Taxol at MDAnderson

I am an MDA patient, I am getting weekly taxol.  They say the prognosis is the same for both but the weekly taxol is much easier on the body.  Also, I get my taxol BEFORE the FAC.  He said by doing that they can give me the max dose of taxol and FAC.  If they do FAC first they have to lower the doses of both.    Hope this helps.  I was very very comfortable with the explainations for why... I am also stage three   I have a port, but MDA couldn't use it the last time.  They put an IV in the vein in my hand for my first taxol.  The nurse said the big thing is flushing.  She said to be very anal retentive that your nurse gives you the steroids and anti nausea, then flushes for at least 15 minutes before taxol.  Also she said you need a minimum of 30-45 min after steroids before taxol so they can start to work.  Then the taxol (it took an hour for the dosage)  I went through 2 bags of IV fluids to dilute the taxol because it made my hand sting.... Then the other big thing is at least 15 min of flushing post taxol and then ice the hand right away.  She said this is important for keeping the vein damage free. 

Good luck, if you have any more questions message me

I've heard it was the same also.  I did my forst round of AC with no port and I felt a burning in my vein as it went in,  I did it though.  I think the nurses are super scared when no port is used, chances of things are worse, so I've been told.

I know a whole bunch of women - at least 5 - who didn't have a port and got through it.  They mostly had treatment a few years ago, but it was basically the same drugs.  I had no doubt that I wanted a port, even though it left a scar.  I am very thankful to mine, but won't belabor the details unless you want them.

and I couldn't imagine doing the length of treatment without a port personally......however like others have mentioned I have a nice "reminder" scar which I could have done without.

Jacqueline

Posy, I can feel your anxiety from here. It's natural to check with us for some commonalities and I am glad you are doing it!  I did not have neoadjuvant chemo, either. I had a very tricky breast cancer that did not show its true size in either a mammogram ( where it never showed up at all) or a sonogram( where it looked the size of a dime) and I was too naive at that point to insist on an mri. My tumor was hacked to pieces three times, (my breast surgeon was a real dud) and only then did they know I was probably stage 3.

It must be comforting to get neoadjuvant and feel the tumor shrinking. Your sensitivity to various chemotherapeutic agents would no doubt have been valuable information for your onc.This lack of information bothered me for a long time, probably still does to a slight degree.In hindsight, my onc tells me it made no difference--he would have done the same drugs adjuvant or neoadjuvant--DD a/c and dd taxotere.

I hope I am offering you some reassurance--compared to the treatment you are getting in Boston, I suspect the treatment I received in the western carolina mountains was in many way amateurish. My lack of conscientiousness about following a recurrence-free lifestyle is already documented here.So, based on my own place in the universe, I would have to bet you will be fine! I know that will be scant comfort to you, but perhaps you will recognize your being a well-informed advocate for yourself is definitely giving you the edge.

I didn't do anything really.  i called my insurance company to ask if I needed a physician referal for a second opinion, I didn't.  If you have to have the phys referal, then your reg Onc or FP needs to request the appt ;( So then I called MDA.  You speak to the initial representative who takes all your basic info.  (or you can do that part online) A new patient care person called a few days later with scheduling dates.  One thing that sucked is they didn't really request any of my medical info.  I had to go to all my doctors and have them sent, I also faxed on my own what I could get copies of just in case.  My pt care rep was in constant contact via email and phone to makes sure I was getting all the reports and test results in.  My insurance covers MDA with no special amendments.  We are in our 80/20 with no copay portion, so I didn't have to lay out anything up front.  I also didn't ask for a specific doctor per say, I just asked for one who had dealt with younger women.  If you look up their docs on their website you can look through their published articles, some focus more on IBC or triple neg, ect....  That definately sucks about the 21k thing, it may be they don't take your insurance or something.  You could try the other top hospitals, like Johns hopkins or Sloan kettering.  There is a list somewhere of the top cancer care treatment facilities in the country

Posy,

Boston has four wonderful breast care centers. Anyone of them would be equal to MDA. Harvard Pilgrim will not pay for MDA unless they are offering a therapy/treatment protocol that can not be found locally. [I have asked directly. I spend so much of their money every year that I have a personal nurse advocate assigned to me.]

I am at the Beth Israel and LOVE the integrated approach to care offered. In fact, the more I have learned about how other places work, I have become more committed to staying at the BI just for that level of care.

*susan* 

It really is a style thing I think.  Treatment is based a lot on what the doctors feel comfrotable with the studies they have read.  And what they have experienced.   Doctors at research centers tend to be a little more progressive I think because the HAVE to stay current with all the research, where as some traditional Oncs just follow a standard protocol. T-A-C are standard third gen chemos and there are numerable ways to treat using these chemicals, so its all up to the Doc and what they usually are comfortable with.

Try doing a pubmed search for the two different regimines.  Its a good journal search engine to start with.  From what I have found, these are all really similar treatments, its more about the side effects.  With TAC you may have 4-5 bad days a week and you are more likely to get post chemo neurolast shots for immune support.  Its a faster protocol though, so you get done in 18 weeks instead of 24.  With the Taxol x12, you won't have as bad side effects because they are lower weekly doses that add up to the big once every 3 week dose.  So your immune system will stay stronger and your other SE will be more mild.  I am on the Taxol x12 then FAC or FEC (TBD in Feb)  So far I have only had one treatment, but it wasn't bad.  I am fairly tired but otherwise no SE so far.  I have number two tomorrow    

Yup, actually they paid for 2 pathology second opinions.  I had an appt at Vandy first and they were really quick getting my slides.  I canceled that appt to go to MDA, my insurance paid for both.  MDA says its at least 600-2500 if you insurance doesn't pay. 

Sorry, bout the insurance thing.  My insurance has a high deductible compensated some what by the hubby's HRA fund from work, but its still some OOP.  Otherwise they have been great about covering things so far,  (keeping fingers crossed )

hi ladies i am stage iv ,

 hi ladies,

    i am stage iv with lungs mets, started taxol 6 weeks ago with herceptin my onc told me i  will stay on this for has long as i can tolerate it and so far so good, is this a normail procedure, only i have been reading that the usual dose is for ywelve weeks.