Neoadjuvant chemo (ACT) - how quickly did you see results?
Had my first AC on March 24. I don't see any shrinkage yet and I am getting discouraged. For those of you who did this regiment first, how quickly did you see results?
Comments
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Hi Tyler, I had 4 sessions of AC then switched to 12 weeks of Taxol. I had an MRI after the AC was completed. That MRI was compared to the MRI I had before I started the AC. There was a dramatic difference in the size of the tumor in the breast as well as the lymph node that had been positive for cancer. I and the doctors could feel the difference in the breast (it was much softer) and the surgeon couldn't even feel the lymph node. It definitely did the job. Give it time.
Kaya
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Thanks, Kaya! I see you live very close to me. I am in Glenview.
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Different DX but I did 4 neoadjuvant DD A/C and it had the 'nest' (IBC normally does not form as a 'lump' but as a 'nest' or 'band') forming into a lump with the first infusion. It continued to form better and shrink. 2 weeks after 4th A/C had a UMX and Surgeon was able to get and the nodes with good margins. 3weeks after UMX I started 12 weekly adjuvant Taxol.
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Ok. I guess I am just impatient because someone in our chemo group said hers had gone to nothing in like 18 days.
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Not sure. I will check. I know she was on the same regiment as me.
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Being on the same regimens really does not ecessarily mean a lot. A/C followed by Taxol is fairly common for many with different DXs. Neoadjuvant has long been the SOP for IBC but is becoming more usual with other types.
Some Drs will do both A/C and Taxol neoadjuvant hoping for a complete response. Mine wanted A/C neoadjuvant as long as it got to a point the surgeon had a chance of getting it 'all' and then post UMX doing Taxol adjuvant just in case there were a few cells still 'hanging out' then rads. This is not what most do but it worked for me. Most will do both neoadjuvant. But the protocohols (and prognosis) are not the same for all.
We are all unique and come into a DX with different health issues (or none) which can effect what works best for us. Our Drs are also different - they do no all march in 'lock step' with only one way of TXing all.
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Mine was about 60% smaller after 1st AC but my doctor was amazed so I dont think that us the norm. Trust that its doing its job
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After 6 Taxol treatments, I had ultrasound that showed 45% decrease in tumor and 70something% decrease in lymph nodes. So, it was/is working...
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Hi Tyler, Yes, I am close to you. I'm in Northbrook, your neighbor. Small world. I have completed my chemo, had a mastectomy and ALND and am now on my 9th out of 33 radiation treatments. My pathology report after surgery was good - clean margins and 1 node out of 14 with cancer which was dying off. From where I started before chemo, that was a great response. I will mention one thing, I had an ultrasound before the 2nd MRI and that ultrasound showed no real change in size. I'm not sure why it didn't see the change, but thankfully the doctor decided to order the MRI, too. I was so upset with the US results and then elated with the MRI results - what a roller coaster ride this disease is!
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Where did you get your treatment?
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Mainly at Resurrection Medical Center in Chicago. I worked for Res for about 17 years before retiring last year. My MO is Lisa Baddi in a practice called Illinois Cancer Specialists. They have several offices including one on Golf Rd in Niles and at Resurrection Medical Center. Amazing doctor. My surgeon is Rabia Bhatti, also at Res. I'm doing my radiation at Dr. Baddi's Golf Rd facility. Resurrection Medical Ctr is installing a new radiation machine that won't be ready for use till June. The machine at the other facility was just installed less than a year ago and is comparable plus it's a lot closer to my house. The RO's name is Joel Schwartz. Very nice man. I've been happy with all three doctors.
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I might switch MO's at some point. I don't like mine at all but the hospital is 5 min away and extremely convenient. What did you do before you retired?
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I was a Data Analyst. Basically did computer reports. I still have access into their computers and do occasional work on a contract basis. Where are your doctors?
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I am going to Northshore for chemo and having my recon in CRBS in NOLA. Not sure about rads yet but I assume yes. I have started hearing about proton therapy so I don't know where I will do that yet if I do it.
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Trvler - there was no response in my tumor until after the third AC treatment. At that point, the PA could not feel the tumor, just some textural changes. I completed the last AC on Wednesday, and the 12 weekly Taxol starts on May 6th.
KayaRose, I also have several nodes. If they are clear following treatment, do they still remove them? I'm confused about that.
Also, I'm a former neighbor to both of you - I grew up in Highland Park and lived there until 15 years ago - now a transplant to PA.
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pennysgal, I had ALND which is more extensive than the SN procedure. SN is done when they don't know if any of the nodes are cancerous. If you already know that some of the nodes are positive for cancer, then you will likely have the ALND procedure. I knew going in that one of my nodes was cancerous from the original biopsy. In the SN procedure they usually only remove one or two nodes. I had 14 removed and 1 still showed a little cancer even after the chemo. My surgeon did a technique called reverse mapping of the nodes so that she wouldn't have to remove any from the upper arm, if possible. The more nodes they remove, the more of a chance of developing lymphedema later on. I don't think they can tell if your nodes are clear after chemo unless they remove them and get a pathology report. If any of your nodes are cancerous, you might need radiation, too. Radiation also adds to the lymphedema risk.
I wish you good luck with the Taxol. For me the AC was the hard part. Taxol, not so bad.
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My tumor began shrinking after the first week of AC, and gradually got to the point where it couldn't be felt. After chemo, the MRI and PET scan showed no active disease.
pennysgal, I had one node test positive before chemo. The MRI and PET scan showed that there was no active disease in any of my nodes after chemo. Still, the surgeon ended up taking out all of my Levels I and II lymph nodes (20 in all!). None of them had cancer in them. I should say that my surgeon would have taken fewer nodes out if my radiologist had put a marker in the tumor that had tested positive. (He would have taken out the tumor with the marker + some of the neighboring tumors.) But, because my radiologist used a fine needle biopsy to check my node, there was no marker. So far, I've been lucky -- no lymphedema.
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Penny: Where in PA do you live? I love PA. My sister is in State College. It is so pretty there.
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KayaRose, very similar situation here. They did biopsy one node when they did the core needle biopsy of the tumor, and that node was positive - I know they placed a marker. MRI then showed additional Level II and Level III - I think six total. The surgeon told me that I would need both ALND and radiation. I meet with him on the 28th before starting Taxol.
ElaineTherese, great news about no lymphedema. May it continue.
Trvler - I live an hour south of State College in Hollidaysburg. My husband works in State College, so I think that will be our next move! Does your sister work for PSU?
Thanks, all, for the great information!!
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My BIL is indeed a professor there.
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