How did AC do compared to T?

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jeffntate
jeffntate Member Posts: 49
Karen, my wife is getting 4 cycles of DD Taxotere then 4 cycles of dose dense AC for a 6 x 8 cm, grade 3, Stage IIB (T3N0M) IDC tumor. How did your tumor shrink on T vs AC? Her oncologist said as long as the tumor didn't grow, we would continue this regime. She went this past Weds for 2nd Taxotere and tumor is 6.5 x 7.5cm. Prior to that on ultrasound tumor was 3.2 cm x 2.4 cm x 1.2 cm. Oncologist said the actual size was inbetween ultrasound and what they measure by "feel" in the clinic (use a ruler). Is this the normal way they gauge the chemo results? Did anyone have a tumor suddenly shrink on either T or AC and if so at what dose (after 1st, 2nd, 3rd, 4th). Finally, her neulasta shot really worked.... WBC went from 9 (9,000) prior to first chemo and after 2 weeks and neulasta it was 25 (25,000). The nurse said that was great but is it too high? Did anyone get a neulasta dose reduction after having a very high WBC? Anyone see a high number but have data to show it still dived in the between (7 days after chemo)?

Thanks,
Jeff

Comments

  • twink
    twink Member Posts: 1,574
    edited August 2007
    Jeff,
    I had AC DD X 4, followed by Taxotere, also DD X 4. At the midway mark, the AC had not done much to my 3.5+ cm tumor. The mass was softer but measured the same on U/S. The BS thought the density of the mass had been affected...he described it as decomposing from the inside out. At that point I made the bilat mastectomy decision but couldn't get it scheduled quickly enough so carried on with Taxotere. By the time of surgery, after the full course of Taxotere, the lump was less than 2 mm in size. Unfortunately the sentinel nodes showed micromets at that time and I ended up having to go back in for a full AND. All other nodes came back negative but I've wondered what was up with the sentinel nodes...the micro mets were probably more than that before chemo.
    The Taxotere dose was 130 mg per Tx I believe. The AC summed to 482 mg (so divide by 4)...I recall that number because 550 is the magic level beyond which heart problems increase dramatically.
    As for a reduction in neulasta, that never happened for me...I think the highest my WBC went was in the low 30's. I skipped a neulasta shot after the first Taxotere (because the WBC was so high and the onc thought the Taxotere wouldn't have such a dramatic effect) and the WBC plummeted to borderline (3ish)...never skipped another.
  • twink
    twink Member Posts: 1,574
    edited August 2007
    Jeff,
    as for measurement...my lump was palpated, US'd, PET/CT'd and Mammo'd...all measurements put it between 3 and 4 cm. Prior to each chemo the onc would take a feel and mid-way through treatment the BS did another US. By the time it could be measured pathologically it was very small. I guess I'll never know exactly what size it was at Dx.
  • maryannecb
    maryannecb Member Posts: 1,453
    edited August 2007
    I had Neupogen(similar to Neulasta) while on Taxotere. My WBC went to 80,000 and I developed a fever. No focus was found but I was treated aggressively with IV antibiotics because of the temp.

    The next round of chemo I reduced the amount of Neupogen and my WBC did not get so high. I will never know whether it was the Neupogen or an occult infection.

    I did not have neoadj chemo so do not know how my tumor responded. But on the positive side mine was 9cm with 2 positive nodes. I continue in good health now almost two years later.

    Good luck with your wife,

    Fists up!
  • Indigoblue
    Indigoblue Member Posts: 274
    edited August 2007
    beat
    cool mind and heart


    The clock
    is timeless
    universe/galaxy/spacial gaps
    strung together with strings of love of life...

    trip\neg =sad
    uncertain
    fear
    you will find truth
    in love
    fear
    is
    silly

    ((hugs))
    Indi
  • nowheregirl
    nowheregirl Member Posts: 894
    edited August 2007
    I did 12 weekly Taxol followed by 4 EC (almost the same as AC) every 4 weeks prior to surgery. My tumor was originally measured 3.5 cm at DX. I was also diagnosed with stage IIB IDC with 2 lymph nodes positive at age 39.
    When I completed Taxol, I had MRI's and U/S and my tumor was measured 2.2cm. By the time I completed AC, it was only measured 0.8cm. Also those two positive nodes were gone. I am 2 years out from DX now and have been doing as fine as I was before DX.

    I hope chemo does wonders for your wife.

    Hugs,
  • j3mcdonald
    j3mcdonald Member Posts: 2
    edited October 2007

    My mom went through 4 treatments of AC and her cancer count went up. Her tumor and nodes had been removed prior to surgery. Next Tuesday she will have her fourth round of Taxotere. We are hoping for an improvement.

  • Negative3Grade3
    Negative3Grade3 Member Posts: 111
    edited October 2007

    I'm just about to finish the 4th dosage of AC and then move to T.  The tumor was clinically 3x4 but the MRI measured it as 1.8 c.m. x1.8x1.9.  The oncologist said that we will measure the success of the chemo by palpation but I read that MRI is used to assess neoadjuvant's success so I'll have an MRI just prior to the 4th treatment.  The tumor clinically was assessed as just over 1cm x 0.75 at the end of the second treatment but the MRI should tell us more.   So, for me, the AC has been working but it depends.  In a study that was done published in 2004, the best results were obtained by the sequential treatment (AC +T) before surgery but more recently, T seems to be more promising than AC and so some protocols have reversed the order, T + AC, to see some results fast.  I hope your wife has a good response.

  • Sadie-Rose
    Sadie-Rose Member Posts: 222
    edited October 2007

    HI All,

    I had surgery to remove several nodes first then I had 3 cycles of AC. We did a MRI after that and there was no change detected. We changed the cocktail to T and Carboplatin for 6 cycles and the tumor reduced in size. Then I had a lumpectomy followed by radiation. I am three years out from treatment.

    Sadie

  • Negative3Grade3
    Negative3Grade3 Member Posts: 111
    edited October 2007

    I had a meeting with the oncology surgeon today and he said 'there is nothing here'.  So clinically, the AC has worked for me (3 dense dosages, one more to go, and then Taxotere).  MRI results should be in next week so we'll see what radiology says.  For the time being, at least in my case, AC worked but as some of you know very well, it does depend on the grade (III) and the mitotic rate (very high in my case).

  • Negative3Grade3
    Negative3Grade3 Member Posts: 111
    edited October 2007

    Update on whether AC worked. As some of you know for Neo-Adjuvant therapy, response to treatment could be different from a clinical point of view, rather than a radiological, or pathological (during surgery). I had already told you that clinically, both the onc and onc surgeon 'couldn't feel a thing' but a rough reading from a local radiologist said that there is still a diameter of 1cm left (note that I didn't get the full volumetric picture). I'll let you know once I get the official MRI report.

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