Weekly Taxol vs 4 dose dense taxol

LHebs

Hello All,

I know this topic has been discussed a lot but just wanted some thoughts and opinions and current info.

My MO is recommending me 4 taxol dose dense biweekly after DD AC. My second opinion MO is recommending 12 weekly dose of taxol bc of less SE. He states that they don't prescribed DD taxol anymore at this practice. I am torn between the pro's and con's of each. I am young, 37 with no other co-morbidities and have IDC with axillary node involvement. I will be having surgery after chemo then radiation. My MO says I can do weekly taxol if I want.

My questions for you all:

Who has done either regimen and do you recommend it?

Why did you choose that regimen?

What are the SE you experienced?

Why did your MO recommend it?

Those who did not have a port placed, how did your vein do?

I have heard the effectiveness is equal in weekly vs biweekly DD but I want to make sure I am making the best choice I possibly can. 

Any insight would be helpful. I should be starting chemo the 2nd week of Feb and trying to have my plan in place.

Thanks

LHebs

Mojojennijo

I'm on weekly taxol. I don't have much nausea. That's a huge bonus for me. But I also don't have that week between. With a/c I felt pretty good the week in between treatments. Towards the end it was about half a week.

I am tired on weekly, joint pain. Just don't feel like myself till about Tuesday. Then have it again Wednesday. But I think it's better than the a/c for me for sure!! The nausea for me was the worst side effect. And with the weekly it's a non issue. Maybe here and there. But one of every 3 weeks I have herceptin perjeta and taxol. Perjeta makes me really sick!!

However I am almost done!! I’ve heard the last few treatments Are hardest. Not sure if it’s a mental thing or if it really is. Just for me weekly has been easier. Besides the fact it drags on sooolong

LHebs

Mojojennijo-thanks so much for the input. Goodluck with rest of your treatment!

CBK

I finished 12 weekly taxol infusions on 12/6/17. My MO was ok with me doing the four dose dense infusions, however steered me more towards the 12 infusions because she said likelihood of neuropathy was less likely on longer regime.

Early taxol I felt great, very little side effects and renewed energy. As time wore on that changed, I experienced fatigue, bloody noses, minimal muscle aches, and neuropathy. Fatigue pretty intense toward the end!!!

I completed all 16 of my chemo infusions without a port and on one arm. I had a pro of an infusion nurse and great veins. I had a complete adversion to having another hole in my chest after BMX, so I was determined not to go through port placement. Most people thought I was nuts but that's what I did. Ha!

Good luck to you!

LHebs

CBK,

Glad to hear you did well. I am going to do the DD taxol. I am just going to try and push though it.  I am not getting a port either. RN and MD says I have great veins and wouldn't risk getting a port. We are going to try and use my left arm, since I won't be able to use it after surgery.

avmom

Hi LHebs,

I did four rounds of dose dense Taxol after after four rounds of dose dense Adriamycin and Cyclophosphamide. While I'm not sure the science is super clear, there is a report from the San Antonio Breast Cancer meeting in December that suggests dose dense chemo improves outcomes in some early stage disease. I will try to make a link:

http://breastcancer.org/research-news/dose-dense-chemo-improves-early-stage-outcomes

As for side effects, I was 55 at diagnosis, so maybe we aren't so comparable. I joined a discussion board group for the month I started chemo, and it was invaluable as a place to share information and provide/receive support.

I was nauseated throughout chemo. The anti emetic drugs are effective at controlling nausea, but as with all side effects, it is important that your care team knows about all of your side effects right away. There are treatments for many SEs.

Other people doing the same chemo regimen didn't have side effects that were too bad, and many were able to work, either on a reduced schedule or some with a couple of days of down time, and they did their chemo late in the week to recover over the weekend. I was able to work a bit, but mostly from home because my immune system was pretty compromised. I did have Neulasta after each round, and was able to complete all eight rounds. It was no fun, but here I am, three years after diagnosis.

I think most everyone experiences fatigue to some degree or another. I was very fatigued by the end. Regular physical activity helps with side effects. One of the women in my chemo group cycled over 2000 miles (I think that's the right number) during the year she did chemo

I lost all of my hair, as expected. I didn't even consider “cold capping" which I understand some people do, to mixed success. The nausea was rough. I had some problems with my finger and toenails, but they are ok now.

I would say my most serious SE was neuropathy. I did develop fairly significant peripheral neuropathy,and while my hands are basically fine now, I had significant problems with my feet, and used a cane to get around all the timefor over a year. My understanding is that while many patients given Taxol develop some neuropathy during chemo, most recover with few long term effects -maybe some numbness in a few toes. My neuropathy has not resolved, but it is much better now than when I finished chemo. Your care team should monitor for neuropathy throughout your Taxol treatments. Some people used icing on their hands and feet during their Taxol infusions. I did not, so maybe someone who iced can chime in.

Best wishes to you as you start chemo. If you have any specific questions, now or anytime during your treatment, please don't hesitate to PM me. I don't post a lot these days, but I do check in regularly, and if there is anything that I know that you would find helpful,please just ask.

avmom

CBK

LHebs- You should be just fine, especially if your Nurse and Dr are guiding you that way!! I didn’t even have any significant bruising on my arms and hands from infusions. Nurse wrapped area tight after each infusion with bandage tape, and I left on for 24 hours.

Make sure you are proactive with Dr on neuropathy thing! It’s the one side effect I wish I was better prepped for! Not saying you will “get it” but there are proactive measures I didn’t take, that I wonder if I did, things may be different!!

Let us know how you do! Cheering you on for an easeful course of infusions!!!

Tpralph

I did the dd taxol and the worst se I got was body aches. Had to take codeine to function. Slight temporary numbness in the fist couple fingers both hands but has resolved now three months after. Walked daily sometimes twice a day which helped with fatigue which really wasnt too bad. Neulasta kept my counts up but also added to my body pain. Found warm baths helped. I had a picc line

LHebs

Thank you everyone for your insight and support. I appreciate it immensely. First treatment is in 2 hours!

LHebs

Thank you everyone for your insight and support. I appreciate it immensely. First treatment is in 2 hours!