To continue FEC-D treatment... or not? Advice welcome!

Tam178

I am looking for opinions, although I know the decision is mine to make, but anyone who could voice opinion either way I'd welcome the feedback.

Helpful info: I am 37 yo with kids age 3 & 5, and the IDC tumour was 1.8cm max with DCIS found too and 0/5 lymph nodes tested positive. ER/PR +ve HER2 -ve. Lumpectomy +SLNB (Jan 2014)+ Radiation (21 treatments to breast incl 5 day boost) & Tamoxofen to follow chemo. Plan was for 3 FEC & 3 D chemo...

I completed one FEC round (25 Feb) at full dose but due to mouth ulcers (plus nausea etc) dose was reduced by 15% for round 2 (11 Mar) & 3 (1 Apr) where the nausea and mouth sores were still present but lessened. I started Taxotere round 4 (29 Apr). I had Neupogen injections daily (day 3-7) which caused me awful bone & muscle pains from my jaw to my ankles and I could barely walk and spend most of those days in bed with the heating pad and doses of hydromorphone every 4 hours plus Celebrex twice a day... Just for extra fun on day 7 (just as the mouth sores re-appeared!) I developed a fever of 38.2C and ended up at the ER with Neuts 0.04 and was admitted for Febrile Neutropenia with IV antibiotics. The blood culture came back positive for staph and confirmed sepsis - scary stuff with no immune system. After 3 days my WBC were up to 12.6 (good fighting the infection!) and Neuts were 1.9. I was let home on day 4 (last Friday) with 3 more days of Cipro antibiotics. I did start to get less body pain since I came home (stopped the hydromorphone) and yesterday I actually felt I wasn't in pain just moving and have even stopped taking the Celebrex!

I've also got awful dry eyes (taxotere causing this) had awful constipation from the meds which caused an anal tear (great fun!) and have to brush my teeth & use medicated mouthwash 4 times a day plus myrhh tincture to keep on to of the mucositis... All this is NOT fun!

I met with my oncologist today who was very sorry for what I'd been through and basically offered me two choices... But I only have until Tuesday to decide (when next chemo is due)

1) Continue Chemo - this would be a 15% lower dose (again) for at least round 5 and then possibly (but unlikely) go on to round 6... Likelihood in his opinion is that I will be hospitalised again with another infection due to the increased risk with my sore mouth and previous reactions...

2) Abandon remaining Chemo and look at removing my ovaries as soon as I'm well enough after radiation is complete to give me additional protection given the ER/PR +ve receptors.

My med onc. was stongly leaning towards option 2 as he feels he's "broken me" enough so far and really wants to "cure me not kill me"!!!

So far I have agreed to proceed with the paperwork for option (1) so I will have the choice, but the more I try to weigh up pros & cons the more I am leaning to option 2... Getting the PICC line out before the summer to enjoy the water with my kids plus no more chemo sound SOOOOOO inviting. BUT if I can stick with at least 1 more chemo he said there around another 1%ish benefit in the chances of recurrence...

WHAT WOULD YOU DO??????????????????????????????

ruthbru

Would it be at all worth it to try a different chemo 'cocktail'? I am surely no medical expert, but it doesn't sound to me like you should be doing anymore of this combination at all!!!!

Trisha-Anne

You poor thing - you've been through hell and back.

I tolerated FEC fairly well, but Taxotere was a nightmare for me.  One thing you could think of is to have weekly Taxol instead of three weekly Taxotere. I think the Taxol is not quite so rough, and it's further reduced as it's done weekly. It may not help, but then again, you may get through it a lot better.

As you are HER2- though - it might not be worth the battle you are having now.

You probably need to really think about whether you've had enough (and no-one would blame you if you decided you have) and stop the chemo, but feel that you wouldn't regret the decision if the cancer came back or spread. 

You are very young - and usually that means you need to try all you can while you are able. But - you could still go through and complete chemo and have it spread or come back. You could also stop now and never have another problem with cancer again. No-one knows.

You have to make a decision that you are comfortable with. It's a hard one to make, but no-one can make it for you.

Sending you ((((hugs)))) - whatever you decide will be right for you.
Trish

xoxoxo