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ACT vs. TCa

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Category: TNBC Forums
Forum Name: TNBC Talk
Forum Description: A place to chat
Printed Date: Jul 03 2020 at 10:09am
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Topic: ACT vs. TCa
Posted By: lbpontel
Subject: ACT vs. TCa
Date Posted: Jan 03 2019 at 3:38pm
I had a Stage 1 TNBC (1.2cm); took three lumpectomies to get clear margins but got it all out. Now preparing for chemo and was prepared for a 16 week regimen of Adriamycin, Cyclophosphamide (Cytoxan), and Taxol (ACT). An expert second opinion was suggesting TCa regimen -- Taxotere and Carboplatin suggesting that the side effects were less. My current oncologist is saying there is not enough data to confirm TCa is as effective as ACT. Any experience out there? Thanks.

Posted By: Meadow
Date Posted: Jan 03 2019 at 5:43pm
I'm not surprised to hear that TCa is likely to have less side effects. But would it be as effective as ACT? That would be the key question for me and I don't see it answered in your post. I was treated 9 years ago, when Carboplatin was not considered for chemo regimens following first diagnosis of Stage I. My oncologist gave me two options: ACT, or TC (taxotere + Cytoxan). There were stats showing ACT was slightly more effective (a couple percentage points) but also tended to have harsher side effects, including a very small chance of serious heart damage. I chose the ACT. I wanted to reduce my risk of recurrence as much as possible and was willing to take on the added risks for those extra percentage points. Side effects from the ACT were not easy, but considerably easier than I anticipated. Taxotere was not hard - I just had fatigue and some temporary neuropathy.

Posted By: Stephanie0917
Date Posted: Mar 25 2019 at 9:25pm
Wondering which chemo you chose? I have a very similar situation. Stage one, ( 1.8cm),node negative and give the choice between ACT and TC. 

Posted By: lbpontel
Date Posted: Mar 26 2019 at 3:08pm
I wasn't really given the choice; I had a second opinion that recommended the TCa protocol to reduce the risk of heart damage.  However, my oncologist didn't have enough personal experience or have any data to support the effectiveness so she was uncomfortable recommending TCa but left it up to me.  Ultimately, since the risk of heart disease given my heath and age was so low, I'm opted to go with the ACT.
I'm through ACT and got through it fine.  Now on Taxol. 
I think it would be important to understand the risks for you personally from a heart perspective. 
Hope this helps and good luck. 
I will also say, don't believe everything you read about side effects.  While they certainly exist, it is so different by person.  My treatment has been very manageable.  My biggest issue has been staying healthy -- listen to your body, rest when you need to and stay at home during your low periods so as not to contract any illness.  I've had both Strep and Walking Pneumonia -- both worse than the treatment side effects probably because I pushed too much. 

Posted By: Stephanie0917
Date Posted: Mar 26 2019 at 8:34pm
Thank you for your response. It's always nice to get someone else's perspective. I hope the Taxol goes well for you and you will be done with this mess soon!

Posted By: BlueWater
Date Posted: Apr 12 2019 at 5:38pm
There are a lot of initials out there and it is very confusing.  I have asked my Onc a 1001 questions and met with her 4 times now.  My last question to her was, what would she give her daughter.  She told me TC (Docetaxel & Cyclophosphamide).  I am supposed to start in 2 weeks.  Dead

Back Story on personal choice.  Everyone will have their own reasons for their choices.
My Onc originally recommended AC + T = Doxorubicin & Cyclophosphamide (4 cycles) than T = Pacilitaxel weekly for 12 weeks.  I refused it because researching the drugs the first 2  drugs can cause Leukemia according to the website.  It says in the pamphlet that they don't list side effects less than 10%, so them mentioning it leads me to believe it's a minimum 10% risk level for each drug.  I didn't want to double the Leukemia risk for myself.  I lower my risk of BC re-occurrence only to up the odds of another cancer.  That didn't make sense to me.

I asked if they had another suggestion, and they offered me TC = Docetaxel & Cyclophosphamide for 6 cycles.  I asked them to switch out the Cyclophosphamide but they wouldn't grant that request.  I realize I'm probably crazy but I keep thinking I have a 70% chance it won't re-occur so I'm nuking my body for no reason.  I'm still wrapping my mind around all of this.  Honestly, I wouldn't do Chemo at all if it wasn't for my tumor being a grade 3.  My surgeon insists that is the reason I need to do Chemo.

I pray all goes well for you.

Dx TNBC IDC 12/18/18 (age 53), Stage 1, Grade 3, 1.6cm, 0/5Nodes, BRCA-1 Neg, BRAC-2 inconclusive, Left breast. Double Mastectomy w/ recon., Starting TC x 6 on April 26th.

Posted By: Kellyless
Date Posted: Apr 16 2019 at 9:36pm
I got way sicker on Carb and Taxol than ACT. TC is typical chemo for ER/PR positive cancer, in our community it's often called "chemo lite". Are there studies showing its even effective? It's still chemo with a host of side effects, so I'd be sure it has a chance of doing anything at all for our disease before bothering with it. How much better than placebo is it? My MD Anderson Dr said no reason to bother with Taxotere with our disease, do Taxol that's proven to work or.. Skip it. Cyclophosphamide is proven to work, when combined with Adriamycin. Has it shown to do any real help alone? I just don't know the answer, I've never seen a study showing it works for Tneg. 

IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/16 Local recurrence same breast, same spot 1.8cm Carb.4x every 3 wks, Taxol 12x once wk. Dbl Mast. PCR!! Reconstruction fail, NED!

Posted By: BlueWater
Date Posted: Apr 27 2019 at 12:00pm
Hi Kelly,  
Here is an article on both treatments" rel="nofollow -

Dx TNBC IDC 12/18/18 (age 53), Stage 1, Grade 3, 1.6cm, 0/5Nodes, BRCA-1 Neg, BRAC-2 inconclusive, Left breast. Double Mastectomy w/ recon., Starting TC x 6 on April 26th.

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