To Continue Chemo or Not (x posted)

fire him.  hands down.  my first onco was like - always using scare tactics, not listening to me, telling me "not to worry about it"  i have a new onco that i love.  listenst to my concerns, has me on a treatment that i'm doing great with and that works for me & that we both believe in, doesn't dismiss side effects...truly, you need to have an onco that makes you feel POSITIVE.  i think that is so important, mental health is a huge part of this.

 fire him. just tell him the next time they call that you are changing doctor's and someone will be in touch about your records, then stop answering the calls.  i didn't start chemo until 2 & a half months after my initial diagnosis (and almost 2 months after my lumpectomy). he's obviously using scare tactics with you with those recurrence rates - no doctor should EVER do that.  they shouldn't be doctors, in my humble opinion.  

try to stay positive.  truly, from personal experience, once you make the decision to change docs (and i did before i even found a new one) i felt so much better.  

Either make an appointment to talk this out with your oncologist (and bring someone with you for support), or find someone else who will work WITH you (which sounds like a better option from your description); but whatever you do, you do need to act quickly. Good Luck!

Oh wow, Lifeisbeautiful - I'm so sorry you're dealing with this! Hopefully by now you've gotten in to see another oncologist!  It sounds like you're not getting any answers to your questions and getting conflicting information from the doctor, which is unacceptable.

I'm not sure if you'd be eligible for any of the platinum drugs at this stage, but surely they need to be considering what to do differently for you!  Different drug/combo?  Preventive steroids?  Help with side effects? 

Did they say what DID cause the leg issues?  Did they see you when you were so sick?   It sounds like your reaction was especially extreme.  Whatever you decide, don't let them blow you off. If you have those kinds of reactions, go to the ER if you have to, to make sure they see that you're not exaggerating.  Don't leave until your concerns are addressed.  Talk about it with your husband ahead of time so he can be prepared to fight for you, in case you're not feeling up to a fight.  

Although I didn't have anything like what you're describing, one thing that helped me was going back in the next day for extra IV fluids.  I thought I was drinking a lot, but the extra IV fluids did wonders, I guess to help flush out the chemo.  It's something you may want to ask about, but definitely get some better answers to the other stuff before you decide how to proceed.

Hugs to you and please keep us posted!

Babyface, so sorry for all you've been through, but congratulations on 5 years !  

please see below, alot of tnb gals get tc now instead of tac, the net if full of studies. There is less side effects improved survival rates and less risk to the ticker. i am not a medical professional but this was the chemo i was put on  with the avastin trial for stage 11b and stage 111(a) breast cancer,  i looked up the net when the oncolgist told me and there are lots of studies supporting this.

Dec. 13, 2005 (San Antonio) - Results from a trial that compared nonanthracycline adjuvant docetaxel/cyclophosphamide (TC) to standard doxorubicin/cyclophosphamide (AC) as adjuvant chemotherapy for women with operable breast cancer show significantly superior disease-free survival and favorable overall survival with the adjuvant TC regimen.

According to lead author Stephen Jones, MD, who presented the data here at the 28th annual San Antonio Breast Cancer Symposium, these results show that "TC should be considered standard nonanthracycline adjuvant regimen for operable breast cancer."

These final results were based on a total of 174 events, up from the 105 events reported in the interim analysis in 2003.

In the study, between June 1997 and December 1999, 1016 patients with operable breast cancer were randomized to receive either standard AC (doxorubicin 60 mg/m² plus cyclophosphamide 600 mg/m²) or TC (docetaxel 75 mg/m² plus cyclophosphamide 600 mg/m²). Each regimen was administered intravenously every 21 days for 4 cycles, and given prior to radiation therapy if indicated. All hormone receptor-positive patients received tamoxifen after chemotherapy. Patient and disease characteristics were comparable between the 2 treatment groups. Overall, 71% of cancers were hormone receptor-positive; 48% of patients had node-negative disease, 41% had 1-3 positive nodes, and 11% had 4 or more positive nodes.

At a median follow-up of 66 months, patients treated with TC had significantly improved disease-free survival compared with the AC-treated patients (86% vs 80%; hazard ratio [HR], 0.67; P = .015) and a favorable overall survival outcome (90% vs 87%, HR, 0.76; P = .13).

An exploratory analysis that plotted the hazard ratios for disease-free survival of the major subgroups, including age (<50, 50 years or older), hormone-receptor status (ER-negative/PR-negative, ER-positive/PR-positive), and nodal status (negative or positive), showed that the treatment effect is consistent across subgroups, Dr. Jones said.

Toxicities were different between the 2 treatment arms, with significantly more grade 3 or 4 febrile neutropenia in the TC arm and more grade 3 or 4 nausea and vomiting in the AC arm.

"This is another study that adds to the evidence that taxanes should be a part of adjuvant therapy," Robert Coleman, MD, FRCP, from Weston Park Hospital in Sheffield, United Kingdom, told Medscape. "This study differs from other adjuvant taxane studies in that it demonstrates that you can omit anthracycline, which is beneficial because anthracyclines are highly toxic and can't be used with Herceptin," he added.

At the end of the presentation, Dr. Jones reminded the audience that this was the 30th anniversary of the publication of the first AC paper that he and his colleagues published, and he highlighted the progress that has been made from those early studies on AC to current research with the introduction of docetaxel in the 1990s.

"Today at the 2005 SABCS, TC replaces AC as a better adjuvant chemotherapy regimen," he said.

28th Annual SABCS: Abstract 40. Presented Dec. 11, 2005.

I wonder what role the taxane played in that study, however. I'd like to see a study comparing AC-T to TC. I'm not sure if that's out there or not.