chemotherapy regime

[Debbie1987]

I am stage 1, tumor size 1.3 cm, no node involvement, had surgery and mammosite radiation, and now looking at chemo.  (Originally diagnosed in March 2009, had surgery and mammosite in April 2009. I am ER positive, PR neg and HER neg)   Had an oncotype score of 41, which I understand is pretty high.  My oncologist originally recommended AC every 3 weeks for 4 cycles, and Taxol for 12 weeks on a weekly basis; I objected to the 12 weeks of Taxol, and now he recommends  TAC treatment for 6 cycles, mainly, I understand, because of the high Oncotype score, which he feels puts me at high risk even though I am node negative.    I am really unsure if this is overkill--should I seek a 2nd opinion?  I am concerned about toxicity, and of course, quality of life issues.  thanks for your input.

[Debbie1987]

thanks to both of you for sharing your experiences.  I am planning pretty much the same schedule--I was going to have mine on Friday, and plan on taking Monday off.  The doctor has talked about the same pre-meds for nausea and the steroids as well.  I had my port put in earlier this week.  They said it was "easy" surgery, but mine ached all week--finally after about 4-5 days, it is feeling better.  I am an attorney for the local government, and my bosses and colleagues have been very supportive.  I will check into a 2nd opinion this week.  We are planning to start this coming Friday.  I think the other doc will recommend the same thing, mainly because of the high Oncotype test result, and the overall grade of my tumor.

It certainly helps to exchange info from people who have gone through this, so thank you so much!

[katarina777]

Another thought/factor to consider  has to do with the quality of your veins. (I mean, with me I had really no choice but to do the chemo so it was not a factor, but it is just something I want you to know and be prepared for as well)  The stuff is very toxic, and unless you have a perfect vein, or more than one perfect vein to use in the unaffected arm, you will need to have a port placed surgically into your chest wall. (there are some other options as well ) I had that done and they put the chemo through that port, because the risk for the chemo spilling outside of the vein was a  real possibility. My oncologist told me it was very serious when that happens.

[katarina777]

PS: still, be sure to get a second opinion. As BJSaws says, she was not a candidate for hormonal treatment but you are, and both that and chemo are systemic treatments as opposed to surgery and radiation, which are local. Sometimes, the hormone treatment is more effective than the chemo.

[katarina777]

Debbie, I had TAC for 6 cycles. As BJSaws says, the second day is the worst. The first day is fine because of the steroids they put in your IV and you have quite a bit of energy and feel quite well at first and after treatment. The first week is the hardest I would say and the third week the easiest. Mostly tiredness; the nausea can be controlled. And then with the Taxol, I had a bit of swelling in my ankles and face, with the leg swelling actually being quite severe. And, I gained weight even if I did not eat much. From what I hear this is very common with bc, and the exact opposite of what one would think, right?
yes, and you would lose your hair, i think this happens about twelve days after first treatment?

[BJSaws]

     I had 4 cycles of AC.  If I were diagnosed today, my chemo regimen would probably have included one of the Taxanes.  Things change so rapidly in breast cancer treatment that what was applicable 5 years ago, may not be applicable today.
     At the time of my treatment, I was a public high school teacher.  I scheduled my treatments for Thursday afternoons, took Friday off from work, and then returned to work on Monday.  Actually, the worst day for me was the second day after the treatment...in my case that was Saturday.  Everyone's body reacts differently, but I never did have any nausea, vomiting, etc.  My oncologist gave me an anti-nausea drug in the IV before every treatment and also gave me a prescription for some anti-nausea pills that I took immediately after the treatment.  I did have some stomach discomfort (like something clawing inside my stomach), but that was usually gone by the third day.
     Other things I had were:  Hair loss on my head, armpits, and pubic area (still had to shave my legs); mouth sores; fatigue that was not profound, but more than I was used to.
     Please let me know if you have any other questions.  I'm hoping for the best with your treatment.  You WILL get through to the other side of all of this and it will be done and in the past before you know it!  God Bless!

[Debbie1987]

thank you so much.  What regime were you on?  As noted, my onco is recommending the ACT, for 6 cycles.  I am much more comfortable with that regime than with the original one he recommended--AC for 4 cycles and then Taxol for 12 weeks on a weekly basis.  I guess I am ready to lose my hair--just worried about the rest of the side effects, as I hope to work as much as possible.  I have a pretty demanding job, but very understanding colleagues and clients.  thanks for any input you can provide.

[BJSaws]

A second opinion is always in your best interest.  I had a 1.1 cm tumor with no lymph node involvement and had a mastectomy.  Both the oncologists I saw recommended chemo, so I went with it.  My tumor was hormone receptor negative and Her2 negative, so the only adjuvant treatment available was chemo.  The chemo was rough and I lost my hair, but it was all something I could deal with.  It is all now in the past.  My original diagnosis was in September 2003 and I finished chemo in April 2004.  I have never regretted by decision to go ahead with the chemo,

[Debbie1987]

thanks for your input.  My Oncologist is suggesting the hormone treatment after chemo.

[katarina777]

Are you doing any hormonal treatment? Normally, this would be indicated in a case like yours,

[katarina777]

I think you should seek a second opinion on this, Debbie1987, for the same reasons as you are wondering about.