Which chemo to choose ? ACT Vs TC?

lilypad · June 2012

Hi Ladies,

I am reposting this here from the Stage I and II thread. I am 30 yrs old and have a healthy heart and healthy everthing else, (well, atleast until the stupid cancer came along). I have a 2.8 cm, Grade 3 , Stage 2a, node negative tumour, which was removed by lumpectomy. I have met 3 oncologists, who all agree I need Chemo, given my age, tumour size and grade.

Two of them recommend the AC-T regimen and one the TC regimen, though they all accept that either is good choice. So Iessentially have to decide between risk of heart damage or risk of cancer coming back. And should I do dose dense? ARRRGH I cant decide. Am I overtreating by choosing ACT or will I be risking cancer coming back with just TC?

How much benefit does the A really give over the TC only regimen? How did you all decide? What did you all choose and why? HELP!

doxie · June 2012

lilypad - So sorry you have to come to this site, and at such a young age. I'm glad to see that you have posted on the Ladies in their 30s. You might also try the Chemotherapy forum and 40s ladies. You should find a larger set of women with more relavent experience to help you on these forums.

Did your MOs send your tissue out for an Oncotype score? Even though it seems understandable they are all saying you need chemo, the oncotype will give you one more piece of information on % of distance recurrance. They might have skipped this step, but I would ask for it. You'll find out if you fall in intermediate or high risk (low risk does happen with Grade 3, but not often). This can better inform your decision.

I had TC over AC, ACT wasn't on the table. I'm post meno and had a smaller tumor, though 30 oncotype score. I started chemo in really good health for my age, but it wasn't easy in the end. Did work throughout tx though.

I hope you can find someone with a similar experience who can help you better than I can. Hang in there, you've at least found these boards.

Racy · June 2012

Hi, I am 40 something. My cancer was ILC 2.2 cm, isolated tumour cells in two nodes (classed as node negative), 90% ER and PR. I also had lumpectomy and radiation.

I saw two oncs and one recommended TC x4 and A x 4, three weeks apart, the other suggested TAC x 6 every three weeks. I was told it was the same cocktail administered differently.

I chose TAC as it was six treatments compared to eight. My main side effects were hair loss and queasiness/nausea but I l learnt to manage that. I did not work during chemo.

You may want to ask about TAC x 6 as you get the full dose and finish faster. I had a heart function test before starting.

I hope this helps you a little.

lilypad · June 2012

Hi Doxie,

Thanks for the pointers will try posting. I have read through a lot of the forums , looking for older posts but it seems like not a lot of people have to make this choice. For now I am leaning towards the AC-T , use the big guns and make sure none of those cancerous buggers are left behind.

I considered the Oncotype DX test. I am in Singapore and while its available , its also rather expensive, takes a long time ,and usually done if the docs are uncertain about whether to do chemo or not. Due to work pressure, I want to start the chemo by early next week, so not sure of the test will come back in time.

Thanks so much , and hope you feel better real soon! Big Hug !

Racy · June 2012

The oncs should be able to advise on respective recurrence risks. Or google cancermath and run the scenario with both options.

lilypad · June 2012

Hi Racy,

Thanks for the input. I see we have almost similar tumours. Did they measure your heart function throughout the treatment, or is it done after? Have you noticed any diffrences heart wise since your treatments?

Let me check with the onc about the TAC *6. The current recommndation is AC*4 plus T*4. Or TC*6.

I am reading that a lot of the heart damage stories come from 10-15 yrs ago when they gave more than 300 mg/m2. But its hard to have choose your favourite vital organ Cancer has a lot of such lose/lose choices

lilypad · June 2012

Racy, cancermath is awesome! Thanks!!

Tweetyb422 · June 2012

Lilypad,

Hi, I was diagnosed at 38, I wasn't given a choice but am doing act, I finished 4 dd AC and last week had first dd taxol. I was told due to being under 40 that they would treat me aggressively as my surgeon said throw the whole kitchen sink at me. Lol. I had a muga scan prior to AC, have not had anything yet. I did not experience any heart problems while on AC. Hope that helps..if seems like there is just so much to figure our with all this. Good luck

Anjan · December 2012

Hi Lily,

I'm posting this on behalf of my wife who has diagnosed with breast cancer 2 weeks back.

Below are the details:

Dx 22/11/2012, IDC, 4cm, Stage IIa, Grade 2, 0/2 nodes, ER+/PR+, HER2-

Surgery 01/12/2012 Lumpectomy (Left)

We are Singapore PR, currently in India on vacation.

Oncologist suggested TC 4 to 6 cycles Chemo followed by Radio therapy.

We are planning to return back to SGP on 15th Dec.

Please advise on the approximate cost of treatment (Chemo & Radio Therapy) in Singapore so that I can decide whether to bring her back to SGP or to continue her treatment in India.

yananma · December 2012

Is am facing the same options. Newly diagnosed as tn, 1.2cm tumor after my 40th bday. i had mastectomy on 11/7/12, now still deciding TC vs ACT...

So what you ladies decide?

dltnhm · December 2012

Anjan - since this thread is from the summer, you might want to private message lilypad with your questions.

She does appear to be active on BC.org, but she might miss your post here.

Just an idea.

Which chemo to choose ? ACT Vs TC?

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