significant shrinkage, but the surgeon and oncologist were hoping for a better response.  The best news (I hope) is that they couldn't find any signs of the cancer in the lymph nodes.  Of course they won't know for sure until after surgery.  I still have radiation and reconstruction in my future.  It feels like such a loooooooooooonnnnnnnnnnngggggggggggg road.

I'm now in that weird limbo place waiting for surgery, waiting for energy, and wondering if I'll ever feel well again! 

Karina121293

Lisa, True, it IS a long road. It took me more than a year to complete the treatment altogether. But I remember my surgery was the best part, knowing that they took the beast out of my body. I woke up from it with a smile. What a relief it was!!!! In fact, the recovery from mastectomy and hysterectomy at the same surgery was a lot easier for me than chemo. It normally took me about 10-15 days after each round to feel normal and strong. So give yourself some more time. Shrinking tumor and no lymph nodes is great. Will you be having adjuvant as well? 

Here is to wish you all the best. You will get there. Just hang on please. 

Laurie09

Hi Lisa, 

I had Neoadjuvant chemotherapy, too.  I had 4 DD AC, 4 DD taxol, then mastectomy, then radiation to lymph nodes, then reconstruction, and now tamoxifen.  

I think the neoadjuvant chemo is being recognized more commonly as a treatment option.  My understanding is that it really doesn't change the prognosis, whether you have it before or after.  For me there were some benefits to having had neoadjuvant chemo.  1st, we could see my tumor responding, and then after surgery, we could see that my primary tumor when away completely after the chemo!   I still had some disease in my nodes which was why we went to radiation for my lymph node beds after surgery.   

Also, it was kind of good to get over the worst part of the treatment first.  

Anyway, good luck to you and it is a hard road, but you will get through it.  {{Hugs}}