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Chemo drug options?

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Seneca View Drop Down
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    Posted: Sep 08 2010 at 9:56am
Good morning, everyone.  I am new to this site, having just learned about it yesterday when I met my oncologist.  By way of introduction, I'm 56, diagnosed on 8/20/10 with a 3 cm TN tumor.  Have been through the battery of additional tests, and so far the lymph nodes look okay on scans.
 
The suggested plan is chemotherapy, lumpectomy, radiation.  The suggested chemotherapy drug combination is TAC, but only that option and one that is a Phase II trial was offered by the doctor.
 
Is the TAC combination the one most used?  Can anyone tell me anything about the side effects they experienced?  Any helpful hints for dealing with them, that I might not hear from my doctor or her staff?
 
Very fortunately, I don't have any close friends who have been through the breast cancer journey, so I'm hoping to learn something here.
 
Thanks in advance, and blessings to all -
Linda
 
 
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dmwolf View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Sep 08 2010 at 10:04am
Linda, TAC, if you mean taxol/taxotere plus adria plus cytoxan all at the same time, is very harsh and in clinical trials appears to be no more effective (and possibly less effective) than dose dense sequential taxol (T) and adria-cytoxan (AC).  I wouldn't do the TAC if I were you.  The other version is known as DD ACT.   It is easier to tolerate.   An even better version is having the T first, then following with AC.  More and more oncologists are thinking that order might matter and having taxane first is better, though definitive studies have not yet come out on this question.   The best schedule for taxane is probably the weekly version for 12 weeks.   Sometimes people add an additional drug to the taxane part of the regime, sometimes a platinum drug.   I am not an MD, but to me this seems the way to go.  If I had to pick right now, I'd do taxol+carbo for 12 weekly cycles followed by dose dense AC for 4 cycles (every two weeks).

Good luck deciding.  It is always a good idea to get multiple opinions before embarking on chemo.  Do you have second and even third oncologist appointments to gather these opinions?  You'll find that there's a lot of individual preference, at least as much that as science.

Best,
Denise
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TNBC_in_NS Quote  Post ReplyReply Direct Link To This Post Posted: Sep 09 2010 at 12:40am
Welcome Linda! Sorry you have to be here but it is a super site! We have gals and guys who are very knowledgeable about this TNBC!!! 
 
My treatment was started after quadectomy so we are not sure if it worked or not.  You have smart to have it first!  I had Taxotere & Cyclophosphamide for 4 treatments.  I was very ill with this so I am hoping that the cancer didn't like it either.... Radiation treatments x 16.  At present I am finally starting to feel human.  I was very fatigued though out the whole ordeal and after but everyone handles chemo and rads different.   Check out the other forums to see what others had and that may give you a good overview to make an informed decision. 
 
I wish you all the best with your decision.  Helen in NS
Diag@57TNBC04/092.5cm Lquad 05/09 TCx4Radsx30CT03/01/10 FU03/31/10ClearBRCA- 01/2011 RTNBC BMX 06/14/2011~2013 clear
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Seneca Quote  Post ReplyReply Direct Link To This Post Posted: Sep 09 2010 at 7:07am
Thank you, Denise and Helen!  You have given me some good questions to ask my oncologist, and I will call her office today about the DD ACT.  My brother is a cardiac surgeon at a large hospital with a good cancer care center, and he is going to do the "second opinion" with the staff there on my behalf.  I would really like to get started with something next week, but also don't want to agree to a course of action that might not be the best in my case.
 
Thanks again,
Linda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote zoomommy2 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 09 2010 at 9:45am
Linda,
I had a 3cm tumor that was removed via mastectomy, followed by DD AC, then Taxol.  The AC was much harder on my body than the Taxol, but there were fewer doses of it. I was also on an Avastin study along with the chemo.  Taxol can cause some neuropathy in feet or hands.   I have a small amount in my feet, but it's not serious.  Fatigue is likely to be a problem, along with hair loss, of course.  Different oncologists have preferences  with different chemo regimens.  I am 8 months out from my chemo and feeling great.  Your energy and your hair will come back.  You are fortunate to have a MD for a brother to lead the way.  Good luck in your treatment.
Lee in Denver
dx6/09,stageII,gr3,(L)mastectomy 7/09,ACx4,Taxolx7,Avastin study,gall bladder surgery 1/10,4/11 Stage 4, mets to lung, 4/11 Started Taxotere and Xeloda, 5/11 Taxotere stopped, off Xeloda
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M Alison View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote M Alison Quote  Post ReplyReply Direct Link To This Post Posted: Sep 09 2010 at 10:11am
Hi Linda,
I had the exact same treatment as Lee above, beginning in Fall 2008.  As Lee mentions, AC was much harder than Taxol - I stayed home from work while on AC.  Taxol was a huge improvement for me.  I think I'd prefer having the harder stuff first and get it out of the way.  I went back to work, traveling, etc while on Taxol.  The neuropathy, which didn't start till about 6 weeks in, was manageable for me.  My hair even started to come in a bit.  There are slightly different treatment regimens nowadays, so get several opinions and then decide.  In hindsight, I wish I'd gotten a second opinion.
Good news is, I'm 2 years out from diagnosis, the hair is back same as before and I feel great.  I'd never wish to have this cancer, but it sure does make me appreciate life like never before.
You sound very positive and I'm sure you'll get through just fine.  Best of luck and let us know as you have questions along the way!
 
Alison
Age 55, Dx 9-08 TNBC, mast 10-08, stage 2, 1/6 nodes, AC + Taxol + Avastin, rad, BRCA1&2 neg
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Post Options Post Options   Thanks (0) Thanks(0)   Quote kirby Quote  Post ReplyReply Direct Link To This Post Posted: Sep 10 2010 at 11:57pm
Just so AC doesn't scare you...I had only AC and worked thruout tx. While it wasn't a walk in the park I did not have any major problems. Everyone tends to respond differently.
kirby

dx Feb. 2001. Age 44
Lumpectomy

2cm. no nodes stage 1 grade 3

4 rnds AC, 35 rads
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