chemotherapy

[suebell]

I was diagnosed with a stage II cancer with a lot of negative features: ER/PR-, HER-2 +, 2.6 areas of infiltration (they were in different spots and did not form a lump) 2 pos nodes, one with just isolated cells. I had a mastectomy and am now on 4 dosed of A/C every 3 weeks to be followed by 12 weeks of taxol concurrent with Herceptin to be followed with Herceptin for 1 year.
Is A/C better every 2 weeks? Is Taxotere better than Taxol? My doctor did not want to do the 2 week shedule because of cardiac risks.  Do you agree?

[CCF-RN,MSN-rf]

Dear suebell:  The large U.S. clinical trials addressing the use of Herceptin in early breast cancer used an every 3 week schedule of AC followed by Taxol with Herceptin. There was a small study done at Memorial Sloan Kettering suggesting that it is probably safe to use the every 2 week chemotherapy scheduling, but the two approaches have not been directly compared in this situation; both approaches are commonly used. A recently reported study comparing taxol to taxotere (without Herceptin) following AC chemotherapy found no significant differences between the two for the treatment of early breast cancer (although more side effects were seen with the taxotere). The decision of which drugs and schedules must be considered in terms of the individual patient.  Without evaluation, we cannot provide specific recommendations for you.  

[Avidhiker]

Unfortunately, a serious but uncommon side effect of adriamycin can be interference with the pumping action of the heart.  Hopefully, your oncologist, like mine, will order periodic heart scan tests such as MUGA scan which measures the ejection fraction of the cardiac ventricles.  I have completed 3 out of 4 rounds of AC and have had 2 MUGA scans.  I suppose I'll get another one after I complete my last round next week.  Good luck and remember that everyone is different with chemo side effects. Keep a positive attitude!