FEC-D chemo not listed as an option?

hi leslie,

i am about to begin my chemo next week too. Nov. 3. My MO wants me to have 6 sessions of FEC alone tri-weekly. FEC seems to be the preference among Canadian doctors, while taxene-based drugs like taxotere is prefered by American doctors along with anthracyclins or AC. My MO says taxene drugs are more cardiotoxic or harmful to the heart than FEC and the latter is more conservative and economical to use especially for early bc stages like us. I also want to add Paclitaxel in my regimen coz i've read that FEC-P increases the 7yr DFS rate (Disease-Free Survival) from 56% to 74% accdg to a 2014 study. Here is the article link to that:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC40147...

Try to look at table 2 for the DFS rates. I hope this article will be of help to you. I also noticed however that your hormonal assays say you have triple positive bc. Mine is considered triple negative since i have weak er/pr and her2- status. i dont know if it has complications as to the use of FEC.

Good luck with your chemo Sister. I will include you in my prayers along with my other friends in this community. Let's try to use the power of group prayers for a common intention, that is for our complete healing.

Take care and no goodbyes please,

gmmiph

Hi

fellow Canadian here....I had the FEC D protocol. This is the "sister" to AC-T that is used in the US. Same effectiveness with less cardio toxic effects on the heart. I did some research on it when I was first diagnosed and I found out that it is actually more expensive than AC-T

PM me if you want more details on how I fared through treatment

hi all,

I followed Leslie here from another board. Wanted to share that I did fec-d January to April.

I'll give you guys the low down, because you won't find many people here that have this regimen!

Fec- Took about three hours, you got three medications and one of them is IV the other two are pushed into your intervenous line by a nurse. Your pee will be read for a little while afterwards.

I usually started getting nauseous about four hours after my infusion, if I took my antinauseants (stemetil) right away and at any sign of nausea, it never got too bad. I never actually threw up! Besides the nausea I usually felt pretty good the day of chemo and the day after, day 3-5 I would feel very worn out (but the nausea would lessen), I think that was also because my steroid dose was going down then, so I was on a steroid withdrawal. Day six and seven I started perking up, and by day eight are usually felt almost like myself except I needed to sit down a bit more than usual. Also I usually started getting out mouth sores around today eight or nine, I had magic mouthwash from the Chemo Clinic and I started it then, if I used it for about four days the mouth sores would go away until the next cycle. Started losing my hair around 17 days after my first infusion.

Taxotore -this is a slightly shorter infusion, about 2 1/2 hours, but it is only one intervenous. The day of the infusion are usually felt great as well as the next day, as if nothing had happened. By day three I would start to feel very tired and achy, and I can't explain it but I felt very buzzy...steroid dose was higher, so the withdrawal was worth. I had to take Ativan to sleep when I was on the full steroid dose. The buzzy exhaustion lasted until around day six, and then I would start feeling better. Like with FEC, by day 8 or so I was feeling pretty normal. I did not have any nausea with this one, I only had the bone pain you hear about the first cycle, the next two cycles I didn't really have it, not badly anyway. I had more taste issues with this one, usually the second week everything would taste like dirt! Again around that time I had to use the magic mouthwash. Iced my fingers during this one, which was no fun, but I did not have any of the nail damage that you hear about. I did not ice my toenails and even though they didn't get too bad, I did lose one of them about three months after chemo, and you can definitely see where they are growing out and where they were damaged. My fingernails have none of that so I definitely recommend the icing. My hair actually started growing back during this time, which sometimes happens, by the time I finish that I had a very light fuzz.

Idid Neulasta shot throughout, it was one shot 24 hours after my chemo. They taught me how to do the shots and I did them myself, they were very easy and not painful. I never had problems with my blood levels, never had to be hospitalized or anything like that. I did go to the hospital with a fever once, but I had a bad cold and figured it was viral but I should still check it out, my blood was fine and they confirmed that it was just from the cold. I took Claritin once a day starting the day I took my Neulasta and continuing for a week, it is supposed to help a lot with the bone pain. I don't know if it did or not because I never tried without, but as I said I only had bone pain for one cycle.

All in all, it was a much better experience than I expected. On both of the chemotherapies I found that week one was rough (I was absolutely not chained to the couch or anything like that, I went out pretty well every day to run short errands or go for a little walks- I found walking and fresh air always helped me, no matter how crappy I felt ), week 2 I did not feel great but I was OK, and week three I felt pretty much like myself… And then it was back for another cycle! I Actually worked weeks 2-3 throughout, I had my chemo on Tuesdays and went back to work the next Monday for two weeks until the next cycle.

Please feel free to ask me anything and good luck! You ladies have got this

My experience was pretty much as lovestofly has written. Although I had the D first with herceptin followed by FEC with no herceptin due to potential heart risks. I am one week out of my final infusion and am so pleased about that. Back to herceptin alone until mid July next year.

I did lose most of my body hair and my fingernails are very discoloured and I'm sure they will drop off.

My first D infusion did land me in hospital for 5 nights and my dose was lowered twice due to diarrhoea and neutropenia I had the shots as well after that. I mangaged the full dose FEC but once again struggled with diarrhoea more than nausea. The tiredness got worse after each infusion.

All the best for your treatment

Helen

Hi there,

I agree with LovesToFLy's description, but have a few things to add:

FEC: I developed an excruciating case of acid reflux while on FEC. Ask your doctor for a proton pump inhibitor if you begin to feel heartburn/acid reflux. I waited to ask for the prescription and the reflux got out of control. The medicine took about two weeks to start working, and I was in real pain. I also had difficulty breathing through my nose, and someone recommended a saline solution nasal spray to me. My hair started to fall out on day 13 of FEC and my scalp really hurt during this period. I took tylenol and it successfully relieved the pain. I use Aveeno baby wash for my scalp. During the first week of each FEC treatment I felt pretty awful, but on day 8, like clockwork, I began to feel better. I was tired during week 2 and felt great during week 3.

Docetaxel: I have a "mouth rash", which I think is thrush? I use the mucositis mouth wash four times a day, and also made a mixture of baking soda, salt and water that I use a few times a day. I have intermittent pangs of pain for which I take tylenol. I have Percocet leftover from my lumpectomy, but I haven't had to use it. Other than that, my only symptom is fatigue. Exercise (walking) has helped me keep my energy level up.

Overall, I found FEC to be much more difficult that docetaxel. BUT, both were much more tolerable than I had anticipated.

LovesToFLy: Your photo is terrific! So inspirational. Gives me hope that I will resume my regular life soon... (one more Docetaxel treatment to go on November 9, then on to radiation).

Good luck to those just starting out, and hurrah for those nearly done (Hi, HelenWNZ!).

Stephanie

I had FEC - no D - in 2008. 6 times. I found the worst ses for me had to do with my taste buds and a very nasty flavour that developed after eating - like my mouth was the bottom of a garbage can - I had to brush & floss teeth at least 6 times/day. Resulting in very healthy gums when I finally went to a dentist again! I took one bite of a Thai dish in a resto & it was like my mouth went on fire - so, from my mouth on down, it was like having a totally new and very sensitive digestive system.

Hated tea, hated coffee, hated water - I know i was dehydrating & finally discovered cold chunks of pineapple, watermelon or cantaloupe to hydrate. One of those meds is red, so pee is pink for a bit - by the time it was over I could not stand that colour red. I never did barf but felt queasy & found it better to eat quite a bit than not. But everyone is different, has different reactions. Me, I loved the steroids, got stuff done right away but by day 3 would crash.

I'm sure by now there are better anti-nausea meds & everyone seems to get so much more info. I believe the FEC is used a lot in Canada as we tend to follow the British system, also so many drs from around the world work here, and they've used British systems too.

Best of luck all - as everyone says - it's doable!

Hope all of you will be fine sisters.. i think this is the best place to my replay and questions .

I saw my doctor (oncologist) today, according to his instructions, he told me to start chemo next week. Its hard to hear that but no choice except crying .

He wrote 6 cycles of treatment ( 4.5 months in total ) , one time per 3 weeks as below :

- FEC ( Fluorouracil - Epirubicin - Cyclophosphomide ) - 3 times

- Taxotere - 3 times .

I read the side effects of each one, its hard to read, hard to think about it, and no ideas what the future hold . according to many medical websites, this is the side effects (common and rare, more and less than 30% of patients ) :

Fluorouracil side effects :

- Cardiotoxicit ( the most dangerous side effect, long term side effect ), Myelosuppression, Cerebellar syndrome, Encephalopathy and Anaphylaxis.

Epirubicin :

- Red Urine, interference with the pumping action of the heart (heart problems can occur as late as 7 or 8 years), leukemia cancer.

Cyclophosphomide :

- Bladder irritation and bleeding, blood cancer, myelodysplasia .

Taxotere :

Fluid retention, weight gain, swelling of the ankles or abdominal area, Muscle/bone/joint pain (myalgias -arthralgias), liver problem, Allergic reactions ( dangerous ) .

as you see, taxotere is tough too much, also Fluorouraci and Epirubicin. long side effects in your life. usually i do trust in the experience of the patients more than side effects list.

any one can help please ? I am afraid

Thanks for all .

Leslie2016 and who take FEC and taxotere protocols . please help us here to write the SIDE EFFECT and how to prepare for chemo . I will start on Monday . I do not know how to be ready. I am Scare.

what is the difficult part in this protocols ? In this community I did not find this protocols as a common, its rare, so please help us and write your experience in details . we will apreciate that .