General chemotherapy questions

home help, 

I assume the decision on how many chemo infusions to get are based on a woman's dx. Adriamycin is not given to some ladies that have heart issues. I had to get a Muga test  before I started  A/C. 

Everyone does react different, I thought Adriamycin was legal torture. Some ladies breeze through it. Taxol was much easier for me. I had 4 dose dense ( 14 days apart ) A/C & then 4 dose dense Taxol. 

If your wife did not have cancer in her lymph nodes, it would explain why she is only getting 4 tx. 

Homehelp- It is so wonderful that you are doing whatever you can to help your wife.  The support, love and care that you give will go a very long way in helping get through her time in chemoland.  I am assuming that the TC regimen you are referring to is Cytoxan/Taxotere.  I had 6 rounds of Cytoxan/Taxotere and not 4.  I knew going in that I would be having 6 rather than 4.  That treatment plan was recommended and determined by a hospital tumor board comprised of my onco, my breast surgeon, pathologists, other oncos and medical staff after they had reviewed my medical history, pathology of the tumor, etc.  

To answer your questions....

1.  My chemo cycles seemed the same.  I did notice that I did become more fatigued and tired after the 3 rd round of chemo.  My side effects were very predicatable and consistent after the first one.  I also noticed that I had shortness of breath and a racing pulse which was attributed to the chemo and a declining red blood cell count.

2.  I received the Neulasta shot after Round 3 because I had developed a high spiking fever/chills 10 days after my 2nd round of chemo.  I took regular 24 hour Claritin ( NOT Claritin D) for 7-8 days starting the morning that I received my afternoon shot of Neulasta.  There is an ongoing clinical trial investigating the use of Claritin to help prevent the bone pain associated with the Neulasta shot.  Muscle aches/pain and joint pain is a side effect of this chemo regimen so it is possible to have aches and pains post infusion.

3.  As to who receives Adriamycin and who doesn't, you should talk to your wife's oncologist and ask what were the determining factors in your wife receiving the chemo regimen that she is receiving and no Adriamycin.

4.  As for the number of rounds of chemo, again, a chat with your wife's oncologist to explain the number of rounds she is being given would be helpful.  I knew I would be having 6 rounds because of my medical case/pathology.

5.  As for the fatigue, each person is different.  Eating well through cancer treatment is important as well as resting and exercising.  The fatigue can be caused the the declining red blood cell count and possible anemia.  My red blood cell count declined during my 6 rounds but not to the point to require a blood transfusion or to take any kind of iron supplements.  Instead, my onco told me to eat more iron enriched foods since I'm not one for taking supplements or vitamins.    During my time in chemoland, I had two cook books that helped because they had recipes but also helpful tips to handle certain side effects.  These two books are "Eating Well Through Cancer" by Holly Clegg and Gerald Miletello , MD and "The Cancer-Fighting Kitchen" by Rebecca Katz.  FYI:  I kept a daily food diary and daily drug diary so I could keep track of what I ate and when I ate and also to help remind me to eat and take my anti-nausea drugs regularly.  Make sure that your wife drinks plenty of fluids the day before the chemo round ( to help the veins be ready and plump for the the infusion) and to help flush the chemo through.  

Wishing both of you the best.