Dose Dense A/C

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  • tiff2008
    tiff2008 Member Posts: 278
    edited April 2008

    I'll be starting chemo 4/24, receiving 4 tx of A/C.   I'm still trying to figure out if I want to do the dose dense (get it done quicker) or the traditional every 3 weeks. 

    Does anyone have an experience with DD A/C they'd like to share?

  • Mary-Lou
    Mary-Lou Member Posts: 2,230
    edited April 2008

    I DID "DD" and I believe it was the cause of my neuropathy. I did it in order to go back to work sooner. Backfired on me big time. Took almost 2 years for me to return to work, and now it is just part time.

  • bluesky
    bluesky Member Posts: 389
    edited April 2008

    hi tiff

    sorry you had to join this group, but you will find alot of support here. i had to do dense dose due to my diagnosis, doctors in nyc are very aggressive with treatment and felt that studies showed that every two weeks works better. it was tough and it took almost a year to feel 80% normal, i went back to work full time 3 weeks after my last chemo, i worked at home part-time, i was too tired to go into the office. i still have minor stiffness in back and joints but it's due to the taxol and radiation as well as tamoxifen. i'm not an expert but given your dx, i don't think dense dose is neccessary, but you should go by what your doctor recommends. good luck.

  • unlimited
    unlimited Member Posts: 327
    edited April 2008

    I did very well with DD AC ---- started it last yr 1/23/2007 --- what kept be healthy during all the AC txs was the Neulasta shot that u get the next day after each AC tx ----

    I didn't find the AC bothering me much until after #3 and #4  -- I was a tad more fatigued -- never had any real issues with nauseau but would highly recommend u stay on top of the meds they give u - after my first AC tx -- heck that nite I went to a HS basketball game  -----  everyone is different - and other then this BC -- I was healthy otherwise .... it was the DD TAXOL  that really pulled me down at the end with EXTREME Fatigue....

    With all of this I was fortunate that I didn't really have an outside job -- I do make candy bqts out of my home and retail at 2 locations - and I was able to continue this level of ' work ' during my chemo txs.....  A year later -- Im doing GREAT -- sure there are days that I get exhausted easily -- but as I continue to exercise  -- this helps it alot .... more energy =)

    I would say to my onclogist  NP --  heck I could be ' poster child ' for the chemo  AC   ......   hugs  and prayers you will do fine too =)

    It is doable .....       

  • trigeek
    trigeek Member Posts: 916
    edited April 2008

    Did dd 4 X ac and then 4 XTaxol. Finished 3 months ago have slight neuropathy on my foot nothing else. Did not work during ac started working during taxol.

    I too chose it cause it is considered a 3rd generation regimen with better outcomes.

    I was pretty strong going into this s..t, so I guess that had a lot to do with me going through it all feeling ok ( not great naturally ! )

  • mthomp2020
    mthomp2020 Member Posts: 1,959
    edited April 2008

    I did 4 dd A/C, then surgery and 2 more A/C tx and did very well on it.  Slight bit of nausea/queasiness, but just eating and sipping on things took care of it.  Never had any fatigue.  I was healthy (outside of the bc), and pretty much kept up my regular level of exercise.  The Taxol was a little worse because of neuropathy.  I did 6 doses, but not dose dense. 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2008

    I did Dose Dense AC, finished up about 7-8 weeks ago. This was the protocol my onco. recommended, he believed it to offer a better outcome to me, and that's all I really care about.

    Either way there are going to be side effects, specific to you, worse than some people have, better than others. No one can predict which will be easier, and your doctor is the best one to call which is more effective.

    What's more important to you? 

  • Diana63
    Diana63 Member Posts: 773
    edited April 2008

    I finished my DD of AC last month, it isn't easy but it can be done. I am now on 1 wk taxol, it seems like its slowing me down more than the AC did. Then again it could be all of the treatments catching up on me all at once, Good luck Laughing

  • twink
    twink Member Posts: 1,574
    edited April 2008

    I found DD AC to be quite manageable.  I had a more difficult time with DD Taxotere but managed that too.  It is doable.  The Neulasta kept my WBC in good shape.  I worked throughout treatment and just took time off for surgeries and am glad I did it this way -- I didn't have time to feel sorry for myself or dwell on my situation too much (must say the Ativan helped on that front too).  I still feel tired and sore and grouchy but then I'm only 3 months out from radiation therapy. Good luck to you.

  • Panchoandlefty
    Panchoandlefty Member Posts: 181
    edited April 2008

    Not only is it faster, it appears to be more effective. If your onc. is suggesting DD, go for it.



    From my oncology report of my first visit-



    "I explained that the results of a randomized trial comparing dose dense ACT vs ACT given in an every 3 week schedule in women with lymph node positive disease showed that the women receiving treatment every 2 weeks had 7% benefit in disease free survival an a 2% benefit in overall survival."



    I'm on DD ACT. I've finished my 2nd A/C with no major complaints. I shaved my head on day 14 when a few hairs were coming out. Given my hardy 5 o'clock shadow, I might still have a head of hair (day 24) but I was more freaked about it coming out than about baldness.



    No nausea thanks to wonderful anti-nausea meds. Fatigue is there, but not as bad as I thought. No side effects AT ALL from Neulasta. About 24 hours after treatment I go to bed and sleep for 3 days. After that, I am mostly normal...



    I don't think the side effects are that different in dose dense v. the older protocol, you are getting the same meds over a shorter time. Plus, you get Neulasta to keep up White Blood Counts. Dose Intense would mean more meds...



    good luck



    stephanie



    1.9 cm IDC, DCIS, LCIS in Rt breast. 1/23 LVI+ ER/PR+ Her-2 neg Bilateral mast w/ expanders. Dose dense ACT underway, then rads...

  • tiff2008
    tiff2008 Member Posts: 278
    edited April 2008

    Thanks for all the feedback.  My onc recommended the traditional 4 treatments every 3 wks but said I could do DD if I wanted.  For me DD would not change the outcome just get it done quicker!

    Good luck, talk to you soon!

  • oldcat46
    oldcat46 Member Posts: 53
    edited April 2008

    I did the A/C on a DD regimen because my doc said it would offer a better outcome for me what with node involvement.  I didn't really have any problems except I needed Neulasta for WBC and Aranesp for anemia caused by chemo.  Right after I finished DD A/C I noticed an increase in reflux problems which I still have.  No nausa during chemo thanks to IV Kytril (great stuff -- really worked).  I then had Taxol every 3 wks apart so can't comment on DD there.  Good luck to you -- I think you'll do well on DD A/C if you choose to do it.  They'll give you good pre-meds.

  • sahalie
    sahalie Member Posts: 2,147
    edited April 2008

    Hi Tiff,

    I was the same stage and grade you are but I am triple negative.

    I did dd A/C and it just about did me in. 

    I think the Neulasta shot was the big culprit for me though.

    I wish you all the best.

    edited to add:

    Twink, your avatar is priceless.

  • Wink333
    Wink333 Member Posts: 143
    edited April 2008

    Tiff,

    I had 4 dd A/C and 4 dd taxol.  The A/C wasn't that bad, 4 dd Taxol was a little harder but more from an accumulation than anything. Guess now they recommend Taxol weekly than dd for better outcome. Dose dense is very doable.

    Sahalie, I agree the nuelasta shot was my problem too, I guess. I loved that shot though, made me feel more protected. At treatment 5 and 6 I was running 101-102 fever for 2 weeks. Guess they determined nuelasta was the culprit, it sure kept my white count up (34,000) better than nuepogen(sp?) (9,000) and I liked 1 shot versus 5 shots and trips back to the center every day. They now have nuelasta listed as one of my "allergies".

    Bluesky, I don't really have joint stiffness but definitely pain. Did any of your physicians tell you that taxol can cause this? I am 8 months out of chemo and it seems to be getting worse but my docs. just shrug their shoulders. It sounded like you might have been told your joint stiffness was from Taxol, is this correct? I see where you take tamoxifen too and I know it has side effects, just wondering what you had been told about taxol and joints?

    Thanks and good luck with whatever way you go Tiff,

    Wink

  • carolynf
    carolynf Member Posts: 262
    edited April 2008

    Tiff,

    I did the dd AC and as everyone said its doable. I started right before Christmas and had 2 weeks off which i was happy because i didn't have to get up early for work.  The neulasta shot wasn't bad after the 1st one.  I took Emend for nausea which I only had maybe 2xs that i felt that way.  Compazine took care of that. I don't think that's too bad for 8 wks. I am now finishing up weekly Taxol for 12 weeks (just did #8).  With this treatment, I am finding i get more fatigued then the AC.  I think exercise helps fight fatigue when you can get some in.  Good luck w/your treatment!

    Carolyn

  • twfisher7
    twfisher7 Member Posts: 1
    edited April 2008

    Tiff,

    I gather that your name is Tiffany.  I am a Tiffany also and from my research it looks like we are getting the same treatment.  I am having a/c every 2 weeks for 8 treatments.  Started the first last Tuesday.  Didn't really have any trouble until Sat night.  Started running a fever and had to go on an antibiotic and 3 shots of Neulasta this week.  THEY HURT!!!!   It would be fun to keep the Tiffany's in touch as we travel through this journey.  I'm more freaked about the hair loss approaching than anything.

    Hugs!

    Tiffany 

  • sahalie
    sahalie Member Posts: 2,147
    edited April 2008

    Tiff,

    Wishing you all the best on the 24th when you get your first A/C.

    Please check in and let us know how you are doing OK.

    Will you have to go back the day after for the Neulasta shot?

    I'll be thinking of you this next week as I'm sure many of us will.

    Sahalie

  • jdg1
    jdg1 Member Posts: 608
    edited April 2008

    I did dd A/C 4 doses as well.  This was not a problem for me.  I found the Taxol was harder to handle.  I also received the Neulesta shot the day after as well.  One thing I found with the A/C is that they had to reduce the amt. of steroids they were giving me.  Once they did that there were no problems.  I also was able to keep working through chemo.  Took 2 days off after my tx then worked part time that wk but by the next wk I was back to full time. 

    I am 4 months post chemo and I can say I am still tired, but on the road to recovery.

  • tiff2008
    tiff2008 Member Posts: 278
    edited April 2008

    Hi Tiffany,

    Yes I'm Tiffany too.  Sorry I've been resting and visiting the April 2008 thread.  I had my first A/C April 24.  I've decided to do the every 3 wk regime, no shots with that....I got sick the first night and had bad nauseau the next 3 days.  Day 4-6 have been pretty good.  I hope next time they try a different anti-nauseau drug, bc obviously this one didn't work :( 

    How are you doing?  I hear mixed review about se's with A/C vs other....some say A/C is much worse and others say Taxol is worse..I guess all depends on our own bodies!  I hope your doing well and let's stay in touch..thanks for thinkin of me:)

    Sahalie-thanks to you as well...sorry took me so long to reply!

    Tiff

  • abbadoodles
    abbadoodles Member Posts: 2,618
    edited April 2008

    Tiff, I did DD A/C about a year ago and had no real problems (that I know of).   They did give me a Neulasta shot the day after each treatment but that wasn't a problem for me, either. 

    Had absolutely no nausea from any of the tx but they gave me Emend to take the day of and the next two mornings.  I think that is what helped so much.  It's very expensive, though your insurance should cover it.

  • pennylane
    pennylane Member Posts: 177
    edited May 2008

    Dear Tiff, Please insist that you need 'emend' for your nausea problem.  I strongly believe it made my dd AC experience kind of doable....I never really was nauseous; but rather just had no appetite.  I am sorry your Dr. didn't realize you needed emend for this very strong chemo....Hang in there, soon it will all be history....Best wishes, p

  • tiff2008
    tiff2008 Member Posts: 278
    edited May 2008

    Thanks for the advice for Emend.  I'm always feel funny telling my doctor what I need..you know she is the doctor and all :)  But I'm going to do that for sure before my next one on May 15.

    I hope your all doing great!

    Tiff

  • LorenaB
    LorenaB Member Posts: 937
    edited May 2008

    I'm also doing dd A/C.  They give me Aloxi via IV prior to the chemo infusion (the first time I took Zofran but it was terribly constipating) and also Emend for three days.  Just some minor queasiness but never seriously nauseous.  I hope the se meds work for you! 

    Three down, one to go for me!

  • tiff2008
    tiff2008 Member Posts: 278
    edited May 2008

    Lorena,

    HURRAY for you, 1 to go. 

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