To stop chemo after 4 rounds in?
Hi there,
I am 40 years old, had a double mastectomy(after finding a lump in my right breast) and will have a hysterectomy shortly. I tested positive for BRCA1. When my pathology report returned my nodes were negative but they did find some microinvasive spots. That led me to chemo(I am also triple negative). After four rounds of AC and barely surviving through it, my oncologist is saying I rec'd the most bang for my buck with the first 4 rounds and that chemo should not be torture. He originally thought I would have another 2 of taxol and 2 of carboplatin. He said the numbers do not indicate it medically necessary to continue chemo. Had the chemo been easier on my body he would have said continue. What do I do? I am getting my free pass but feel I will always regret taking it if I get a reoccurance....any thoughts?
Comments
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Ladyjennifer - I am also triple negative and I just completed four rounds of TC (Taxotere/Cytoxan) last week. There was never any talk of me doing any more than four treatments and I did just fine on it. I hope this helps!
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Hi Ladyjennifer, the regrets about "...what if..." is one of the main reasons a lot of us do choose to hit this with the big guns in the beginning. For me personally, and I know for a lot of us, the Taxotere/Taxol was much easier to tolerate than the AC.
We triple negs don't have any further treatment beyond the initial surgery/chemo/rads that some of the others have, and we have a significantly higher risk of recurrence, so I chose the most aggressive treatment available. I didn't have the option of a platinum drug and thought those were only for trials and stage IV, but they are showing a lot of promise for TN.
Have you talked with your doc about the pros and cons of stopping now versus continuing with the chemo? Are you familiar with the side effects of the AC that you've already done compared to the SE from Taxol and Carboplatin? Have you been to www.tnbcfoundation.org - the Triple Negative site? I bet there are people there too, who have more experience with these chemo regimens.
Best of luck with this very difficult decision! Make the best choice you can now, and then don't look back. Hugs!
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Sugar, did you also have a mastectomy? Our data looks the same! Thanks for sharing. Jen
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Ladyjennifer - I also had four rounds of taxotere/cytoxan (TC) and was never given an option for anything beyond that. For stage 1 it seems that four rounds is pretty standard. I'm sorry to hear that you had such a rough time with chemo. Hugs to you!
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I had a terrible time with AC, and ended up in the hospital three times for a total of twelve nights. We gave my body some time to recover and then moved forward with taxol. Taxol was nothing compared to AC. If it will make you feel better to try it, talk more with your doctor about it. Seriously, taxol was comparatively a breeze.
Hugs and good luck, whatever you decide.
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ladyjennifer - I didn't have a mastectomy. I had a lumpectomy and will have radiation in March.
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Hi Ladyjennifer, I am also one of the AC casualties...In and out of the hospital and finally almost went bye-bye, and wound up on a ventilator for 2 weeks. However I too managed to get the 4-rounds under my belt. That was over 4-years ago and knock on wood here I am. Back in 2005 it was usually just the 4-rounds for the Stage 1 women, but taxol was starting to be offered in clinical trials. My onc is on this site (Dr. Siedman of MSK), and like your Dr, he felt the 4-rounds of AC offered plenty of protection. Of course I have wondered if I have had enough treatment, but I have few regrets, and like you, it seems like it would be playing with fire after our lousy time with the AC...As far as pathology goes, I did not have any other micro-invasive sites that I know of (lumpectomy done), but tumor was slightly larger for stage 1 (1.7 cm)...I think you have been thoughtful and agressive in your approach to treatment and I just wanted to write to present myself as an example of 4-years out with just 4-rounds....I know you will be really fine no matter what you decide!!!, Best wishes to you,P
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If it makes you feel better, when I was first diagnosed, I spoke with a 10 year TN survivor whose treatment was 4AC and then 6T. She barely made it through the AC and opted out of the T. She is more than 10 years out and doing fine!
Lorrie
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My Sister had such a bad time with the Red Devil that she decided to quit after her 3rd treatment. Her onc just convinced her to do the last dose. She's not going to do the Taxol. She's triple neg too. She had double mast and hysterectomy.
I have mixed feelings about it.
I wish you the best of luck girl.
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Sister, if your counts make you able...I say go on to 4 dose dense taxol....it is not nearly as bad as AC....I think it can be a life saver. For so many of us that did chemo before surgery (neoadjuvant) we find that AC is the one that kills off some tumors ( it did mine ) yet for others, it is the Taxane drugs (Taxol).....if your body can take it I say go forward and kill cancer cells. The time passes so fast..if you are medically able, so good to have that extra.
-meg
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I agree with Meg,
I would ask about the taxotere. I, too, became very ill with chemo and had 4 rounds of TAC and one additional of AC, due to persistent fever and lung infiltrates, thought to be due to the taxotere. It really is the taxanes that work so well for TNBC. Kathy
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Mmmm - don't assume taxanes work well with all triple negatives. I had neoadjuvant chemo and my regular MRI scans showed the tumour was not responding so after 4 rounds of 4 different chemos (including a round of Taxotere and a round of Taxol) my chemo treatment was withdrawn. I was supposed to have 8 rounds of chemo.
Anyway, I had a lumpectomy in January and I am now having rads. It's just that whenever I read posts on the triple neg forum that this cancer responds well to chemo, I get annoyed
. XX
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I had 4 rounds of AC and 4 rounds of T. My onc told me because I am TN she wanted to be really aggressive. Taxol was easier in terms of nausea and fatigue, but that bone and joint pain was pretty bad for me. However, percocet really helped in that regards and I was able to make it through. You should really talk with your onc about getting taxol. I think with us TN women we have to through everything at this.
Anita
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Thank you ladies for all of your responses. I have opted to go for 4 more treatments(Taxol). My onc. said that if I had never done chemo, my chances of reoccurrence would be 10-15%, with just doing the AC my chance of reoccurrence is now 5-10% and by doing the Taxol, I will be at 3-8% chance of reoccurrence. The difference in percentage points for doing the Taxol are not large but as we know, it all matters. Thanks for your support, your kind words, and may we suffer no more ladies.
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If you can take the chemo....go forward. I don't know about 2 taxol and 2 carboplatin though. When I did my chemo, and I think still, the gold standard at Stanford was 4 ac then 4 taxol. I think 2 is not a full treatment of a particular chemo drug. If your white cells and all that remain good I say go forward with taxol. Taxol for me was not nearly as much as ac...it was much much easier. I did 4 taxotere/carboplatin later and that was tougher. I just realized I didn't read all of your posts...just the first....maybe I am responding inappropriately.
The way I kept myself going on chemo was I said, well how much chemo will I have to take if I get a recurrance? I hope that doesn't sound too harsh...it is just the mantra that I said to myself to keep on taking it.
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hi Jennifer,
I had the same diagnosis but with slightly larger tumor and am 38 yo. And I am going through TC now with the same option. What did you decide to do, and how are you doing?
All the best.
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hi,
I was diagnosed triple neg and offered the same option as LadyJennifer bit wanted to connect with someone who had done it. How are you doing now?
Best,
Bird7
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Great advice, Kayb --
bird, let us know if you need any help starting a new thread -- you're sure to get answers that way!
Sending a warm welcome,
--The Mods
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I have stage 2, grade 3 TNBC. I had mastectomy and have completed 4 rounds of Taxotere and Carboplatin. My oncologist thinks I should stop. But if I insist she will give me 2 more rounds of Carboplatin alone. She feels the Taxotere has been difficult for me and I agree. But I will do anything I need to do to keep this from coming back. I would appreciate opinions or experience about this subject. 4 or 6 rounds?
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Hi Chisty, welcome to Breastcancer.org. Until other members weigh in with responses and help, here is what we have about Treatment for Triple-Negative Breast Cancer in our main site.
Hope this helps! Again, welcome to the community, and let us know how you're doing!
The Mods
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Hi Christy, I had a hard time with taxotere and stopped at 4 out of 6. Stanford recommended 4-6. I just couldn't get out of bed to finish. My dr wasn't thrilled but didn't offer anything else or just the carboplatin. What did you decide? Did you have a mastectomy or lumpectomy which may make a difference.
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I think your MO knows best. Round 4 seems to be a really hard round for most. I begged my MO to stop, but he said "You're doing so well." It certainly didn’t feel like I was doing well. I did the last two rounds, but with a reduced dose.
If your MO is telling you to stop then he/she may be trying to prevent some permanent side effects that could really effect your quality of life. Its hard to imagine now, but eventually your life is going to get back to normal and you don't want to be left with any more issues than are necessary. Four rounds of chemo was plently of poison and it just may have been enough. Good luck to you.
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