Too continue or not?

Hi! I just finished 12 weekly Taxol's this past Tuesday...While it was easier then the A/C I had first, there are side effects I experienced, but I would rather have those then stop treatment....I had peeling of the skin also but it was on my feet, runny and bloody noses, eyes watering, I've had 4 fingernails fall off and one toenail, have a few more that are starting to come off also, and constant fatique which got worse and worse with each treatment...But I would rather go through these minor SE's versus stopping treatment, I want every chance possible at beating this. And each of us is different, each of us has different SE's, you may not have any, it's worth a shot to see...I would go with the weekly..it's nothing you can't handle if you've already been through all of this.

Hugs and Prayers

Deb

Hello LadyJane,

 I am sorry for your recent diagnosis of bc, and for the life threatening affects of your treatments to fight it. We all know that strangers commenting on your question is risky and yet since we have breast cancer here (I was like you except stage IIa) we have gleaned some real life experience.

  Your situation really gives one pause. Certainly this is a time for great, in depth discussion between you and your oncologist. Do you have that type of a relationship with him or her? If not, is there another oncologist in the group whom you might ask to speak with? 

Nowadays, a test called Oncotype analysis tumor is commonly done. This is a test of various markers,proteins done on the tumor which gives a composite score helpful in analyzing one's cancer relapse risk. If the risk is high or intermediate high, more thought is given to chemotherapy and if its low or intermediate low, often discussion is given to limiting chemotherapy.

Since your tumor is ER+/PR+, you probably have been counseled about hormonal therapy: the aromatase inhibitors (arimidex, femara, aromasin) or Tamoxifen. Recently, more discussion has surfaced based on studies showing if a tumor's estrogen receptor is fairly significantly or strongly positive, the tumor appears to respond in early stage disease to hormonals, with less benefit from chemotherapy. This would be one explanation which would be worth going over in detail with your oncologist as well as the risk factors you may have against hormonals.

Your tumor grade is a risk factor for treatment discussion, albeit just one risk factor. The older statistic which might be given to a patient before the Oncotype analysis, is that 30% or so of women with negative nodes may relapse with recurrence. Since the grade suggests a nastier devolution of the cancer bc cells from the normal cells, the chemotherapy has been suggested. But because of your twice life threatening very low white counts, you were able to do only 3 out of the typical 4 AC. A certain percentage of deaths do occur from neutropenia, so it's wise to re-analysis and stop when appropriate which your doctor did. Do you have any other medical conditions where low white counts surfaced? Were you always prone to infections or have problems with your immune system which may factor in here?

Your description of your Taxotere reaction is a serious one also. Whole body rash and deep pealing of the hands and feet after one dose is significant: is this an allergic reaction which may result in worse with a second dose? Will the same happen on reduced dose of Taxotere or its sister drug, Taxol? These are some questions I'm sure you and your doctor are pondering.

If your oncologist feels chemotherapy is advised based on the grade of your tumor and any Oncotype score, is there a different chemotherapy drug from a taxane which might be considered given your reaction?

A second opinion may be very helpful. Telephone consultation with Johs Hopkins University Oncology might be an idea, since you are in Maryland. You're in a tough situation, which is often when second opinion on a treatment issue is most valuable.

I hope the Oncotype test may guide you if it was done. This is a situation where clearly its benefit may be great.

Wishing you a quick recovery from your pneumonia and help from the doctors,

 Tender