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Breast Cancer  (Expert Forum)
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Taxol After AC or not?
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

Taxol After AC or not?

by chirok17, May 13, 2006 12:00AM
Hi. I have a few questions regarding the use of Taxol following AC chemotherapy. I am 46 years old, pre-menopausal with stage II, grade 3 invasive carcinoma, with extensive intraductal component. Had modified radical mastectomy. High grade DCIS  0.3cm from deep margin and residual infiltrating mammary carcinoma 1.8cm from deep margin. PR/ER+; Her2-neu+; 2 sentinel nodes pos; axillary nodes neg. Finish 4th cycle of AC next week. My first medical oncologist did not strongly recommend Taxol, however a second opinion was different and felt it would offer me an advantage. My questions are:
1. Would the Taxol be offered because I am considered at "high risk" for having recurrence?
2. Are the side effects of Taxol compounded with the AC side effects (nausea, fatigue, hair loss)?
3. If I have a difficult time with Taxol side effects (peripheral neuropathy), could the treatment be stopped before 4 cycles are completed, or could I be switched to Taxotere?
4. Is Glutamine used for peripheral neuropathy?
Thank you so much for this most informative site.

by CCF-RN,MSN-rf, May 15, 2006 12:00AM
Dear chirok17:  In a situation where chemotherapy is recommended, it is given to reduce the chance of recurrence.  If you have been prescribed dose-dense therapy (which it appears you may have been), the standard of care is AC followed by taxol.  The common side effects of taxol are low blood counts, hair loss, mild nausea, muscle aches and peripheral neuropathy.  If the toxicity is found to be too great, the option to lower the dose or stop the medication exists but the amount of benefit from incomplete therapy is unknown.  Your doctor will work with you to help with side effect management and determining the benefits versus risks.  There has been a small amount of research suggesting that glutamine may reduce peripheral neuropathy.  You should discuss this with your physician.

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