2 different opions..soo confused

jarsam

Hi again. I hope everyone is having a wonderful Christmas and New Years.
Just curious, One oncologist told me chemo for 4 months and one told me 5 months. So how do I know who is right. One is a cancer hospital only and one is not. Should that make a difference. I really don't want to go to a third. This is costing a fortune. Who do I listen to. I don't want 5 months but does that make me better longer?

Tomorrow I find out about my gene testing...I pray it is negative so i can choose a second lumpectomy. I am sooooo confused about everything.

Please help if you can with any ideas.
Thanks!
Michele

Rague

Perhaps they plan on using
Perhaps they plan on using different drugs that have different dosages.

jarsam

Rague said:

Perhaps they plan on using
Perhaps they plan on using different drugs that have different dosages.

I was told exact same drug.
I was told exact same drug. Are there different doses? I asked one doctor about how harmful it is to your heart and he said only in very high doses. I asked the same question to the other doc and she told me everyone gets the same dose. There is no higher or lower. What do you all think???????????

Rague

jarsam said:

I was told exact same drug.
I was told exact same drug. Are there different doses? I asked one doctor about how harmful it is to your heart and he said only in very high doses. I asked the same question to the other doc and she told me everyone gets the same dose. There is no higher or lower. What do you all think???????????

I don't know about all but
I don't know about all but at least some can be given at different dosages. When I was on A/C I had dense dose every other week for 8 weeks to shrink it and try to get good margins (it worked). Then surgery 2 weeks after the last A/C. Currently I'm on Taxol - weekly for 12 weeks. (Started it 3 weeks after surgery.) It can also be given every 3 weeks for 12 weeks. As I understand it from my Dr. the weekly is a lower dosage but by doing it weekly it keeps a more level amount working at a time. The every 3 week is a higher dose but does not stay as level. Perhaps someone else can explain it better.

Susan

Calleen

Rague said:

I don't know about all but
I don't know about all but at least some can be given at different dosages. When I was on A/C I had dense dose every other week for 8 weeks to shrink it and try to get good margins (it worked). Then surgery 2 weeks after the last A/C. Currently I'm on Taxol - weekly for 12 weeks. (Started it 3 weeks after surgery.) It can also be given every 3 weeks for 12 weeks. As I understand it from my Dr. the weekly is a lower dosage but by doing it weekly it keeps a more level amount working at a time. The every 3 week is a higher dose but does not stay as level. Perhaps someone else can explain it better.

Susan

Decisions
are never easy are they?? If it was me making the choice I would go to the one that I felt the most comfortable & made me feel like I mattered to them. Doctors recomendations for treatments seem to vary depending on what they believe and what they have experienced with the Sisters before us. You are the one who is going to make those trips to the facility you choose. You will make the right choice!! It's weird when a final decision has come to me!! It just feels right!!! And I don't look back!! Let us know!!!

Calleen

Lynda53

FTR Not all the same drugs,and yes heart issues
Your heart is tested if there could be issues.
TAC is most common but not always are all 3 given.
I do not have (The A)doxorubicin, which was originally called Adriamycin due to heart issues. Don't want the clicker quitting on me right now!
I also was taken off all due to taxotere(taxol) reactions (not breathing is not good!)
The T shrinks the beast
Usually 4-6 cycles are given, ASK
Different doses are also used, as are iv's and pills
So I have the C (cyclophosphamide,also used for rheumatoid arthritis!) and aromasin (old lady drug)for now
Write down your questions and concerns and ask them all

Peace

LadyParvati

Dosages depend on Dr. & on Type of Cancer
It sounds like one doctor is talking about a does-dense regime (a higher amount of the drug more often, generally every two weeks), while the other is talking about what used to be (and still is for some doctors) the "standard" regime of a lower amount of the drug every three weeks until you have received essentially the same total amount of the drug. There is some evidence that for some cancers a dose-dense regime is more effective at preventing recurrence. Hence, it is entirely possible that the four-month regimen would help reduce your risk of recurrence more than the longer one would. As a result of research showing the potential for increased effectiveness of dose-dense regimens, the NCCN (National Comprehensive Cancer Network) has issued guidelines that include dose-dense regimens in a decision-tree format. You can access those and read them for yourself at their website, www.nccn.org.

An oncologist working at a cancer hospital should be more up-to-date on current recommendations, though it is certainly possible that a doctor at a regular hospital may also work to keep up-to-date, especially if he/she is an oncologist.

They should be willing to give you very specific information--what drugs, how much, etc., and what all the risks and benefits are. Ask each doctor why they recommend one regimen in particular--how will that particular regimen benefit you? How will it affect your risk of recurrence? What are the risks of that particular regimen? What new research supports a particular regimen? (Get them to be specific if you can--if one doctor is relying on older research, that might not be good, but if the other doctor is relying on brand-new research without solid support (plenty of evidence that a particular regimen is proving to be good), that's not good either.

Lots of luck making your decision, Michele!

Merry Christmas! Sandy

jnl

LadyParvati said:

Dosages depend on Dr. & on Type of Cancer
It sounds like one doctor is talking about a does-dense regime (a higher amount of the drug more often, generally every two weeks), while the other is talking about what used to be (and still is for some doctors) the "standard" regime of a lower amount of the drug every three weeks until you have received essentially the same total amount of the drug. There is some evidence that for some cancers a dose-dense regime is more effective at preventing recurrence. Hence, it is entirely possible that the four-month regimen would help reduce your risk of recurrence more than the longer one would. As a result of research showing the potential for increased effectiveness of dose-dense regimens, the NCCN (National Comprehensive Cancer Network) has issued guidelines that include dose-dense regimens in a decision-tree format. You can access those and read them for yourself at their website, www.nccn.org.

An oncologist working at a cancer hospital should be more up-to-date on current recommendations, though it is certainly possible that a doctor at a regular hospital may also work to keep up-to-date, especially if he/she is an oncologist.

They should be willing to give you very specific information--what drugs, how much, etc., and what all the risks and benefits are. Ask each doctor why they recommend one regimen in particular--how will that particular regimen benefit you? How will it affect your risk of recurrence? What are the risks of that particular regimen? What new research supports a particular regimen? (Get them to be specific if you can--if one doctor is relying on older research, that might not be good, but if the other doctor is relying on brand-new research without solid support (plenty of evidence that a particular regimen is proving to be good), that's not good either.

Lots of luck making your decision, Michele!

Merry Christmas! Sandy

Well
I would probably have them talk to each other with you present. See if they are using different chemo drugs or why is the one asking for longer treatment. Don't be afraid to ask them anything. Most hospitals offer some assistance or will put you on a plan if you need help with paying for anything. Also, you could contact the ACS. I know they will help or put you in touch with someone that can. Good luck.

Leeza