Thoughts on dose dense versus normal TC treatment

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Origins
Origins Member Posts: 1
edited June 2014 in IDC (Invasive Ductal Carcinoma)

Hi-

This is all so new.  It was just before my 31st birthday in December last year that my significant other found a lump in my left breast.  In the following weeks my tests were scheduled and came back BI-RADS 5.  I had my lumpectomy and 6 lymph nodes removed on 13-Feb and after a successful fertility treatment cycle to retrieve and freeze some of my eggs I am about to start the next phase of my treatment.  My tumor was 1.5 cm, clean margins, Stage I, Grade 3, 0/6 nodes, ER+/PR+, HER2-, BRCA1- BRCA2-, Oncotype DX 23 (15%).  

I have decided against a AC/TC clinical trial as I want to avoid the cardiac side effects of Adriamycin and the whole trials process in general.  That siad, I have had two different opinions from competing oncologists - one pushing heavily the clinical trial and begrudgingly offering the "standard of care" or ACT and the other one offering "individualized treatment".  

I have been told that given my age (31) I should take as much as I can possible survive (ACT + RT + 10 years of Tamoxifen) and have also been told that given my age and my pathology that TC for 4 or 6 treatments (my choice) followed by RT and 5 years of Tamoxifen is also perfectly acceptable as well in reducing my 15% possibility of recurrence .

I know the "everyone's cancer is different" disclaimer, but any thoughts on my situation and on choosing a dose dense (14 day) versus normal (21 day) TC cycle? Or on ignoring the long term health risks and going with the all-in approach?

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  • heather214
    heather214 Member Posts: 142
    edited April 2013

    Seems as though we were given the same advice, I was recommended dose-dense AC-T pre-surgery for 12 cycles, surgery, then more chemo/rads and Tamoxifen for 5 years. I had fears about Adriamycin as well, but was seen for treatment planning at City of Hope in California, and the director told me this regimine in her opinion gave me the best long-term chances of survival as well as to avoid recurrence. I am 43. I guess I am agreeable with the advice to hit it as hard as you can tolerate. Only you can make that decision, wish you the very best!

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  • Timbek2
    Timbek2 Member Posts: 204
    edited April 2013

    I don't have all the answers but I am 40 and just finished radiation after BMx and ACT chemo. None of it was pleasant but it's doable. Next I will take tamoxifen for ten years. I have three kids to fight for and I'm giving it all I have. I never want to look back with regret. Wishing you all the best in whatever you decide. :)

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  • maltomlin
    maltomlin Member Posts: 343
    edited April 2013

    I'm in the UK so slightly different, but I too had 'the red devil' on a dose dense regime i.e. every 2 weeks. It was hard, I can say that, but in my opinion, was worth it. I had a grade 3 with 3 lymph nodes affected. I'm celebrating 5 years in a couple of weeks.

    The worst about the dose dense treatment is that you don't have that good week. When you're looking ahead at treatment it seems as though it's going to last forever! It doesn't, and the only way to deal with it is to keep your head down, mark off the treatments on the calendar and just get it over with.

    Looking back, I'm glad I had the opportunity. I'm here and enjoying life.

    xx

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  • Robin3
    Robin3 Member Posts: 145
    edited April 2013

    Hi Origin,

    Sorry you are here. I was diagnosed in december also. I based my chemo on my oncotype dx score. Mine unfortuntely fell in the intermediate range, so my doctor recommended chemo. I was against the whole act thing for so many reasons. #1. Scared. #2 Hair. #3 Further health issues. So we discussed the cmf regime.  There is a thread on here about it. Most people call it chemo-lite. I hesitate to bring it up, because everyone has to do what they feel is best for them. I'm 5 treatents into an 8 treatment cycle. It's been very do-able. I did not lose my hair. My oncologist (who is an excellent oncologist) is comfortable with this regime and feels we are doing our best to fight my cancer. Yes if he had his way --I'd be doing ACT. Because it's the "gold standard" for my area. But.....it may or may not have been any better (if you go on cancermath.net you can use your pathology report to find out what the statistics are for any treatment you have).  I have 3 boys that I want to live for. I wouldn't play with my health and I'm 100% certain I can sleep at night that I did fight my cancer and did what was right for me. Good luck..i hope you beat this....i'm sorry you joined us, but you couldn't be in a better place for information.

    Robin

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  • Maureen1
    Maureen1 Member Posts: 614
    edited April 2013

    (((TheOrigin))) so sorry to hear you have to face this beast and at such a young age...you have so much life is ahead of you, sounds like you got it "early" and from what others have said the high grade breast cancers respond well to chemo so that's in your favor. I did the every 2 week dose dense cycles of AC X 4 cycles followed by Taxol X 4 cycles. My oncologist recommended dose dense because I was, in her opinion "young and healthy enough" to take it and she felt it was more effective/aggressive. I wanted to do it because I wanted to get thru chemo as fast as I could and the dose dense meant I could start in mid September and be done before the New Year started. I am grateful that I tolerated it well even though I did lose my hair and my nails turned dark. The nails have grown out and my hair is almost 2 inches long now since my last chemo dose almost 4 months ago. I wish you the best with your decision...as others said to me, you have to make the decision based on what you feel is best for you and don't look back...(((Hugs))) Maureen

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