Weekly Taxol versus Biweekly?
I've noticed that it seems most women are doing 12 rounds of weekly Taxol with the AC+T regimen. I went through chemo early last year, and did 4 rounds of Taxol biweekly.
I know I can't change it now, but I'm wondering is the weekly Taxol more effective? My oncologist definitely preferred the dose-dense biweekly protocol, and she is one of the top oncologists in the country. I'm just curious of what the differences are with effectiveness.
Thanks
Comments
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Mom of Twins, Good question. I'm so new to this (DX 4/12/17) that I haven't a clue, though I am one of those who will be having 4 treatments of AC biweekly over 8 weeks, followed by 12 treatments of Taxol, weekly. I read on another thread that spreading the 12 Taxol treatments over 12 weeks lessens the SE, but don't know if that's true. Now that I know your oncologist prefers 4 rounds of dose dense Taxol biweekly, I'll have to ask my oncologist why the difference in approach. Did you have a lot of SE with the dose dense dosage?
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Dose dense dosage?! Excuse my redundancy! Dose dense Taxol, is what I should have typed!
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Hi Notanisland,
No, my side effects were minimal compared to AC. I had very brief and transient tingling in like a finger during a treatment, but it resolved very quickly. It honestly was a breeze for me compared to AC. I have also heard that the weekly regimen reduces side effects, so I imagine it's different for everyone. The obvious advantage to the 4 cycles is being done quicker and less visits. I just worry that they've learned it's more effective, but I haven't seen any direct comparison studies. I know they've compared weekly to every three weeks (and weekly had the edge), but I don't believe they've compared weekly versus biweekly.
Anyway, thanks for your response and please keep me posted on what your MO says!
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Hi there Mom of twins,
Everything I've read describes AC as hellish. I'm glad to hear that your experience with dose dense Taxol was an improvement.
It looks like I will be starting in May (going through the last of my tests and port placement in the next 2 weeks) and trying to prepare myself for the worst, hoping for the best. Once I saw my MO on Friday, things started moving fast. I will be having neo adjuvant chemo, followed by surgery, radiation and hormone therapy. This coming week I have Chemo Counseling with the Nurse Practitioner in my MO's clinic and I have many, many questions for her. Among them - can I still dog-sit by daughter's very frisky puppy from 5/17-5/21?! I guess it will depend upon where that falls in my chemo treatments; and maybe she'll just say absolutely not. I know that sounds like a silly thing to have on my list of concerns, but it's just one example of how I'm staggering around in this new normal. (No, no, no, I don't want this to be my normal!)
I've read through your posts on various threads and appreciate the concerns you address and the information and encouragement you share. I will be sure to get back to you with my MO's response on Taxol dosage and scheduling.
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Thanks, notanisland! I know how intimidating the beginning of this journey is. Hang in there. Hard to believe it's been almost a year since I finished chemo. Seems eternal while you're going through it; but when I look back on it, it seems like a blur. As you would probably guess, the first several days after AC are the worst and then the second week you'll feel quite a bit better. I literally have notes on my phone of how I felt during each day of each round, so feel free to reach out to me if you want more details--I will be here to support you if it helps (feel free to PM me)!!
Some tips: make sure you chew on ice during the entire AC infusion (and a little before and after). It really does help reduce mouth sores. Also buy Biotene toothpaste and mouthwash, and an extra soft toothbrush. Use regularly. Take the anti-nausea meds on a schedule, regardless of how you feel to stay on top of it. This will help ward off any nausea, and the drugs they prescribe really do a good job. It's much more effective to be preemptive than reactive to it. Get some nice natural lotions and lip balms and use regularly. And find some series to binge watch on Netflix! I also found that walking helped me feel better during treatment. You might not be up to it the first few days, but if I dragged myself out of bed and walked, it helped with my energy (I also read some studies that exercising during chemo makes it more effective...so a bonus!) With the nicer weather, some fresh air will feel great!
Good luck, you'll do just fine! I will be looking out for your updates! I'm sorry you're going through this, but before you know it, this will be behind you. One day at a time!! Hugs
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A/C is not "hellish" for all who do it. There are many posts here at this site from differemt women who say that for them Taxol was worse than A/C. I'm one who had a much worse time on adjuvant weekly Taxol than on neoadjuvant DD A/C. I've written about my experiences in many Threads.
Neoadjuvant A/C did not slow me down at all. Hair did go 'bye-bye', did loose appetite, sense of taste and smell. Loss of appetite - eating was not a problem - I just never thought about eating/never hungry. Hubby would call me every few hours during the day to remind me to eat 'something'. (This was probably what was the hardest on him throughout my DX/TX. The first 4+ yrs we were married, he had seen what the ravages of anorexia nervosa does to the person living it and what it does to the entire family - Mom was anorexic and had been for many years.) As far as taste - nothing tasted 'bad', it just had not taste at all (or smell). (We went to Deadwood, with some others, for prime rib. I love hot horseraddish in moderation but I was basically 'ladleing' it on but couldn't taste it. The others who were with us started stareing at me, Hubby noticed before I did. Explained to them - waiter too who was a bit concerned about how much of the hot horseraddish I was 'chowing down' on - that I could not taste it.
Adjuvant Taxol was not 'nice' - I basically was utterly and completely EXHAUSTED the entire time - basically existing in bed or on the couch most of the time. The loss of appetite, taste and smell continued but 1/2 way through the 12 weekly Taxol, my K (potassium) levels plummeted and had to go on mega doses of K (still 7+ yrs later, I still have to take K to keep my level in the 'normal' range.). I also had 'big issues' with low temperature. I had to be in one of the glasses in cubicles with it's own thermostat turned up as high as it would go and layers of warmed blankets piled on just to stay 94f or a bit higher. Still am seldom above 97. The other 'issue' (if you can call it,that) on Taxol I was given IV benadryl (had oral on A/C) and within seconds of it starting I would go 'nighty night' until 20 min. before end of infusing. As quick as I went to sleep, I'd wake up as if nothing had 'happened'. Good thing though was that I started feeling less EXHAUSTED the week after last Taxol when I started Rads and felt better every day/week.
Other than the low K, all of my blood work stayed great throughout all TX.
I did do Neulasta with A/C as a 'precaution' (according to Dr T.) but not with Taxol.
I only know that Dr T. (and those he had consulted with) suggested the 12 weekly Taxol as being the best option for me (was given other options), so I chose it. As I remember, he said the 12 weekly will maintain a more constant level - guess it worked for me.
Most will do either Neoadjuvant or Adjuvant - weird me did both neoadjuvant (A/C) and adjuvant (Taxol).
None of us can tell anyone else what 'they' will or will not experience. There is no "One Size Fits All" as we are each so unique.
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I never had a problem with my nails. Have always had 'crappy' nails all my liffe - till chemo. At the 'Look Good - Feel Better' class before starting chemo, the Lady doing it in addition to what is usually given, she gave us samples of OPI Nail Envy. It worked great for me! Still use it but not as 'religiously' as during TX.
One of my big toes did get a black area (1/4 of nail) but chemo had nothing to do with it. A couple of days after 2nd A/C, I drove in a Mud Bog (got 2nd) and succeeded in bruising it going through one of the nastier 'holes'.
I never had any nausea. During A/C, I took everything I was told to and no issues. On Taxol, I decided to stop taking the anti-nausea meds and had no problems at all. I was told that there may be a correlation between Morning Sickness and chemo nausea. I had absolutely no morning sickness with either Son and no nausea with chemo. Haven't seen any legitimate documentation on it - only anecdotal.
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Had to smile at how Kicks blackened her toenail. Hopefully, if I don't drive in any Mud Bogs my nails will last through 4 treatments of AC! And if I'm very lucky and there ISa correlation between pregnancy and chemo treatment, I won't suffer from nausea. Never felt better as when I was pregnant ...but that was 30+ years ago!
Mom_of_Twins, I spoke to my MO's nurse practitioner today and finally had a chance to ask about 12 rounds of Taxol weekly vs 4 rounds of dose dense Taxol biweekly. Her response confirms what Kicks and KB870 have said - everyone reacts differently and uniquely. She said that chemotherapy drugs and delivery are not only based on the individual's cancer, but also factors such as age, overall health & fitness and tolerability. Your MO must have made the right decision for you, since you tolerated the dose dense Taxol so well. I on the other hand, at age 64 and not at my physical best (to say the least) will likely have fewer SEs if I have 12 lower doses weekly.
Interestingly, I learned that my neo adjuvant AC chemo is considered dose dense. I'll have 4 rounds, biweekly, starting on May 18. Then it's on to Taxol for 12 weeks, Wish me luck. I've made note of the many helpful hints from all of you so I feel I'm as prepared as I can be. Thank you!
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