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Carbo/Taxol Weekly vs. Every 3 Weeks?

RachAndMom
Posts: 8
Joined: Mar 2010

My mother will begin carbo/taxol chemo treatments in the next couple of weeks for Stage 4b UPSC and the oncologist suggested a possible weekly lower dose carbo/taxol treatment plan. Anyone have experience with this? We were told that some studies have shown a better response to this regimen but we are very concerned about side-effects. Is the toxicity/incidence of neuropathy reduced/increased from these lower weekly doses?
Thanks!
Rachel

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

Somewhere on this Board I posted a very recent interview with a famous gyn/onc that talked about weekly franctionated carbo/taxol as the new 'gold standard' for ovarian cancer, a paradym shift from the 'every-3-weeks' that had been the accepted initial treatment protocol for so long. UPSC is so like ovarian cancer that I am not surprised to see this being prescribed. You should feel great that your mother's gyn/onc is so 'current' as to what is coming out of the newer clinical trails about timing carbo/taxol infusions.

When I had my recurrence I had WEEKLY fractionated single-agent taxol for 10 weeks, every Monday. It was at 1/3 the dose I got with my initial diagnosis (and no carboplatin mixed in), so with the 4th week, I was actually getting more of the taxol in me. I had no side effects at all other than baldness and fatigue. None of the neuropathy, nausea or bone pain and no real trouble with my blood counts (as opposed to having to get 3 blood transfusions & numerous treatment delays when I got the carbo/taxol every 3 weeks during my original six 'every-3-weeks' treatments.) The 'fractionated' weekly doses are actually suppossed to be less harsh on your system than getting the 'big dose' and having 3 weeks to recover. I did get Nuepogen shots every Tuesday, Wednesday, & Thursday every week for the 10 weeks, but I honestly don't think I needed them. I never had bone pain from that either! And the 10 weeks of taxol brought me into REMISSION again! :D

RachAndMom
Posts: 8
Joined: Mar 2010

Hi Linda,
Congratulations on being in remission! Thank you so much for taking the time to share your experience with the weekly dense dose taxol. I am so happy to hear that that this regimen has worked so well for you AND with less side effects from when you did the original every-3-weeks carbo/taxol. If I understood correctly, my mother would be getting taxol AND carbo weekly, since this is her first chemo. Do you know of anyone who has received this? I would be interested to hear if it is just as well tolerated as the single-agent weekly taxol was for you. Anyway-thank you again for the encouraging words.
Rach and Mom

maggie_wilson's picture
maggie_wilson
Posts: 616
Joined: Nov 2009

linda,

such a lovely word: remission. i haven't seen much of your postings lately, though did read awhile ago that you were ned after 10 weeks of chemo. thanx for spelling out exactly what you did, and the wonderful results. it's always so encouraging to hear good stories; makes such a difference to us all.

mazel tov on your continuing remission.

warmly,
maggie

maggie_wilson's picture
maggie_wilson
Posts: 616
Joined: Nov 2009

hi rachel,

i had pretty much the same chemo, but at 3 week intervals because it is so heavy duty. my last treatment was mid november, and i still have some neuropathy in my fingers and toes; not too bad, but definitely there. hasn't actually changed that much in the last 4 months. i don't know re: reduced lower doses, which are more frequent, but i can imagine it would be easier on the system overall. i know extra hydration after the chemo was very helpful. if you don't know about this, be sure to ask. you wear a bag, much like a fanny pack, with all kinds of things in it to reduce nausea, help relaxation, hydrate, etc. i wore mine for about 4 days after each treatment. it was when it was removed, that i had the most difficult time. i too would be very interested in hearing others' experience of this regimen. really, the chemo treatments were unpleasant some of the time, difficult some of the time, not so difficult other times, and overall bearable.

hoping for the best.
maggie

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

When I was first diagnosed with uterine my doc put me on carbo/taxol every 3 weeks. He informed me if this dose was too much....with too many tough sideaffects -- he'd go with every week, but with a smaller dose. I was lucky to make the every 3 weeks, as enjoyed the down time to recover.

Side affects with me weren't much except the upset tummie and as time went on, had more tiredness. My last treatment was July '09 and side affects are pretty much non-existant...knock on wood!! A bit of neuropathy in my hands, mainly at night. After up and moving in the morning, it's totally gone.

I've always been an avid runner and workout gal prior to treatments. To this day I work out but at a much lesser extent -- walking, elliptical type equipment, weights and yoga. I feel the movement with exercising has been my saving grace!!!

I'd like to hear of anyone with weekly treatments with carbo/taxol and how they faired.

NED for me still....cross my fingers & toes~~
Jan

RGW
Posts: 59
Joined: Mar 2010

I just had my first Taxol/carboplatin treatment today. Got Emend & Zofran for anti-emetics. So far I feel pretty good. When do I hit the wall, when do the side effects start? When does the hair fall out?
Rebecca

TiggersDoBounce's picture
TiggersDoBounce
Posts: 413
Joined: Oct 2009

Rebecca,

Congrats on making it thru Day 1!

For me days 2-4 seem to be fine and 5-8 get a little edgy. My first round with Cisplatin, produced no side effects except the dreaded constipation. No hair loss, no neuropathy, no nausea and vomiting...

My second round switched me to the Carbo/Taxoplatin and this time I did have side effects.
Day 2-3 were fine, but on Day 4-8 I had terrible neuropathy in my knees and lower legs. I also had the constipation again which stinks. Hair loss started for me around Day 14 after the dose. Once I passed the first week, I was back to normal. The next time they lowered my dose of Taxoplatin, started me on the Decadron (steroids) the day before to hopefully thwart off the neuropathy. However, like the first time, Day 4 came the neuropathy. Thankfully it was somewhat less and now a week later has subsided.

Everyone's experience will be different. Just be sure to prepare to feel "less than perfect", don't freak when and if it happens and give your body a few days to heal. You will rebound :)

Also, make sure you talk to your doctor....they can help, this is their specialty and why be in any more discomfort than you absolutely have to ??

Stay in touch and best wishes over the upcoming days.

Laurie

Ro10's picture
Ro10
Posts: 1356
Joined: Jan 2009

Glad you are still feeling pretty good. Everybody is different with their side effects. Most people had problems with constipation, so make sure you keep your fluids up. I never had trouble with constipation, but drank apple juice every day.

My hair started falling out on day 12 after my first treatment. It was totally gone by the time I got my second treatment (which was every 3 weeks).

I got out and walked every day. I had to gradually increase the amount as I had my first treatment 3 weeks after my Robotic Surgery. Take it one day at a time. Ask all the questions you may have. Someone will have an answer for you. In peace and caring.

A1pena's picture
A1pena
Posts: 93
Joined: Jan 2010

Hi Rachel,

I'm glad to see another doctor recommend this schedule! My mom is getting carbo/taxol weekly and is doing great! She has UPSC with extensive lymph node involvement but no organs showed signs of cancer. She has had next to no side effects- occasional nausea and has to keep up on fiber/stool softeners to fight constipation but aside from that, she is living her normal life. She even tells me that she forgets she has cancer. So far she hasnt lost her hair- she is about 5 1/2 weeks into treatment. The doctor told us she probably would, so we're still on standby with cutters if need be. From what I have read, the weekly schedule is already in place for breast cancer and is being actively researched for Ovarian. There was a recent study out of Japan that Linda had posted showing some promising results with the weekly schedule. It still a relatively new concept so only time will tell exactly how effective it is. It does seem to carry less side effects tho...

Best of luck to you and your mom!! Keep us updated on her progress :)

Kind Regards,

Amanda

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