4 sessions T/C verses 6.
My doctor ordered 6 sessions of T/C but insurance turned it down saying studies show 4 is adequate. Any thoughts on this? I am TNBC grade 3 with 1 knode involved
Comments
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It's not uncommon to have 6 TC treatments and I've never heard of anyone have insurance deny 6 TC. Your doctor (and mine, I assume) have studies to back up the recommendation for 6 treatments - your doctor's office will appeal for you while you move forward with the first 4 treatments. I just checked the NCCN guidelines and see only 4-treatment TC protocols listed but, strangely, 6 treatments for TAC.
I chose TC over TAC but left the 6 vs 4 recommendation to my doctor. The last 2 treatments were much tougher than the first 4, for what it's worth.
Sorry about the insurance problem, as if FC isn't enough.
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Patti777,
I have a long story so I'll try to make it short. I was thought to be ER+5% and PR+8%, with 1mm in the sentinel node which he and my surgeon considered node negative I had 22 all clear. He wanted me to do 4 treatments I wanted 6 which I had. I was done with treatment the end of April and just changed oncologist this week. She specializes in BC. She actually got my slides from my surgical path and it turns out I am TN. I was so freaked out that I didn't get the right chemo. She assured me that I did and that 4 would have been fine, I just really wanted the 6, I was lucky because my insurance did pay for it. I was worried with TN that I needed the TAC.
I agree with crabbiepatt the last two were tough.. My chemo buddie was also TN and her oncologist had her do 4. Hope this helps I remember worrying so much about it. My original oncologist was just so wishy washy on everything that's why I decided to change. I hope this helps.
Carla
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This sounds so strange to me, especially being triple neg and having a node involved. Triple negative is so agressive. I would ask you onc to really push the insurance to cover 6. Sometimes....I can get so angry and frustrated with the insurances. They are not doctors! Why do they run the show? Pardon my rant, but this is your life we are talking about. I'm very sorry you have to go through this. You have enough on your plate just keeping up with the chemo. Hope this issue is resolved for your sake.
Thinking of you,
Carlatap
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Hi Patti,
I'm newly diagnosed TN and my onc is proposing 4 rounds of AC and then 12 weeks of Taxol. Just thought I'd let you know for comparison.
Kelly
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Hi - like Kelly above I am also TN (but with a very small progesterone positive receptor). I too have just completed 4 rounds of AC and 12 weeks of taxol. I start radiation therapy in a couple weeks and am scheduled to get 6 weeks worth.
At this stage no follow up pills (like tamoxifen) are required because TN doesn't respond to that. Doesn't worry me though as I'm looking forward to detoxing after chemo and getting well again so my body can hopefully heal itself better
I am being tested for BRCA genes.
Good luck with your treatments. -
Hi Kelly, I am getting the same protocol as you. Long story but I have both ER+/PR+ and triple negative. Luckily they found the triple negative by accident after the original pathology, pretty scary how close it was to being missed! Last week I had my second round of A/C, two more to go and then 12 weeks of Taxol. After that I will likely do Arimidex for the hormone receptor positive status and also removal of my ovaries...
Martha -
TC is a pretty common regimen for smaller tumours, minimal or no node involvement. And don't assume 6 is more chemo, or better. Dosages are adjusted based on frequency. You may end up with the same amount just staged slightly differently. For example, I was told that my 12 taxols weekly would be roughly the same (overall amount) as 3-week or biweekly regimens. There is some evidence that aggressive tumours respond well to more continuous (frequent) chemo. -
I also an TN, and went for a couple of opinions (on onc affiliated with Dana Farber, and I had 4 treatments of T/C. She thought I may have 6, but a study was being done comparing 4 to 6 and she told me there was not any evidence of 6 being any more helpful than 4. In just the last couple of years, many of the people I have met that have small tumor/under a few nodes involved, have been treated with t/c x4. I was given a choice to have the "A" but both said they would be fine with t/c. Hope this is helpful, and not more confusing!
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Thank you so much. I have already had the 4. Doctor has been very aggressive with the request to increase but insurance keeps giving us the run around. Papers not put in properly or this was not included ect. This has gone on for 2 months. I am scheduled for my 5th one next Friday but looks like it is pretty unlikely it will happen. Was just concerned that 4 was too little
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Patti777: I understand your fear. I have almost the same diagnosis as you, only difference is I'm a 2A being my tumor was 1.5cm but I dad have 1 node pos. I had the same TC regime but did have the 6 rounds. I am questioning whether I should have gone with AC-T now. My doctor said she would take the same regime she gave me if she was in my situation but it still makes me nervous that the standard regime is something with an anthromyicin (sp?). She's see some bad effects from the A. There really isn't a perfect regime that all tnbc fits into. I try to stray positive that what I had was right for me. I know it is hard, I hope you have resolution to your situation. It's crappy the insurance company can dictate your care. That's a bunch of crap. Good luck with all and stay positive.
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