Need advise/chemoterapy

Chriisstina · February 2017

Hi

I'm feeling confused and nervous about my mother plan treatment.

She had surgery ILC 2.5 cm and 12 nodes positive and her protocol is adjuvant 4 A/C every three week than 4 taxotere every 3 weeks , as I saw from other posts that woman's with higher nodes positive tend to have dose dense chemoterapy , I talked with the doctor and he said this is the most agresive treatment every 3 weeks and can't do it every 2 week because of the side effects.

My mum is 56 years old , pls tell me what are those side effects from your experience and can we menage them ?? Is it better to do dose dense ?? Thank you !

SSInUK · February 2017

hi there - my onc gave me the choice between dose dense taxol or 3 weekly. I chose the latter. I understand there is a slight difference in terms of effectiveness - but only very slight.

fondak · February 2017

I don't remember what I took....that's bad I guess. I do know I went weekly for one followed by weekly treatment of 2 more chemo's. That was 5 years ago....actually this Valentine's day will be 5 years since my last chemo!

They have something that they give now for nausea which is wonderful. One thing I wish I had known before chemo is to take fiber or something. Severe constipation can be a horrible side effect. I would ask if fiber is okay or if there is something else you can get over the counter to take as a preventative. Also, drink plenty of water before and after chemo. They say it reduces side effects and is good for your kidneys. I would even drink during chemo.

For me, mentally....prior to getting started was the worse time. Once I did, I felt like I was doing something which was helpful. It is wonderful that your mom has your support. I'm glad you found this forum too. The ladies here are amazing! There are so many people doing very well after such a diagnosis.

MinusTwo · February 2017

Chrisstina - you should go to the main BCO discussions and read the information given. Some things appear to be universal - maybe fatigue. Other things depend the individual reaction. Yes, some people get very constipated. I on the other hand had diarrhea for the entire chemo period and lost 60 lbs. Unfortunately I only needed to lose 5. It's hard to plan for many side effects since they can be exact opposites for different people.

There are threads & discussion boards for AC and for Taxotere (although I expect it will be Taxol after the AC) Or pick any "chemo starting xxxx" thread and start reading. It will be useful for your Mother to join the current thread - chemo starting February so she can share experiences with others doing the same thing. It will be useful for you to read December or January chemo threads to see how everyone has been managing.

muska · February 2017

Hi Christina, I had AC therapy that your Mom's doc recommended for your Mom when I was 54. I chose it over dose dense AC because I didn't want to get Neulasta shots in between the infusions (dose dense protocol requires Neulasta shots that might have their own side effects) and wanted more time to recover naturally between the cycles. I was healthy 54 year old with no pre-existing conditions. I handled AC very well by my medical team's assessment and continued working while having chemotherapy. Before the last AC treatment I needed an emergency blood transfusion because my red blood cells were very low. I also could hardly climb a flight of stairs - would be short of breath - so had to use an elevator to get a floor up. I am not even mentioning small issues because I had very few. This was considered very good. My heart fully recovered with proper exercise.

Generally speaking, when MOs recommend a particular chemo regimen they take into account the specifics of the case. So if your Mom had doubts and wants to consider a more aggressive regimen she should ask questions and get a second opinion if needed. From what you describe, I would ask why they want to give her taxotere after AC and whether 12 weekly taxol infusions would be an option. Taxol is easier than taxotere and from what I remember the results are not worse than with taxotere. But your Mom's doc might have reasons to give her taxotere.

Claire_in_Seattle · February 2017

I did six dose dense AC followed by six Taxol as I was participating in a clinical trial and that was the protocol I was assigned. I got through just fine, although I did need Neulasta. There is a slight survival advantage to dose dense versus once every 3 weeks. I would also ask about weekly Taxol. There is no survival advantage of dose dense Taxol over weekly and the study I participated in showed that weekly is easier for most patients to tolerate.

I was a bit older than your mother at the time, and I was able to work and exercise throughout chemo. I do endurance sports to keep fit. My idea of a fun weekend away is a lot of Nordic skiing which I will be doing next weekend for my birthday.

With your mother's diagnosis, she needs very aggressive therapy. Did she have her tumor tissue tested? Genomic profiling can open up other avenues for treatment.

Can you get a second opinion at this point??? It might be helpful as I question why your mother wouldn't be offered dose dense with Neulasta. It's pretty standard here in the US.

Wishing you and your Mum the best. BTW - if she can remain active - that is take a good walk every day - she will have a much easier trip through treatment and beyond. Good luck!!! - Claire

Chriisstina · February 2017

I am really feeling sad , My mum has good general health condition, I think she should take dose dense , I talked with the doctor he said that this is the protocol and it's the most agresive treatment. We live in Albania , in Ballcan maybe this is the protocol here but as I am reading everywhere the woman with higher risk take dose dense chemo I dont care about constipation or feeling tired ... , I need to be sure that she's taking the right treatment and don't understand why they dont use dose dense protocol ...

Yes the resulst was the ki67 was 30% , er 100 % positive and progresteron 0 and Her2-1 + (negative)

Thank you for responding me ladies, but I feel lost and in pain, I think I need to go for a second opinion

Claire_in_Seattle · February 2017

Hang in there Christina. So glad you are going for a second opinion. Neulasta is not cheap which could be part of the explanation. I was willing to do whatever it would take to be just fine in the end. No, it was not fun, but hardly the end of the world.

It's a very good thing that hormonal therapy will be an option once she is done with chemo. Wishing you and your Mum the best. - Claire

muska · February 2017

Christina, I don't think there is a significant difference in survival between dose dense AC vs "every three weeks" protocol. I wouldn't take what you read on these forums over the doctors advice. It would be interesting to see what research the claims that dose dense results in better survival and fewer recurrences, is based on.

Chriisstina · February 2017

Muska

Yes DD it is heavy and kick those stupid cellsand as i read here from other woman's with higher nodes involvement they are all done DD . And as ki67 is high 30% it's better ...-Cells are most sensitive to chemotherapy when they are rapidly dividing, therefore the early stage, smaller tumors are often more sensitive to chemotherapy. This is also why surgery may be used to remove as much of the tumor as possible, leaving a small number of cells to then be treated by chemotherapy. Standard chemotherapy regimens call for a standard dose of chemotherapy given every 3 or 4 weeks, depending on the regimen, allowing for healthy cells to recover between doses (such as blood counts, oral mucosa, and GI lining). However, we now understand that this 3-week break may also allow the now smaller, more rapidly dividing tumor cells to start growing rapidly again.

Dose-Dense Chemotherapy (DDC) aims to achieve maximum tumor kill by increasing the rate of chemotherapy delivery, not by increasing dosage (which is the theory behind many stem cell transplant protocols). By administering the same doses of chemotherapy previously given every 3 weeks on an every 2 week schedule instead, the chemotherapy interrupts the rapid growth phase of the tumor cells. Thus, the medications interfere with the Gompertzian curve, hitting the tumor cells at the time when they are just beginning to grow rapidly again. In other words, "hit them while they are down." This model was called the Norton-Simon model, after the researchers who first described it.

Need advise/chemoterapy

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