I am newly diagnosed with the dreadful TNBC and have been reading a lot from this forum and getting a lot of information, strength, and encouragement here. This is my go-to place for wonders. Thank you all for contributing to this valuable resource so we are together in the hard fight. 

-has less side effects; 

-has similar disease free survival as weekly, 

-and is what his facility does as common practice

-if I choose bi-weekly, it will be 6 rounds to match the T x12 total length of time. 

-is one of the recommendations (the first one) on NCCA guidance. So far the clinical comparison between bi-weekly x 6 and weekly x 12 may be adopted to eliminate variables for easier comparison, in my opinion. 

- no evidence of improving clinical outcomes to extend T from four to six cycles. 

-dose-dense T can improve DFS for TNBC. 

-Less people drop out or change regimen in x 4 than in x12. 

-less neuropathy events in T x 4 than in x 12. 

1.SWOG S0221: A Phase III Trial Comparing Chemotherapy Schedules in High-Risk Early-Stage Breast Cancer  https://ascopubs.org/doi/10.1200/JCO.2014.56.3296" rel="nofollow - https://ascopubs.org/doi/10.1200/JCO.2014.56.3296  

2. Six cycles of doxorubicin and cyclophosphamide or Paclitaxel are not superior to four cycles as adjuvant chemotherapy for breast cancer in women with zero to three positive axillary nodes: Cancer and Leukemia Group B 40101.  https://www.ncbi.nlm.nih.gov/pubmed/22826271" rel="nofollow - https://www.ncbi.nlm.nih.gov/pubmed/22826271  

3. Cost effectiveness and tolerability of dose dense versus weekly paclitaxel chemotherapy in patients with early breast cancer: A real-world comparison. https://ascopubs.org/doi/abs/10.1200/JCO.2016.34.15_suppl.e18264" rel="nofollow - https://ascopubs.org/doi/abs/10.1200/JCO.2016.34.15_suppl.e18264  

I heard the x12 is a common and safe way to go, but I am thinking of the BEST plan. Since my knowledge is so limited, please give your input: were you offered with both x 4 and x 12 options? What was your experience? 

Thank you in advance,

Vivian

 

Hope this helps!

I am doing AC now and feel each infusion is hard to get by, and imagine 12 of such when it comes to Taxol would feel endless.  

I still have time and need to think more...Thank you again, Lisa!

I was diagnosed 12/17/17.  1.6 cm no nodes.  I did 4 ac biweekly and 12 taxol weekly, 16 rads and 4 power blasts. AC just made me very tired.  Taxol...was very tolerable.  I had no neuropathy and I felt like myself...minus hair!  I have no side effects from treatment.

So, I hope this helps. I went to Sloan in nyc and I will keep you in my prayers...as I keep you all in my prayers.

The beginning is rough, you read a lot, you are nervous and scared..but one day I realized that during treatment I could relax...as I was being monitored and watched like a hawk.  So, I did.  All those months, I decided not to worry about cancer.  I was diligent about caring for me.  My counts always were good and I caught a cold..that lasted a long time but never turned into anything else.  I followed the rules of chemo and remained healthy throughout treatment.  I iced my hands and feet and avoided neuropathy and kept ice in my mouth and never had mouth sores, this was during infusions.  For my toe and finger nails...I would soak them each day in apple cider vinegar.  They discolored, but I never had them lift or fall off.  I guess what I am trying to say is during treatment...just stay on top of you and don’t worry about cancer.  They are watching you carefully.  

Godspeed dear friend and I know your decision will be the best one for you.

My doctor said the 1st Taxol has to be done during weekday (I am doing AC on weekend). He will prescribe ice gloves and booties during infusion. I can see why with the possible reactions. A lot of anxiety and uncertainties, but you are right that I should relax and focus on taking care of myself. 

Thank you for your time and kindness!

Yes, you are tired...but taking care of yourself in a gentle way and knowing that everything you do for you...will be for your betterment.  It does not take much time, I worked, cooked, cleaned...I just did it at a slow pace.  Please note, on ac I did not work...I was off.  But, cooked and cleaned...at a slow pace...very slow.  With taxol and radiation, I worked the entire time.  Took off to get my infusion...and went back to work the next day.

Best, marymom

So...more Mary tips!  Love you kid!

I am a school teacher so it's not possible to work while getting chemotherapy. Being on the go for many years, I think now it's time for me to put away everything for several months. 

Thanks for the Mary tips! 

http://chemocare.com/chemotherapy/drug-info/doxorubicin.aspx" rel="nofollow - http://chemocare.com/chemotherapy/drug-info/doxorubicin.aspx

I have some of the side effects and feel very tired after each infusion of AC. The worst part is losing appetite (I don't count hair loss as the worst). Eating is hard, drinking water is even harder because I want to force myself to drink enough water to prevent bladder cancer. Other than that, it's tolerable. 

Just a reminder: an accumulative effect may show after 2 rounds of infusion in terms of skin color change and overall level of discomfort. But how you feel about nausea and vomiting will generally about the same as the 1st time. This is what my doctor told me and it's true with me. 

  

Adriamycin is commonly referred to as the red devil.  Here's a good link for information on chemo drugs:

http://chemocare.com/chemotherapy/drug-info/default.aspx#a" rel="nofollow - http://chemocare.com/chemotherapy/drug-info/default.aspx#a

I pretty much skated through the AC - the nausea and side effects were easily managed and minimal for me.  The Taxol was definitely harder and I did get some mild neuropathy.  For the me, the worst part is that the side effects were not as predictable as they were for me on the AC, I could also time it down to the minute when I would start feeling bad and how I would feel following the AC.  The Taxol was different and varied every time, but I still managed o.k. once I figured out that Tylenol and a heating pad/blanket worked for the aches.

I've also learned that EVERY person experiences it differently, but I highly recommend doing the 4 and getting it over with - I ran into chemo the last day so excited to get it over!!!!!

Best wishes for you whatever you decide.

I also feel 12 times seems forever. I know more people did the weekly than bi-weekly, but I feel I've had enough from AC and can't imagine repeating the same 12 times with Taxol. 

Taxol may or may not be easier than AC. My doctor said patients normally suffer more from either AC or T; nearly no one can be as lucky to escape from both in terms side effects. If I run into severe reactions, I can still go back to the weekly. I've planned for 12 weeks off work for Taxol; if I can complete the bi-weekly successfully, I will have the last 4 weeks to rest and recover. 

Thank you and I hope to join you soon at the chemo finishing line. 

I was told everyone is different in their reaction to chemo, and weekly Taxol is generally easier than bi-weekly ones. So if I don't have smooth path on bi-weekly (I will try it first), I can always go to weekly. 

I learned the drugs by their brand names so I feel neutral toward them. I also try not to think of side effects during infusion; I turn my head away and don't look at the red. It helps!

Yes, Neen, survive and live! Treatment for survival, and minimize the side effects to live after we are through all these. Thank you for the tips!!

I just wanted to drop by and give you a word of encouragement.  I got it over 11 years ago with Taxotere, 4 treatments 3 weeks apart.  The weekly Taxol or biweekly Taxol looks like it may have less neuropathy side effects due to lower doses at a time.  At the time, my onc suggested B-6 Vitamin 100 mg twice a day.  I had the side effects during treatment and after treatment ended.  I found the more I moved and exercised, it helped improve the condition.  The mornings were always the worst getting out of bed.  I felt 100 years old.  Now it's been 11 years later and the only continuing thing I notice is a slight tingling in my fingers from time to time.  It doesn't bother my day to day activities and I'd say I'm 95% recovered.  Hopefully any side effects you experience are short term and will get better in the year or years following treatment.

Here are a few links on this subject:

https://www.medicalnewstoday.com/articles/323481#natural-remedies" rel="nofollow - https://www.medicalnewstoday.com/articles/323481#natural-remedies

https://news.cancerconnect.com/treatment-care/neuropathy-numbness-and-tingling-how-is-it-prevented-and-treated-U9XFey6x0kW1Jq_uWtGI1A" rel="nofollow - https://news.cancerconnect.com/treatment-care/neuropathy-numbness-and-tingling-how-is-it-prevented-and-treated-U9XFey6x0kW1Jq_uWtGI1A

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/peripheral-neuropathy/managing-peripheral-neuropathy.html" rel="nofollow - https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/peripheral-neuropathy/managing-peripheral-neuropathy.html

http://chemocare.com/chemotherapy/side-effects/numbness-tingling.aspx" rel="nofollow - http://chemocare.com/chemotherapy/side-effects/numbness-tingling.aspx

Thank you for sharing your experiences and links! Sorry that I didn't reply earlier: I didn't notice the page number at the bottom where you post is on the 2nd page. 

I will start my first bi-weekly Taxol next Friday. As much as I'd like to finish Taxol quickly, if I run into any concerning Neuropahy symptoms, I will not hesitate to make adjustments. 

Thank you again for the information! I will watch closely how my body reacts and remember to ask my doctor about Vitamin B6. 

Cancer treatment will leave permanent marks on us. I truly hope any side effect is short term even if it takes years to go away; we all do.  

For AC, I usually feel bad in the first 3 days. I take 2 long naps in the first days. From day 4, I regain a little energy. Day by day I feel better. I still need a lot of rest and always take a nap but am able to eat/drink more regularly. I start moving/exercising more from there. 

I have been lurking the forum for a little while. I bumped into it while searching online about my diagnosis. It is hard to find out that you have cancer, let alone to know that you have the most aggressive form. I was diagnosed a week before thanksgiving 2019. A 3cm tumor was removed, triple negative ,no limph nodes involved KI67 20%. I received 4 a/c every three weeks and now I am on taxol weekly .My oncologist never mentioned anything about dose dense. She is a great doctor, but she hasn’t had many triple negative patients. If someone could recommend a triple negative expert I live in San Diego C.A. I will like to see one once I am done with my treatment. I feel that the more I learnt about this disease, the more I think I could have made a different decision. I don’t Know everything happened so fast.

Thank you 

I don't know any doctors in San Diego but I am sure other people can give you some recommendations when they see your post. 

You said you had the tumor removed before chemo. My treatment is chemo first, then surgery. I wanted to know how my tumor would respond to the chemo drugs. Either way will lead to the same survival rate (research shows). It's just that knowing how tumor responds to chemo helps to know the prognosis. But again it doesn't affect the treatment outcome. 

I see you had A/C every 3 week. Mine is every other week. My doctor followed the guideline exactly since I don't have other health/genetic situations.  

https://www2.tri-kobe.org/nccn/guideline/breast/english/breast.pdf" rel="nofollow - https://www2.tri-kobe.org/nccn/guideline/breast/english/breast.pdf   (page 51 & 53 for triple negative breast cancer) Mine is the 1st preferred regimen. 

My doctor also didn't mention dose dense Taxol. I requested it and he agreed. It all went all. I will write a update later with more details. 

Will you have radiation after Taxol? I will have surgery soon (3 weeks after my last chemo), and then radiation starting one month after surgery. 

It's a good idea to seek 2nd opinion/different doctor if you don't have full confidence in your doctor. I hope you get some recommendations soon. 

Our diagnosis came around the similar time...good luck to us!

https://medschool.ucsd.edu/research/moores/about/leadership/directors-office/Pages/clinical-science.aspx" rel="nofollow - https://medschool.ucsd.edu/research/moores/about/leadership/directors-office/Pages/clinical-science.aspx

https://providers.ucsd.edu/details/22465/Razelle-Kurzrock-Cancer-La_Jolla" rel="nofollow - https://providers.ucsd.edu/details/22465/Razelle-Kurzrock-Cancer-La_Jolla

Thank you for answer. My biopsy came back negative. It seems like the tumor was hardened and did not catch cancer cells. They did a lumpectomy that is when they realized it was cancer. I will talk to my doctor about dose dense Taxol. I am receiving 12 one every week. The last 4 A/C left me in really bad shape and with low counts. I am also having radiation after Taxol. Hopefully everything turns out well for both of us. 

I hope your Taxol infusion is going well. My oncologist told me weekly Taxol was more tolerable, and less toxic than bi-weekly ones. 12 weekly Taxol is one of the standard regimens, more frequently used than 4 bi-weekly Taxol. I chose bi-weekly hoping to get a less total dose of the drug, but it might not matter so much. 

I am recovering from the side effects from chemo. AC was hard on me, and Taxol was much easier. During Taxol, I didn't have allergic reaction, nail problem, nausea/vomiting, or bad taste. The downsides of bi-weekly Taxol are:

-I had to use white blood cell boost shot (filgrastim, a short term daily shot) for 7 days for each infusion. This shot caused some bone pain/muscle sore.

-I felt some bone/muscle pain from the chemo: weekly Taxol may only trigger mild symptoms.

-neuropathy: I had mild symptoms after each round of chemo. It usually appeared abouot 1 week after chemo, and improved after several days. The symptom is odd: my feet feel itchy if I exercise/walk a lot and they become warm. My fingers handled it better, especially in the last 2 rounds. My doctor said he had never heard of such form of neuropathy. He considered the symptoms mild and temporary. It's been 2 weeks since my last chemo and I still feel the itchiness when I go for walking, but like in previous rounds, it's getting better. So there is hope.

Everyone is different in how they respond to chemo drugs. To me, Taxol is a much easier course than AC. I am simply happy that I have completed it.  

I managed to get through chemo without delays but I read other people's posts talking about delays they had during chemo. You can talk to your doctors about your concerns and the potential impact on prognosis.  

I had more and worse side effects during A/C than Taxol; I didn't have carboplatin with Taxol. You may or may not feel the same as others; everyone reacts differently. I hope you can get through chemo without too much hardship. 

Vivian

I also think Carbo is the cause. It can promote pCR but it has a lot of serious side effects. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278059/" rel="nofollow - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278059/

Let us know how you do without it.

Since you’ve pulled yourself through this very difficult drug combination, A/C probably won’t be even harder. You can make it!