CMF dose reduction

I just completed chemotherapy: 1 infusion of cytoxan & taxotere, 6 infusions of CMF.  My chemo was changed to CMF when I had a severe allergic reaction after the taxotere infusion, and after a shot of Neulasta.  Because it was unclear whether the reaction was due to taxotere or Neulasta, it was decided I should have neither and I was switched to CMF.  But without the Neulasta, my white blood cell count dropped too much after one CMF infusion, so the CMF dose was reduced to 85% and the cycle was extended from 3 weeks to 4 weeks from infusion to infusion. Then, for the remaining 5 infusions, my dose was dropped to 75% and I remained on the 4-week cycle.  Was the efficacy if the treatment compromised, and if so, by how much, due to the dose reductions and one-week time extension between infusions? (I had stage 1 tumor, 1 cm., grade 3, negative lymph nodes, and no cancer cells found in tissue surrounding tumor.  I had lumpectomy and sentinel node biopsy.  My oncotype dx score was 29.)  

[werez1]

I had an Ecoli-kidney infection after radiation. I developed Polymyalgia Rheumatica as a result of an Immuno-compromised immune system. I had massive doses of Cipro and then Prednisone for the PR. It is important to have a rich anti-oxidant diet. Was a TSH test performed? What was your HER-2-NEU factor.

WEREZ1

[lhughes]

I doubt your treatments were compromised.  Sounds like to me, that your onc did exactly what he could by lessening the dose and then extending your treatments.  There are articles out on the internet about whether or not a strong and short treatment schedule were better than less and longer schedules.  

I had an allergy to Taxol (same family of drugs as taxotere) and got to use the newer drug Abraxane which is supposed to be good, although being new it's not as well tested and doesn't have the history like the others.

I could worry that the newer drug may not have been as effective, like you could worry that your treatment was compromised.  OR you can look at what you've been through, knowing that your doc is looking out for you.  It does certainly sound like he was working in your better interests to get you through treatment.

Talk with him on your next checkup and get his view of what happened.  Take someone with you to listen too.  

Then, head into life with a positive attitude and just give thanks you are still here to talk about it.  It does really sound like you've been through a bunch and came through it well.  Your doc sounds like he had a good plan and a good alternate plan.  Always good to have a backup plan.

Are you heading into radiation now?  Will you take a subsequent drug like Tamoxifen?

Best of luck,
Lisa

[Laurie252]

Lisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, Laurie

[Laurie252]

Lisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, LaurieLisa, Thanks so much for your encouraging and positive message.  You make a lot of sense.  And you are right, I have a very good --and caring-- oncologist.  I start radiation beginning in February for 6 weeks, and then tamoxifen, or one of the post-menopause estrogen blockers.  (I just turned 55.  I was perimenopausal before chemo, and the chemo put me in menopause.)
Sounds like you have been through a lot with chemo also.  Are you done with radiation and taking tamoxifen?  How are you doing?  I hope you are doing well--sounds like you are from your message.  Thanks again, Laurie

[lhughes]

Hey girl!

I've been through 4 rounds Adriamycin/Cytoxan while pregnant in 05.  Had a beautiful baby girl in Feb 06 and had 4 rounds Abraxane 06 just after her birth.  Completed radiation (7 weeks) like a champ and FINALLY got to get my new boob just this past summer in 07.  Got a tummy tuck and lifted boob to boot.

I've got 3 years and 7 months remaining on tamoxifen treatments.  Taking effexor with it to help with the lovely side-effects.  I am STILL premenopausal, unfortunately.  Get all the bad menopausal side-effects and still have a period like a teen-ager.  What's up with that?????  Oh well.  Thankfully I'm cancer free at this moment and hope to stay that way for many decades to come.

I'm turning 39 this March, have a husband who still thinks I'm hot, even when I have a hot flash.  haha....  2 beautiful baby girls, spoiled rotten, and loving every minute.  It's a challenge, but it's worth it to see them laugh and smile and say things I never thought babies would say.

I've got, strangely enough, 2 oncologists in my pocket, a radiation oncologist who is a wonderful female concerned about things the other two males are not (another story there) and a host of friends who pray that I stay healthy (now that could be because I sit the nursery at church and teach 3 year old sunday school!).

May you find a host of friends and docs and strangers even who watch out for you and hope that you too are here for a long time.

In the words of my favorite theme songs "If you are going through hell, keep on going" and "Life ain't always beautiful, but it's a beautiful ride".

Keep the faith, and best wishes to you!
Lisa

[alarson]

I too find it hard sometimes to trust my doctor.  But I do.  If you think he is good and you are also keeping on top of things then trust yourself and your doctor.

I also just finished chemo and start radiation in February for 6 weeks, and then tamoxifen.  I am 34 year old.  I have a hot spot from a pet scan that we are watching and it's hard to just wait and watch.  But I do trust my doctor.  I will make sure that he is watching it and once radiation is over I will have another PET scan.

I would suggest that following rad you have a CT or PET scan to make sure the cancer is gone. Plus make sure that you have 3 month follow ups for the next year.  (My doctor just had me do a CT/PET scan before radiation.  Have you had a recent test?)

Keep on top of things!  

[alarson]

I too find it hard sometimes to trust my doctor.  But I do.  If you think he is good and you are also keeping on top of things then trust yourself and your doctor.

I also just finished chemo and start radiation in February for 6 weeks, and then tamoxifen.  I am 34 year old.  I have a hot spot from a pet scan that we are watching and it's hard to just wait and watch.  But I do trust my doctor.  I will make sure that he is watching it and once radiation is over I will have another PET scan.

I would suggest that following rad you have a CT or PET scan to make sure the cancer is gone. Plus make sure that you have 3 month follow ups for the next year.  (My doctor just had me do a CT/PET scan before radiation.  Have you had a recent test?)

Keep on top of things!  

[lhughes]

Thanks for adding about the additional checks.  I just celebrating going to yearly checks and forget that just after all the treatments are over there are 3 month checkups, then 6 month checkups.

I find it so hard to believe so many women in their 30s are going through this, even those in their 20s.  I do hope you become cancer free and your hot spot isn't hot anymore.

Good luck in your radiation treatments.  They are mostly easy, except the skin thing...Vigilon and Oat-beta glucan lotion are what my rad onc told me to use.  Vigilon is a strange water based bandaid type thing which really does work to help get fluid back into the skin and the Oat-beta glucan can be purchased from CVS.  An excellent lotion to promote quick healing.

I'll keep you in my prayers!
Lisa

[Laurie252]

Thanks for your message.  I also have a very healthy diet.  My Her2 was negative.  I don't know what a TSH test is.
How are you?  I hope you are well now.  Laurie

[Laurie252]

I appreciate your feedback.  I trust and respect my doctor a lot, I just know that there's often more than one valid way to see a situation, especially with all the gray areas in cancer treatment. So I try to get info from a number of sources.  I guess what I hope to hear--undoubtedly what we all hope to hear-- will be reassurance that the treatment plan was/is/will be effective, even with the unexpected decisions that had to be made in process.
I hope your next petscan comes back clear.  I too am starting radiation at the beginning of February, and I am in the process of scheduling a breast MRI.  I also plan to be screened every 3 months.
I just turned 55.  I wish you the best and would be happy to hear how you are doing if you feel like communicating. Laurie