TC vs CMF ?

allicat1214

Saw my MO yesterday for results of Oncotype and he is "reluctantly recommending chemotherapy."

My Oncotype score is 19.

He explained to me that just with the lumpectomy, I have a 15% chance of recurrence. Having chemo would give me an extra 2- 3 percentage points, so a 12% chance of recurrence. Then because my cancer was ER+/PR+, taking AIs for 10 years would give me another 4 percentage points, so then down to 8% chance of recurrence. (He said radiation doesn't add percentage points from being cured because that is just to kill of any remaining cancer cells in the breast, whereas chemo and anti-hormone drugs are systemic through the body.)

He gave me some choices on the type of chemo:

--TC which he said was more "brutal" and would be 4x every 3 weeks for 12 weeks, but gives the full 3 percentage points for reduction of recurrence

--CMF which he said had fewer SEs and would be 6x every 3 weeks for 18 weeks, but only gives 2.5 percentage points. I did a quick google search I did see that CMF is older protocol and potentially causes long term brain issues. Scary. http://www.cancer.net/new-study-shows-breast-cancer-survivors-who-were-treated-cmf-chemotherapy-may-have-subtle-long-term

He said I could take a few days to make the decision, so I'm doing my research.

I'm trying to get a second opinion with a different doctor at a different hospital, one associated with MDAnderson.

In the meantime, I'd appreciate any advice/ experience/thoughts/stories/prayers on either one.

Thanks so very much.

vlnrph

Good job on going for a 2nd opinion - get a 3rd if you need to (and your insurance cooperates!)

I seem to remember Adriamycin being paired with Cytoxan/cyclophosphamide plus a taxane until more recent studies were done that showed TC without the "red devil" was just as effective, with fewer side effects. Many of us found the regimen you describe to be doable. Is there a concern due to your age or other medical conditions?

Getting it all over with in three months vs 4.5 might be an advantage also. Hope you come to a decision you will be comfortable with because trust in your doctors & therapy is important.

allicat1214

Oh Rose I am so sorry. But thank you so very much for posting here. I had no idea about the long term hair loss.

mdg

I personally used caps but have two friends that did not use caps and also never got normal hair back after taxotere.  Not all ladies have this issue, but the occurrence of permanent hair thinning and loss is higher than the doctors tell you.  Both of my friends have bald spots and hair that is super thin and will not grow long at all.  Both are devastated.  I do have to add there are tons of ladies here that had taxotere and did not have permanent hair loss. The hard part is you just don't know how your own hair will respond. 

jennyunderthesun

Hey allicat1214-- what did you decide? How's it going? I'm on the same fence and looking for first hand experience