IDC Stage 2b.. questions on taxol after surgery

ghostmyst_76

I was just diagnosed in November with stage 2 IDC er/pr positive, her2neu negative grade 3 breast cancer, and just started my first chemo treatment (AC every other week for 4 treatments). I looked at my "regimen" and it said I have to have AC every two weeks for four treatments followed by Taxol for 12 weeks. I am 35, great health, never had any problems at all, nor does breast cancer run in either side of my family. I understand wanting to get rid of all signs of cancer and being myself again,  but is there such a thing as getting the AC done first, surgery ( I chose mastectomy regardless of what chemo does), followed by reconstruction, then the Taxol, if needed? I honestly feel like they are just literally throwing everything at me without any options. Kind of like being bombarded. The whole thing, in a nutshell, looks like this: Chemo (AC every 2 weeks), taxol weekly for 12 weeks, breast conserving surgery, radiation therapy 5 times a week for 6 weeks, then hormone therapy every day for 5 years. Really?!?  I do want my health, so since they chose chemo first, I chose mastectomy and removal of the positive node plus any surrounding ones next. I haven't had any major problems or side effects so far from the chemo. Just tired off and on. Any advice?

1Athena1

Hello, ghostmyst - I have a very similar diagnosis to yours. You can certainly ask your doctors about that option. It's frustrating because at our stage the chemotherapy is administered "blindly" in that there isn't actual knowledge about whether there are cancer cells in need of killing that wsould actually respond.

I would ask your onc his/her opinion - ask why both ac plus t. There may be other chemo formulas. I would also be very specific about what your concerns are - if there are specific side effects you are concerned about, mention them, as different chemo agents have different side effect profiles.

I felt as though I was being handed the kitchen sink too, so I know how you feel. 

You ask: but is there such a thing as getting the AC done first, surgery ( I chose mastectomy regardless of what chemo does), followed by reconstruction, then the Taxol, if needed?

There is the option of having chemo before surgery to shrink your tumor so that the surgery will not have to be as extensive - I don't know if that means AC would be given pre surgery and T later. But it can happen for threatment to go like this:

chemo

surgery

chemo (the explanation for this at this stage is to kill any rogue cancer cells floating around in your body)

other (hormonals, etc...)

Good luck - it does feel formulaic and forced. It is hard to make decisions in an environment of so many uncertainties. My only 2 cents: Do whatever is in keeping with your values, goals and heart.

SelenaWolf

Also, Stage 2 here... you may be advised to do the Taxol in addition to the Adriamycin/Cytoxan because you have a Grade 3 tumour.   That means that the cancer cells in the tumour are dividing at an aggressive- and rapid rate, much more so than a Grade 1 or a Grade 2 cancer.  In addition, if you had positive nodes, then the cancer is, already, starting to break out of the breast and attempting to spread.

The good news is, a Grade 3 cancer may respond better to chemotherapy drugs like Taxol because they are dividing so rapidly.  Adding Taxol to your treatment protocol may, actually, provide more benefit for you than for someone with a lower grade cancer.  I, also, believe that Taxol is, often, added to early stage treatment protocols because there are better long-term disease-free survival statistics associated with it.

Certainly, you have options and can opt to say "no", but please talk this over with your oncologist first - and, maybe, get a second opinion - before ruling it out completely.

placid44

I just got my MRI results after doing 4 cycles dose-dense AC followed by six weeks of weekly taxol. I am half way through the taxol, with six weeks left. The mri showed that tumor has only shrunk 40 percent, BUT there is very little cancer remaining. The radiologist described it as like an apple - the outside skin shows some enhancement/cancer, but the inside is all scar tissue from the chemo killing the tumor. We're hoping all the cancer will be gone by the end of chemo/surgery.



For triple negative, the taxanes are very important. The standard of care is AC-T, according to my onc.



I think the tumor responded more to the taxol than the AC, but both were necessary. I'm glad I had both chemos early (ie before surgery) so that the could go to work killing any cells that might be circulating in my body.



Just a little info about my individual experience. I am a big fan of taxol at this point.

Dawn1008

Ghost, the ladies are right!  AC/T is the "standard of care".  But your treatment is ultimately up to you.  I have almost an exact diagnosis, except I had 2 lumps, 3.5cm and 4.5cm, and I am 43 years old.  I am also on the AC/T regimen, followed by Tamoxifen for 5 years (at least... since new studies show that 10 years have significantly better survival rates).  Absolutely you must talk to your oncologist about your level of comfort with the plan.  If he/she won't talk, I recommend you get a second opinion which never hurts....even if you are already in treatment.  Good luck.

msphil

hello sweetie, I too had idc, I had 3 months of chemo first to shrink the tumor then mastectomy, then 3 more months of chemo, and I was in the process of making wedding plans so the extra stress wasn,t good after I finished the chemo I was told I could continue ewith wedding, we did and what a wonderful husband and marriage, then I completed the rads 5 days a week and for 7 weeks and 5 yrs on Tamoxifen, I did reconstruction But my body rejected the expander, and it was removed it hardened, and Praise GOD, I am now an 18 yr SURVIVOR, hang in there and you are in my prayers.  msphil(idc,stage 2, 3 nodes removed,chemo, L mast, rads and 5 yrs on Tamoxifen