TC vs ACT Chemo for Triple Negative?
Comments
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I found this old post while doing research to determine AC+T vs. TC (if I do surgery first and they confirm node-negative). I'm so conflicted about it and am willing to go aggressive, but I'm finding occasional references to "TC being best for TNBC". I'm set to start AC this Thursday, so I don't have much time. Are any of you from this discussion still active and have thoughts about this?
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Hi, I'm new to this forum -had lots of questions regarding Chemo TC x4 every 3 weeks or AC-x4 and T X12 - My 44 year old sister was diag. with TNBC IDC stage 1 (1.9 cm tumor) Grade 2 - Negative nodes- Onco recom. 4 cycles of TC only after surgery. I have done lots of reading and found TNBC to be very aggressive and most forums that i have read recommend to do AC-T or T & cythoplatin) with AC- I'm very scared that my sister is not getting the correct chemo for this type of cancer- I have tried to contact her Oncologist but she says this is the correct chemo given at her stage. Its too late to get a second opinion and I just wanted to hear from someone who had been treated with TC and is doing good. If any one has had a NED ( no evidence of disease) please give me some encouragement. I would appreciate it.
Thank you
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Hi analove! I'm sorry about your sister; my own sister was diagnosed with colon cancer a month after I was diagnosed with BC. I know the pain you're going through.
It's wonderful news that she's node-negative. That's a very important predictor of good prognosis! And with early stage TNBC like your sister has, the typical route is surgery and 4 rounds of TC. It would be bumped up to the AC + T if she had node involvement. I'm very happy for her that it was found at stage 1, that it wasn't Grade 3 like most TNBC, and that there are no nodes involved. I know it's terrifying, especially hearing 'triple negative', but honestly she is in as good a situation as she could be in with this. And there are MANY women out there who are NED after being treated with exactly this protocol, including women with much more advanced cancers. Please have hope--it sounds like she's being treated by a very competent team!!
Amy -
Ladies, I hope you don't mind me butting in, not being TN but.....when I made the chemo decision, I asked my onc about the differences between AC-T and TC because I had heard that AC-T had better efficacy than TC and I wanted to kick cancer's butt. My oncologist is part of the US Oncology Network and there is a trial that is almost completed pitting AC-T against TCX 6 (not 4). She said the early results were that TC6 had the same efficacy as AC-T without the side effects associated (possible heart damage and risk for leukemia). That doesn't mean there are no possible risks/se with TC, just that they are considered less by most oncologists. You may want to ask your oncologist about having 6 cycles of TC instead of 4. Here is the link to the clinical trial information https://clinicaltrials.gov/ct2/show/NCT00493870
Good luck!
MsP
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I had TNBC 3a. I had four cycles is AC every two weeks and 12 weekly cycles of Taxol with every 3 weeks having Carboplatin. I got a NED at surgery. They removed 20 lymph nodes and 5 were treatment affected meaning chemo killed the cancer.
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I'm almost triple negative. ER-, PR+34%, HER2-
I started my period late, at 14, pregnant at 26, 4 pregnancies, 4 years breastfeeding. I thought all those were protective against BC. Reading now, it seems those are only protective against ER+ BC, and some sources question whether ER- PR+ (which I supposedly have, one report said 35-40% PR+, the other report said 34% PR+) even exists. So I chose the more aggressive dose dense chemo, knowing hormonal treatment will be little or no help for me.
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Hi to all,
Thank you CarolinaAmy and to all you responded to my concern. My sister will be have the 4th Taxotare and Cytoxan Round on 10/05, I'm praying that this meds take care the C - Cells if there are any remaining in her body. I will contact her Onc. with the information provided by MsPharoa of 6 rounds of TC-
Thank you for a11 your information.
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I was stage IIA and had the same treatment and response as Redporchlady. I did ACT + DD Carbo and had a complete pathological response.
My MO originally suggested TC, but I kept seeing others on ACT. I have a friend who is a nurse at Memorial Sloan Breast Center who was kind enough to ask several MO's in her department and every single one of them recommended ACT. A few of them also suggested adding DD Carboplatin along with the Taxol since I was BRCA+.
Wishing those making these tough treatment decisions all the very best.
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Three cheers for a pCR!!!!!
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Hi guys
I had dose dense ACX4 & TX3, no node involvement and also received a Pcr!
I only received 3 out of the 4 Taxol's because I developed terrible neuropathy but it's almost all gone now.
Praying and sending lots of hugs as you all make your decisions.
G
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More cheers for a pCR!!!!!
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Has anybody had TCX4 recently for TNBC stage 1 grade 2 and has been NED.
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I was diagnosed with TNBC in May of 2013. Stage 1, grade 2, node negative. I had 4 tx of TC and so far have been NED. I am almost to the 2 1/2 year mark.
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Hi,
I'm 3/12 years out and had 4 rounds of TC. I was diagnosed back in January of 2012 with TNBC. Stage 1b (6mm), Grade 3, node negative.
Knock on wood, NED.
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Hi,
I'm so glad to hear from chi-girl and from jarris77 doing great after treatment with TC X4 for TNBC- The last few months have been so hard- having surgery and the side effects of chemo and how this process has changed my sisters physical as well as psychological well being that it has taken a toll on my self and I get so scared thinking that there is something more I should be doing for her. Reading the post from you gives me so much hope. Thank you !!!!
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Analove, like you, I was questioning if I needed to go with a "stronger" chemo regimen. My Oncologist and I walked through all the alternatives on a site called Adjuvant Online. His initial recommendation and the one I ended up sticking with was TC*4. But we looked at things like CMF, TC*6 etc. I wrote the numbers down from just the TC*4 piece. He put in specific things about my medical history and my cancer type. Here's what came out:
10 years w/out chemo:
90% alive, 8% die of BC, 2% die of something else
10 years w/ 4 rounds of TC:
92.2% alive, 5.8% die of BC, 2% die of something else
The big thing was that the chemo reduced the risk of reoccurance. The risk of relapse was reduced by 7.4% with Chemo. I think it went from 76.1% no relapse without Chemo to 83.5% no relaspe with Chemo. Here's my notes about TC*6 vs TC*4: Any benefits to 6 vs 4? Answer 2%. (I apologize because I don't know if that is 2% onto the 92.2% alive or 2% onto the no relapse. All I remember is that it seemed reasonable to go with what he was recommending for me.)
Please take my notes as an example only and have your sister review with her Oncologist for her specific case. And this was done in 2012, so many things could have changed since then.
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I am interested in knowing what treatment regimen you decided upon in 2009. I am currently undergoing chemotherapy and had a lumpectomy with clear margins and clear lymph nodes and I am scheduled to take my fourth round of TC this Friday (I am scheduled to have six). Thanks for your help!
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@ Jarris77 and chi-girl: So glad to hear. I am scheduled for round #4 this Friday, but they would like for me to take six. I'm glad you have NED.
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@chi-girl: Did you end up having 4 rounds of TC or 6.
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Hi lovelifeBR, I ended up doing TC*4 which is what my doctor recommended. I usually ask a lot of questions when I go see him (he calls them quizzes) so that's why we looked at other Chemo Regimens. After looking at the statistics for my case, I chose what he recommended in the first place. But looking at the statistics with him made me feel better. Please keep in mind that the statistics i posted above were based on the pathology of my cancer, my medical history etc. They are different for everyone.
Can you ask your doctor why he/she is recommending TC*6 for you? Everyone's cancer and everyone's situation is different. So there's likely a reason behind it. If you know the reason or can see your statistics, maybe you'll be more comfortable with the decision to continue? You mentioned you have your 4th Chemo on Friday, may you can ask him/her then?
I will add that once you finish treatment, the doubts set in. (Not sure if everyone has them, but I did.) Did I do enough? What if it comes back? What if I did this or that differently? I still have doubts from time to time. I still read the notes that I took during appointments when I think that maybe I didn't do enough. Or when I see that someone else did something differently.
On a side note, I know getting through Chemo isn't easy. One of the things that I did was to "reward" myself for each treatment I finished. Usually it was something frivolous that I wanted but normally wouldn't buy. I love to garden. So for the first I promised myself a really nice set of garden gloves (no mind the cost.) I ended up with a $5 pair because I ended up liking cheaper ones the best. For the 2nd treatment I promised myself a really expensive pruner. (Which I did end up buying.) For the third treatment I got myself some garden lights that I had been looking at for awhile, but could never justify buying. And for the last treatment I got myself a magnolia tree. My mom had Chemo for Uterine Cancer and I had her doing the same thing and it seemed to help some. For her it was things like flowers, a new lamp and a comforter. I'd ask her how she was going to reward herself each time and it gave her something to think about. So maybe reward yourself in some way to give yourself something to look forward to after going through each treatment? And as a recognition that it isn't easy and you deserve something nice for getting through it. I hope Friday's treatment goes as easy as possible for you.
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Hello Charlotte NC! Hope you are still doing well! I go to the Levine Cancer and just had my 3rd taxol. So far feel good w/ no fatigue. I also did well with AC. I was lucky and had my Shot dose cut in half the last two times. I started acupuncture from the start and feel this has helped me not have many SE. (studies prove this). I still fear that lumpectomy vs Mast. but, my surg. swears it's not needed and if the cancer wants to come back in will regardless if you have a Mast. (due to Btissue still there). My 3 tumors were a total of 4cm. (also Lnodes). They shrunk in 1/2 before chemo due to high dose cancer fighting herbs and plant based foods. ONe week after chemo they completely disappeared. (I thank God for giving me this guidance). My Integrational OC said this just doesn't happen and what I did contributed to the tumors. She sd AC normally dsnt go that and that the Taxol finishes it. I am so very bless that I have done so well from the beginning and will just keep hoping for the best.
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Hello,
It's been 2 months since my sister had her last 4th TC chemo treatment and so far she has been doing good, her hair is growing back, however her finger nails are still dark in color and also seem a bit tick. She has had a hard time sleeping and her energy is also low. We had consultation with the Onco - I had many questions unanswered and this is why i wanted to ask you for your help. One of my questions was: If a Pet scans will be done now ( She was stage 1 -1.9 cm, node negative, TNBC with very close margin 0.2 mm to the muscle. Radiation was NOT recommended- this was very concerning to me due to the close margin. Her Onco said that at this stage Pet Scans or any other kind of scans were NOT needed - Not even blood test to follow up after chemo. Has anyone had the same response from their onco. I worry so much about the treatment not been aggressive and having to wait for symptoms to appear in order for scans to be done. Also has any one done natural med. after chemo. I have read about Brassica Tea from JH hospital - Tea made from Broccoli sprouts- Is there anything I should be concern at the this point that maybe the onco did not mention-
Please give me some advice.
Thank you to all may the new year bring us all health and happiness
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Hi,
My Onc doesn't does PET scans or blood tests for stage 1 cancer. My breast surgeon doesn't recommend them either. I will admit that it makes me somewhat nervous. What they both say about the blood tests is that they're unreliable and cause a lot of needless worry. They practice at a well-respected hospital and follow the NCCN guidelines so I trust what they recommend.
I'm confused a bit by the no radiation. Did your sister have a mastectomy? If not, I thought it was fairly standard practice to follow a lumpectomy with radiation. But it could be that has changed as well? I would ask about that.
If anything that your sister is being told doesn't sound right to her, or if she isn't comfortable with what she's being told, she can always go for a second opinion. I never did that, but I did ask my doctor why he was recommending a certain treatment (or not recommending it) so that I understood why.
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Good Day,
Chi-girl- I'm glad to hear from you- my sister had bilateral mastectomies, tumor was 1.9 mm with node negative, however, the posterior margin was very close 0.2 mm- with Negative Sentinel Node. The margins was " Clear" but very close. She had 4x TC- The Radiation Specialist said the risk outweigh the benefit and this is why she recommended against it. I read some where that for TNBC better results are achieved if radiation is done to the full breast even if nodes were negative. I wish I had read this before - It's just so hard to stop thinking about the possibility of the cancer returning and not catching it early if test such as pet scans or blood test are done for early breast cancer. Chi-girl, have you had Vit. D levels checked. I keep reading about Vit. D - Which Onco never mentioned either. Her next visit will be in 6 months.
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What about Vitamin D?
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I've read various things regarding Vitamin D and how treatment is more successful for women with good levels before it starts, how women with TNBC almost universally have very low Vitamin D levels, etc. I can't get mine up even taking 10,000 IUs of D3 daily.
Nutritionforcancer, what herbs did you use? I definitely want to come at this from a nutritional standpoint as well.
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When I asked my onc (who is very conservative) if he would recommend any vitamins or supplements, he told me Vitamin D, definitely, and at least 1000 IU's. He's not the type to go off label and told me to save my money on the rest. So I figure Vitamin D must be worth taking.
I think my levels were low at the time and probably still are. I take 5000 IU's each day at the recommendation of my regular doctor.
@analove, I don't know much (okay anything) about radiation and mastectomy's and when it applies. John Hopkins has a message board where you can put in your information and they'll let you know if its the standard of care or not. You may want to post there and see what they say.
I think a lot of us struggle with "did we do enough." For me, I made of list of everything I did and what the doctor said and that helps.
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