Taxol for 12 wks verses dose dense (every 2 weeks x 4)
Will someone please advice me on which route I should take by laying out the pros and cons? I am on a dose dense AC+T. I have received 4 treatments of the Red Devil and Cytoxan with the last administered on July 1st. My Oncologist gave me 4 weeks between, and asked me to make a choice between getting 4 treatments every two weeks of Taxol, or getting 1 every week for 12 TWELVE weeks. I am sick of being down; at the same time, I want to get this over with.
Comments
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We're all different so chemo can affect us in unique ways and these are not easy decisions but I'll share my experience. Like you I did dose dense Adriamycin and Cytoxan for 4 cycles and two weeks later started 4 cycles of Taxol. I just wanted to be done with chemo so I chose to stay on the DD protocol. I was able to keep working throughout the chemo. I found Taxol to be easier on me than the "red devil" and Cytoxan. My hair actually started growing back on the Taxol - just peach fuzz but at least it was hair however I did lose my eyelashes and eyebrows on the Taxol. And I had peripheral neuropathy which caused burning pain in my hands and feet but I found if I held frozen water bottles in my hands it helped drive the Taxol away from my hands and prevented the neuropathy. MY MO also put me on high dose Vitamin B to fight the neuropathy. I'm sure others will also weigh in on what worked for them. Good luck with your decision...(((Hugs))) Maureen
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I think the one advantage to weekly is that you are less likely to have serious problems with neuropathy because it is lower doses. On the other hand, you get done faster with dose dense. The weekly was fairly easy for me. Especially compared to AC. A little bit of neuropathy in my feet that went away a couple months after I was done. My taste buds were off for about 24 hours after each infusion then back to normal. Fatigue definitely kicked in towards the end. I don't work so going in weekly wasn't an issue with me. Maybe that could be a deciding factor?
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Thank you so much, Maureen1, for weighing in. You give me hope! And, I'm very happy for you that you are done. I'm at the halfway mark, and leaning toward continuing with the dose dense regime as my Oncologist thinks I'm healthy and we should get it done. I'm just dreading 4 more high dose treatments.
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I did 4 DD A/C neoadjuvant and it did not slow me down at all. I did 12 weekly Taxol adjuvant and I was completely and utterly EXHAUSTED the entire time.
I was given 3 choices for the adjuvant (not with the neoadjuvant). Dr said he had taken my case to not only the facility I was atat but other ones he was on Board at - the unanimous suggestion as the best was 12 weekly Taxol in my case but was given 2 other options but I don't remember what they were - I went with the suggested best option. Apparently, the 'right' decision for me - still NED almost 6 yrs post DX.
Ask your Dr the pros and cons and why the different ones are being recommended to you.
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kayb, thanks for pointing out the SWOG trial, of which I was a participant. I had been told by everyone that Taxol was a "walk in the park" compared to dd AC, so I eagerly joined the trial and was randomized into the dd arm (6 treatments instead of 12). I experienced significant bone pain that was debilitating at times. I wanted desperately to continue the trial so i ended up taking pain meds for most days after each cycle. I understand my experience wasn't the norm for many participants, but it was a concern for the researchers. I think if j had a choice, even knowing what I know now, I would have done the same dd treatment. I liked having two weeks between treatment, and would have struggled time-wise to do 12 weekly treatments.
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I did 12 weekly taxols. My dose had to be lowered even on this "lighter" regimen b/c my liver enzymes were significantly elevated on taxol. Even on reduced dose Idid get slight neuropathy by the end that went away after I completed treatment.
Keep in mind that taxol infusions take less time than AC infusions, so if schedule is a concern it may be easier to squeeze weekly taxol in your work week, some facilities do infusions late in the day and on Saturdays.
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Wow Nancy...doing 6 dose dense cycles of Taxol! you are stronger than I am and so brave to participate in the research project...I was counting the days to my 4th and last one Muska...Unfortunately my Taxol infusions weren't shorter the way my MO did them. AC infusions were about 4 hours but Taxol was almost 6 by the time they did my labs, gave me the iV Benadryl and then the IV steriods and sloooowly ran the Taxol so I didn't have an allergic reaction...it took from 7am to about 130pm YUK!
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I think dose dense taxol takes longer simply because it's a higher dose than what they give you with weekly infusions.
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I did DD A/C and chose the 12 weeks of Taxol vs the DD Taxol due to the possibility of the neuropathy being permanent. I went yesterday to have my 4th Taxol and because I already have numb toes, I wasn't able to have it....it's been delayed for a week. I can't imagine what the neuropathy for me would be like on DD. I do believe it is a very personal decision and each of our bodies handles these chemicals differently. I would suggest making your best informed decision and going for it! Good luck to you and God Bless.
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Is there anyone who has done the DD Taxol (4 times @ once every 2 weeks)?
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I did DD Taxol (every two weeks, but for 6 treatments instead of 4.
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I did dose dense for both AC/T and Taxol. I found AC/T to be far more tolerable than Taxol..... I am told that is an unusual experience. I found the bone pain on Taxol to be horrible, don't know if it would have been more tolerable if I had weekly instead.
I worked full time during this. During AC/T I took off infusion days, and that was it. No problem. For Taxol, I was generally knocked out for about three days and took quite a bit more time off.
Everyone is different. It was nice to get it done and over with quickly, and I do hear that my experience is unusual, most people tolerate Taxol better than AC/T.
Good luck!
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I did DD Taxol every 2 weeks for 4 cycles. I was fortunate, I was able to work and manage the side effectsbut I did need to take Neulasta to get my blood counts up and vitamin B to counter the neuropathy. We face difficult decisions in fighting this beast, take care, let us know what you decide.
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Hi Shanann, I've had 11 doses of weekly Taxol and have to say it has been easier than I expected. I'm dreading the AC, which they say is coming next, after I see the BS. No neuropathy (knock wood) or joint pain. Some gastric symptoms (but no nausea) but very manageable. GL and enjoy the four weeks off.
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I did 12 weekly doses of Taxol. I was told that weekly Taxol was found to be more effective than once every three weeks. Possibly because it gives the cancer cells less time to recover. However, there were no studies comparing one and two week doses. Also, the side effects are milder with the weekly dose. I had no problems with nausea, and some neuropathy in my finger tips and toes towards the end. My blood counts stayed a little below, but still close to normal. I am a week out, so I'm not sure how long it will take to return to normal, but it should. Also some bothersome body aches towards the end. But nothing too bad. Even though you have to go every week, it was nice to not have to be there so long.
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I also did 12 weekly doses of taxol. Pretty sure my oncology nurse told me they don't do DD taxol anymore only the weekly. I do have some slight numbness in my toes, but most of the time I don't even notice it - just when I'm sitting on the couch lol. I took l-glutamine throughout taxol. My MO said it was ok to take
Nancy
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I decided to do the 12 weeks of Taxol, instead of the DD every two weeks X 4. I questioned my Oncologist about many things! He explained to me that people with a higher stage cancer are the ones who usually take the 12 week regime although both are equally effective, and that it is a matter of weighing which SE's I'd rather deal with. The DD would cause way more fatigue and nausea, which I want to avoid at all costs as I'm heading into my busiest season at my job. Believe it or not, the DD has less issue with the neuropathy, which was scaring hell out of me, but the nurse explained to me that I should report any and all issues as we go, so that they would know, if needed, when to stop treatment before if became irreversible. DONE! One other thing is that I don't have to drive to the hospital the next day for that nuelasta (sp) shot. So, I have to go 4 extra weeks, but the hospital is only 24 miles away, and I can better deal with having a POSSIBLE one 24 hour down time verses 4-7 days.
I asked him how long it would take to recover when the treatments are over. He reminded me that I had to get through radiation, then there was the pill, but that I had get my 'game on' to deal with the second phase of treatment. Having said that, he said that it would take as long to recover as it took to take the treatment, so my treatment was a 5 month regime, and I would recover as slowly as I went down, but would gradually start feeling better just as I gradually started feeling bad. In other words, I would be feeling much better in about 5 months, and my hair would start coming in about 3 months after treatments ended.
I asked him for his OPINION on why so many women are getting cancer, and he explained that one reason the statics are so high is because 'we' are catching things much earlier now, but he also felt that it is environmental. Perhaps in the chemicals in our foods, and the products we put on our bodies, etc... I am definitely trying to read those food labels. It would be much cheaper to pay a few extra bucks for, say organic fruits, and chicken that is not pumped with chemicals NOW than pay for chemo or other medications later. I'm trying to eat more greens, like kale, spinach, avocados, and trying to cut down on grains (grass fed butter and meats), and cut down on sugar. I love wine, and Merlot is dry.
I asked him how he would know if I were still cancer free when the treatments were over, and he explained that they would continue, each 6 months for, I forget- 2 years- to check through my blood work, and would be able to see how my liver, heart, and other organs were functioning, as well as checking my lymph nodes. So, that's a nice safety net for a few years.
I also asked about taking some supplements to help build up my system against the SE's, and he explained to me that I could take Vitamin D-3 in 5,000 I.U. daily dosage. This is something we ladies with cancer are usually greatly lacking. Got some- CHECK. He also said I could take a B- Complex, but not to worry about taking supper high dosages, because our body only absorbs 100-200, and anything over that we just pee out of our system, so paying more is a rip off. Got some- We are just not supposed to take excessive amounts of antioxidants while taking treatments.
You guys are probably already aware of these things, but I wanted to share for anyone who MIGHT have these same questions.
While I was taking my 4th DD treatment of AC, another elderly lady was sitting beside me getting her FIRST treatment. The nurses were upset and whispering because she did not have a port, and THEY called HER doctor while she was there. Of course, they were concerned about collapsing veins, and the harshness of taking chemo this way. An appointment was scheduled by the nurses for this lady to see her doctor about getting a port before her next treatment. The lady asked me about it when I was leaving, and I explained to her that she would be much better off to get a port placement, and it would not hurt. When I went in yesterday, there she was, and all upset, because rather than get a port she opted to get a catheter in her arm, and now the dang thing had slid down a bit so the nurses could not test it by drawing blood (to make sure they were in), and that had her worried some more. I am glad I don't have HER Oncologist. God has been good to me in directing me to the right doctors and surgeons. That Poor lady. Please, say a prayer for her.
I haven't heard much for anyone. I enjoy reading what each of you has to say and your doing on your journey. In other words, I miss you!! You are in my heart and thoughts, and in my prayers. -Shan
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I will be starting Taxol, 4 doses every two weeks when I complete AC. It was not an easy decision to make. Because I am Diabetic as well, my risk of infection and peripheral neuropathy are both increased. As I understand it through my Oncologist and research - the advantage of weekly Taxol - less risk of blood abnormalities and the need for granulocyte-colony stimulating factor (which saves money) but with an increased risk of Neuropathy. Taxol every two weeks - requires the support of granulocyte-colony stimulating factor but less risk of Neuropathy and is completed sooner - costs more money.
The first study involved 12 week Taxol at a lower dose vs. 6 dose dense treatments every 2 weeks. The researchers decided on 6 treatments to make the doses ultimately the same. Efficacy was the same in either arm of the study. Another study later decreased the dose dense(every 2 weeks) to 4 doses. They found the efficacy of 4 doses vs. 6 doses to be the same. So, I finally decided with my Oncologist to go for 4 cycles every 2 weeks. I'm going to use hypothermia gloves and slippers during infusion(like the cold caps). I think most women do OK either way and most say it's easier to tolerate than AC - but we're all different. Definitely one of those "what should I do" decisions. All the best!
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So how are people doing with the DD? I start it in two weeks
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