Chemo treatment: ddAC-T or TC

Very few of us have done both ACT and TC, so we won't be able to compare for you one vs the other. There are a lot of threads here about the SE (side effects) of both. What you'll find is some people sail through with minimal SE, others have typical ones that usually are not as bad as they anticipated, and a few have quite a lot of trouble. This is true for both chemo regimens.

The question of why one vs the other is really a question for your doctor.

I'm sorry you are here with recurrence. I'm sure it's a scary time. Once you have your treatment plan established, it will probably be easier for you. At that point, you just show up and do it. Keep us informed about how it's going. I expect others will chime in with more information and reassurance.

I have done both after I had a local recurrence. It isn't exactly the same because had already had the mastectomy with no further treatment. And the IDC was ER/PR negative and HER2 positive for the recurrence. And I don't have to have hormone treatment. But for what it's worth:

Taxotere, Carboplatin, Herceptin & Perjeta. 6 rounds - 3 weeks apart. I had serious diarrhea. I blame the Perjeta. Also was dehytrated so went in between every chemo infusion for a bag of saline. I had neulasta shots 24 hours after each infusion. Lost hair of course but it came back with no problem. Iced fingers & toes so didn't lose nails. Lost a lot of weight that wasn't necessary, but I've been happy to keep most of it off. I have some permanent CIPN (chemo induced peripheral nephropathy) in my feet, but fortunately no pain with it.

Adriamycyn & Cytoxan after ALND surgery because I didn't have pCR with the TCHP. It was supposed to be 4 doses 3 weeks apart. My WBC & my platelets tanked and there was talk of a transfusion. That was over a holiday weekend & I decided not to go into the hospital on a holiday. Blood resolved but I did NOT complete the fourth infusion.

Not really relevant to your situation, but I did go on to have rads and take Herceptin for the balance of a year. On balance - I felt like TC was easier than AC. But that could have been because my body was just worn out.

Good luck with your decision. I suggest you join a current chemo thread. It helps to be talking to others going through the same thing. Also I'll post the chemo tips for you.

Recurrence, I'm sorry you find yourself here. I personally found dose dense AC to be easier than TC, but that's because I had a nasty neurological reaction to Taxotere. It really is different for everyone though. My heart has been okay from the AC, and thankfully my hair came back normally after Taxotere.

I will say that unfortunately chemo can be quite damaging, so my non-expert advice is to only do it if it's warranted. I'd wait for your Oncotype score. Have you been on hormone therapy? If so, a change in hormone therapy is probably warranted too.

Recurrence,

The oncotype test has been shown to do a good job of predicting who benefits from chemo. Waiting for your test results is a good idea and gives you more information. Some of us just want to throw the kitchen sink at our cancer and hope that we'll never have to deal with it again. But, we never know. Hormonal therapy is a very powerful, systemic treatment just like chemo. Switching from Tamoxifen to an AI may be just as beneficial as chemo for you. Again, who knows?

I personally have had only minor long-lasting effects from chemo. I have a little neuropathy in my fingertips, and my eyelashes will never be the same. However, my neighbor (who did four rounds of Taxotere + Carboplatin + Herceptin + Perjeta before she stopped) has suffered from heart problems and seizures since chemo. (She did have a pre-existing heart condition). In fact, I'm getting worried about her because I haven't seen her walking her dog lately.....

Anyways, I wish you well in your surgery and hope that your pathology report has no unpleasant surprises!

I had six rounds of TAC (taxotere, adriamycin, cyclophosphamide). Chemo was always on Wednesday, and I took Thursday and Friday off work. I really could have worked those Thursdays but I gave myself the time off for being a good girl and taking my medicine; I slept in and rode my bike and hiked and had lovely days. Fridays were when the fatigue and aches and brain fog descended, so chemo-Fridays were chill days. I always rode my bike or got in a walk, though. By Saturday afternoon I was feeling better, Sunday was even more improved, and on Monday, I was ready to go back to work.

I know I'm among the very lucky ones who tolerated this harsh chemo well. I have some permanent neuropathy in my feet that burns toward the end of the day, but that seems to be the only lasting effect. Besides saving my life, of course.

Like most ER+ tumors, I didn't get a PCR and there were active cancer cells in the breast after mastectomy. Because of this, we opted to do six rounds of navelbine and xeloda toward the end of radiation treatment. I really pushed for this because IBC can be tough to cure and I never wanted it to rear its ugly head again.

It looks like it worked, at least so far. It'll be ten years in October. I know we won't ever know we're permanently "cured" until we die of something else, but every year gives me more hope and puts cancer further and further behind me.

Recurrence. I *hope* your Oncotype is low and you can skip chemo, but if that is not the case I hope you do well on it. Even though I totally understand the desire to throw everything at it, do remember that Oncotype and those tests can help determine whether chemo will actually help you. It may, but it may not, and chemo certainly does cause some harm, although many people make it though just fine. Your doctors will guide you. Ovarian suppression and AIs or Faslodex are the next hormone drugs in line.

It's hard to be in this situation. Based on the situation it seems like you will probably do chemo. Best wishes, whatever happens, and please keep us posted.

You are right, there are so many uncertainties. We do the best we can, and put one foot in front of the other, and hope for the best. But you're doing all the right things, taking charge, and being proactive, and that in and of itself is a lot. Hopefully the treatment will also do its job and keep the beast away for good!

I had TC the first time and AC +T the second time. I tolerated the AC+T better than the TC, though in general, I tolerated both of them well. If you do end up needing to do chemo, pm me. I have a long document I compiled with my "chemo survival tips". I kept detailed nots during chemo both times.

Wow. You are dealing with a lot. Do update us on how things are going.