What would you do: 4 heavy rounds of taxol or 12 mini rounds?

Options
Marmotka
Marmotka Member Posts: 26
edited February 2020 in Chemotherapy - Before, During, and After

Hi everyone,

I just finished my fourth AC treatment (yay!) and scheduled to start taxol in two weeks but I'm given what seams a hard choice:

1) pursue with dose dense taxol, meaning a large dose every 2 weeks with neulasta shots for a total of 8 weeks of treatment,

OR

2) get a milder dose weekly (1/3 of the dose of the first regimen) spread over 12 weeks.

The sum total of the drug entering my body will be the same in the end. What would you do? Suffer more for a short period or get milder but constant SEs and for an extra month?

I would love to hear from those who have done the 4 heavy rounds. If you could have spread it out, would you make that decision in retrospect?

PROs of the weekly regimen: infusion lasts only 1 hour instead of 3; is slightly more effective (levels are kept constant in the body) but it's a marginal gain overall; less toxic because of the low dose, so perhaps less neuropathy and aches and pains?

CONS of the weekly regimen: no neulasta shot so immune system more vulnerable (it's winter here and I have 2 small kids); weekly blood work and appointements maybe heavier on the psyche; last but not least, an extra month of treatment! ...

Decisions, decisions...both regimenrs are equally supported by my conologist, the choice is mine.

Please help me make up my mind!! :-) Thanks!

· Share on FacebookShare on Twitter

Comments

  • Ingerp
    Ingerp Member Posts: 2,624
    edited January 2020

    I'm not the best to comment--only did the 12 weekly Taxols. I gotta say it just was not that bad. With little kids around I'm wondering if it'd be better to feel a little crappy every week or really crappy every other week? Tough decision, but I do believe it's important to remind yourself that long-term it won't matter which way you decided. Hold on to that.

    · Share on FacebookShare on Twitter
  • NancyHB
    NancyHB Member Posts: 1,512
    edited January 2020

    I participated in a clinical trial (SWOG 0221) to compare the efficacy of dose-dense (every two weeks for 12 weeks) Taxol vs. weekly Taxol (12 weeks). The result overall was no long-term benefit. On the other hand, higher incidences of side effects were reported with the dose dense protocol. My experience was rough; I had severe bone and joint pain that was only alleviated by opioids for the first week after treatment. Apparently I’m sensitive to taxanes but I didn’t know that going in, and I wanted to complete the clinical trial so I forced myself to continue. By the 6th treatment I hadn’t yet recovered from the 5th, and really struggled to get through. I can look back now and say I’m glad I did it - it saved me having to drive to the treatment center every week for three months - but the SEs can be more challenging. I encourage you to ask your doctor about their experiences with patients and dose dense SEs before you make a decision.
    · Share on FacebookShare on Twitter
  • Cowgirl13
    Cowgirl13 Member Posts: 1,936
    edited January 2020

    I would go for the lower dose/longer period of times. Much easier on your system, probably much less side effects. If your numbers drop you can always have a nulesta shot.

    · Share on FacebookShare on Twitter
  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited January 2020

    Since you're not in a trial, can you start with the dose dense and if the SEs are too bad, back off to the longer, less toxic program?

    · Share on FacebookShare on Twitter
  • lovepugs77
    lovepugs77 Member Posts: 296
    edited January 2020

    I did dose dense taxol immediately after dose dense AC. It was harder on me than AC was, but I think some of that was just the cumulative effects of chemo. The bone pain was bad, and I had bad heartburn. I also developed peripheral neuropathy during taxol. That mostly cleared up, but I do have some very slight numbness in my fingertips 2.5 years later. I don't even know that numbness is the right word - my fingertips just don't quite feel right.

    Would I do dose dense again? Yes. For me, it was worth it because I knew I would be finished soon. I think I remember my MO saying that if the dose dense was too much for me, we could switch to weekly. It's worth asking about.

    · Share on FacebookShare on Twitter
  • berries
    berries Member Posts: 277
    edited January 2020

    I honestly think it depends on the individual and how they react.

    I had the opposite reaction as lovepugs. I had my last dose dense taxol today (yippie!!!!!) after four dd rounds of AC and Taxol has been a breeze for me, even at the larger 250mg dose. I have had some bone pain and aches, but SE were nothing compared to AC, which left me hospitalized for two days due to neutropenic fever.

    I chose dd because I wanted chemo to be over. I did not want to take a day off every week for 12 weeks.

    Like I said, I think it depends on the individual. I still have most of my eyebrows and eyelashes (sparse, but there), no neuropathy symptoms and I work out 4x a week and walk 30 minutes every day. I feel good. I am also 35, so that could also have an impact.

    Good luck with your decision!

    · Share on FacebookShare on Twitter
  • Kamboka
    Kamboka Member Posts: 975
    edited January 2020

    I started out with DD taxotere and stopped after the first dose d/t hand/foot syndrome. A few months later, I started on DD taxol. Had a rough time with that too. Had really bad muscle and bone pain and neuropathy. It seemed worse than AC. I still have neuropathy five months later. I think, if I had time to spare, I would have tried the weekly taxol as I was told that it would be a piece of cake after AC--it wasn't.

    · Share on FacebookShare on Twitter
  • Jaybird627
    Jaybird627 Member Posts: 2,144
    edited January 2020

    If I knew that the side effects would be less with the weekly I'd go for that. What are the stats/% of which is better tolerated?

    I did 4 A/C, then was supposed to do 4 Taxol. I did 1 and it was awful, got really bad neuropathy. My onc let me skip to week 3 and I did one more and it was even worse for me. She let me quit as it was a QOL, I was in tears all day from the pain and I was working full time.

    Some can tolerate the taxanes better than others. I guess you don't know until you experience it. Read the trial(s)? Speak again with your onc.

    I had a new primary (other breast) 14 years later and onc wanted me to do only taxanes and I said NO.

    I wish you the best outcome!

    Jaybird ~

    · Share on FacebookShare on Twitter
  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited January 2020

    I did 6 rounds of TCHP every 3 weeks. But after surgery, AC just about put me under. Funny how we're all different.

    · Share on FacebookShare on Twitter
  • Nancy2581
    Nancy2581 Member Posts: 1,234
    edited January 2020

    I did weekly taxol. My WBC dropped. They couldn’t give me neulasta because it wouldn’t kick in in time for the next dose. They gave me neupogen (I think that’s what it was called). Other than that I handled weekly taxol well. I don’t think I could do DD taxol even my AC infusions were 3 weeks apart.

    Nanc

    · Share on FacebookShare on Twitter
  • Mariadelpilar
    Mariadelpilar Member Posts: 65
    edited January 2020

    I am doing the same treatment in 4 rounds. Going for my 3rd one next week. My oncologist reduced the day after shot from 6 to 4 ml(?) after my first shot and I didn’t have any bone pain the second time. It was amazing! Overall I found the 4 rounds very manageable. Took the Claritin and Benadryl daily for 10 days as instructed also. Good luck!

    · Share on FacebookShare on Twitter
  • Marmotka
    Marmotka Member Posts: 26
    edited February 2020

    Thanks everyone for taking the time to give me advice. Perhaps I'll ask my oncologist if it's possible to switch regimen after the first dose if I don't react well. Not sure she will agree. If not, I'll go with the 12 weeks, I think. Neuropathy scares me too much.

    · Share on FacebookShare on Twitter

Categories