how many cycles of Adrimycin and Cytoxin (AC) ?

Hi Sophie,

I'm 42 and was dx with locally advanced IDC in February. I didn't ask my stage, but it's definitely at least a 3...my first symptom was a large lump of matted lymph nodes that I found under my right armpit. I initally had no symptoms in my breast whatsoever. By the time I started treatment, I had a large rock-hard tumour in the right breast, with skin involvement and pointy "micro-tumours" also developing around the main tumour. It had also spread to a palpable node in my left armpit, which they tell me is extremely unusual and considered "metastatic" because it was the exact same kind of breast cancer as on the right side. (hormone-negative and HER-2 positive.) The status of my left breast was unclear. No definitive signs of breast cancer there, but since I started treatment, it's hard to say if it would have developed.

I live in Canada. My oncologist has me on 4 rounds of AC (I did the third round 11 days ago) every 3 weeks, and then I will have 4 rounds of Taxotere every 3 weeks. On the 5th round, they will add in Herceptin and continue it every 3 weeks for at least a year. When the 8 rounds of chemo are done at the end of the summer, I'll have a double mastectomy with the axillary nodes on both sides removed, and then 5 weeks of radiation. (every day from Mon-Fri).  

From what I understand, the advantage of having the chemotherapy first is that you can see how the tumours respond. I knew from research, and confirmed it with my oncologist, that hormone-negative and HER-2 positive cancer has the highest likelihood of responding well to chemo. I am still filled with anxiety about things changing, but in my case there was a huge improvement after the first round of AC, and now you can't feel the tumour or the nodes under my arms at all. I'm incredibly grateful, and seeing the response gives me the motivation to keep going with the treatment, because it has been hell.

Some people may sail through chemo, but I'm not one of them. I have an underlying bowel disease, so the oncology team has thrown every anti-nausea medication possible my way in order to prevent vomiting. (and hopefully weight loss. I am borderline underweight to begin with.) I take Emend, Zofran (or Granisetron/Kyril), Decadron, gravol and ativan. I'm also on home hydration for 7-10 days and can get injections from home-care nurses of Stemetil or Gravol when necessary. I'm still nauseated after a week, when most of those drugs aren't effective anymore, so then I take Olanzepine (another anti-psychotic that has been effective for breakthrough chemo nausea) when I need to.

The whole experience is very difficult, and even with all the meds I am still severely nauseated for 7-14 days, but I have only vomited a few times. I am also crushingly tired (bedridden for at least a week), get headaches, feel "buzzy" and removed from the world...in other words, nothing like my normal self. I have a 9-year-old son, so it's tough to be so sick and removed from most of his daily life for a few weeks. And the effect has been cumulative, so each round has been a bit worse than the one before. I am much weaker and sicker now after round 3 than I was after round 2, which was worse than round 1. But I tell myself that I am allowing this poisoning to take place to give myself the best possible chance of long-term survival. One day at a time, I can do it...and before too long, the treatment will be behind me. I don't know about how you're reacting to the A/C, but if you can hang in for a few more cycles, perhaps you will get further shrinkage of the tumours, or even a complete response. 

I wish you all the best.