Stage 2A, 11mm, Grade 3, 1/17 Which Chemo Regimen?

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ThinkingPositive
ThinkingPositive Member Posts: 834
edited November 2014 in Stage II Breast Cancer

Need to make my decision...had two regimens thrown at me and was told first visit that ACT was standard of care and then there was TC....I have been struggling with it...ACT vs. TC. Second time I was given the NCCN guidelines for stage 2 invasive ductal carcinoma and shown that both were regimens that were used. I already have my date to have port placed for Monday, I have an echo scheduled for Wednesday in case I decide to go ACT regimen....now just need to let them know which regimen by tomorrow so I can get the chemo scheduled. Really having a tough time with this.. heart risks with the ACT bothers me, but since I am grade 3, that means its pretty agressive..I am assuming thats what spread to the lymph node, which makes it aggressive as well...but it didn't go any further...the report did say extracapsular invasion, don't know exactly what that means.. But the other 16 nodes were negative.. I did have a mastectomy and the resection margins were negative, 10mm or more away on all margins... The ACT is 4 treatments every two weeks then once per week for 12 weeks...the TC is 4 treatments every 21 days.. Has anyone had to choose between two regimens?? If anyone can give me your reasons for choosing the treatment you chose it would be so helpful... I don't want to make the wrong choice... I will also be on hormonal drugs for 5 years after and possible radiation after chemo.

I posted this in the chemo..before after and during to hopefully get additional responses...

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited November 2014

    How old are you? Are you post-menopausal? How is your health overall? Any other medical conditions you are dealing with? Have you had them run the numbers of risk recurrence on each regimin?

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  • ThinkingPositive
    ThinkingPositive Member Posts: 834
    edited November 2014

    I am 58, Post menopausal. I have high blood pressure, dealing with ovarian cyst, following up on that every six months, hepatic cysts, lung nodules... I found out about all of these cysts nodules when I had kidney stones, they do the cat scan and then send you a certified letter in the mail telling you what else you have besides kidney stones... other than that I am in okay health. I did ask about the percentages and if they could tell me what the difference was between the two and was told that there is nothing comparing the two..

    Robo47, were you offered two regimens or just the one. I would assume it was because you are node negative ??

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited November 2014

    Actually there is. You can go on cancermath.com and put in your own stats for a rough estimate, but doctors can use the following site. I am copying over what their web page (adjuvant online) says:

    "The purpose of Adjuvant! is to help health professionals and patients with early cancer discuss the risks and benefits of getting additional therapy (adjuvant therapy: usually chemotherapy, hormone therapy, or both) after surgery.

    imageThe goal is to help health professionals make estimates of the risk of negative outcome (cancer related mortality or relapse) without systemic adjuvant therapy, estimates of the reduction of these risks afforded by therapy, and risks of side effects of the therapy. These estimates are based on information entered about individual patients and their tumors (for example, patient age, tumor size, nodal involvement, histologic grade, etc.) These estimates are then provided on printed sheets in simple graphical and text formats to be used in consultations.

    Because of the complexity of interpretation of some of the input information (ambiguities about tumor size, margins, etc.), the information should be entered by a health professional with some experience in oncology (cancer medicine)."

    Insist your doctor go on the site, enter your information using each protocol (preferably while you are sitting there), print it out and go through it with you.


     

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  • Rose_d
    Rose_d Member Posts: 144
    edited November 2014

    Thinking,

    I had a similar diagnosis - 1/18 nodes 1.7cm tumor. Grade 2. ER+/PR+ HER-. I was 39 at diagnosis. I wasn't given a choice of chemo - did AC/T - all dose dense, so 4 rounds of AC every 2 weeks and then 4 rounds of Taxol every 2 weeks.

    My understanding was their rationale was to give me the most aggressive chemo option possible given my young age and my overall health (aside from cancer of course).

    I certainly understand the fears around long term side effects, but my perspective was - if I'm going to do chemo, I might as well go all the way and hope it works! If I had had other health concerns maybe I would have thought about it in a different way.

    Best of luck with your decision. For what it's worth I am 2.5 years out from chemo and feel very good physically. I still worry about recurrence of course but that's a different thread :)

    I did also do radiation, which I was not expecting when I started chemo. And that was a more borderline decision, but it again came down to my age and them wanting to hit me as hard as possible.

    Going to cancermath is a great suggestion, I think you can plug in the different chemo options and see what it does to the survival rates.

    Rose

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  • Jennie93
    Jennie93 Member Posts: 1,018
    edited November 2014

    When I was told I needed chemo I was not given any choice as to which kind. Later on when I had done some reading on the subject I found that there were so many different chemo drugs used for BC. How do they ever choose? So I asked my MO and she said that there are only two that are "the best" (ACT & TC) and they were both equal, she chose TC X6 for me because of a strong family history of heart problems. I still had to get an echocardiogram beforehand to make sure my heart was healthy.

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  • ThinkingPositive
    ThinkingPositive Member Posts: 834
    edited November 2014

    Jennie93,

    I see you have truncal LE...can you tell me something about this..I had my surgery 4 weeks ago and I have swelling on the side of my chest... plastic surgeon, breast surgeon, and MO all have told me its swelling due to the surgery and will go away. How did you know yours was LE?

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  • momand2kids
    momand2kids Member Posts: 1,508
    edited November 2014

    Hi

    I was stage 2 grade 2--did four rounds of A/C--had a muga scan before to see how my heart was (great)..... surgeon and onc said this was standard of care.... and 4 rounds left some left over in case I (hopefully) ever need it again. I had heard that the taxanes caused lots of neuropathy----

    I am 6 years out and feel great---- I do think you should do as little as possible-- lowest dose, most appropriate. I did lose my hair but it all grew back (still as thick as ever). I tolerated it well-was able to work all the way through. Had small kids, but they did ok as well..... hardly remember it. but I do remember the tech telling me at the muga scan that I had a "beautiful heart".....

    good luck.

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