A/C + T vs. T/C

winsomebulldog

I'm sure this has come up at some point in the past, but I just don't have the energy to go hunting for it.
I am 39 with a grade III IDC, hormone receptor negative, HER positive. I've had a lumpectomy and there was no node involvement, but the tumor itself was kinda large. (T2)
The oncologist said I could do A/C + T, followed by radiation, then Herceptin. Or I could do T/C - radiation - herceptin. A/C is the most recommended for my cancer, but there's the whole heart damage thing to worry about. The T/C is showing a lot promise (according to my oncologist) but it doesn't have the history and track record that A/C does. So either I risk damaging my heart or I risk the cancer resurfacing because I wasn't aggressive enough with the chemo. How am I supposed to make that choice? I just don't know how to go about weighing those two risks.
I'm having a Muga scan done to make sure my heart is okay before the A/C is even an option, but assuming it's clear, I'll have to decide which route to go. The T/C is a little enticing because it would be an overall shorter course of treatment. But like my husband says, we don't want to find ourselves in the middle of recurrence somewhere down the road and be wondering if it could have been avoided by using A/C instead. Then again, as my DH pointed out, what's the point of being healed from cancer only to die from heart failure? I'm just not sure how to make this choice.
I've got some time. I just got the options yesterday. And the Muga scan may rule out the A/C option, too. I'm just trying to do some research and finding it more difficult than it should be. So much of what I get when I do a general web search just brings up stuff from 5 or 10 (or even more) years ago. I wasn't something more current.
Anyway, I just thought I'd toss this out here and see what you guys have to say about it. You've been there and I trust your opinions.
Thanks for all the support and help.
Jenn

Sunrae

I couldn't take the A/C
I couldn't take the A/C because of heart blockage problems and my onc put me with Cytoxan and Taxotere which wasn't fun and had 12 treatments once a week. Just finished and will be starting radiation soon. Hope you find more info that will help you make the right decision for you. Let us know what the Muga scan reveals and keep posting. Best Wishes.

Lighthouse_7

I was given the option of
I was given the option of the easier one or more aggressive one too. Although tempting, I decided that if I was going to fight this thing then the fight had to be hard! I too was very concerned about my heart, It felt like playing Russian Roulette with my life.
Another thing that was a horrible thing to worry about was the radiation. My Rad Onc. had to tell me that a small portion of my lung would be hit with radiation, there was no avoiding it, so lung cancer was now another worry.
This disease doesn't play fair, but for me, I chose the aggressive chemo.
All the best.

Hubby

2nd Opinion?
My wife just finished four rounds of AC; last one was Wednesday, and we are expecting a chemo crash tomorrow or Sunday. It was rough on her, but doable. Next she starts four rounds of Taxol. You're 39,and you are not saying that you've had any previous heart issues, so if the muga-scan is good, listen to your doctor.

Also consider Taxol vs. Taxotere; supposedly there are more side affects to Taxotere, but more alergic reactions to Taxol.

Get a second (and if need be third) opinion. We had a first and second opinion onc recommend dose dense AC-T as the first option, so that's what we went with.

Good luck with the decision.

Bob

carkris

Hubby said:

2nd Opinion?
My wife just finished four rounds of AC; last one was Wednesday, and we are expecting a chemo crash tomorrow or Sunday. It was rough on her, but doable. Next she starts four rounds of Taxol. You're 39,and you are not saying that you've had any previous heart issues, so if the muga-scan is good, listen to your doctor.

Also consider Taxol vs. Taxotere; supposedly there are more side affects to Taxotere, but more alergic reactions to Taxol.

Get a second (and if need be third) opinion. We had a first and second opinion onc recommend dose dense AC-T as the first option, so that's what we went with.

Good luck with the decision.

Bob

I am older than you and had
I am older than you and had AC. I had an echo prior to, and after and function has been ok. so far. I think at your age it is better to do the more aggressive therapy as you have many years to live and your heart should be in good condition. I was not offered a choice. I also has 12 weeks of taxol.

Moopy23

Decision
Jenn, from what I have read so far, it looks as if eventually C/T will be recommended without A. Some high-profile East Coast cancer centers are using it instead of A plus CT.

I did not have a choice and had TAC. I finished 6 rounds last April. If I had been given a choice, though, A would still have been included. For me, the tried and proven course gave/gives me most reassurance. I'm not a risk-taker by nature, and I figure my risk of death by BC is greater than death by heart failure.

Good luck with your decision. Both course of treatments have been effective, so in either case you are doing the most important thing, which is getting the chemo.

missrenee

Moopy23 said:

Decision
Jenn, from what I have read so far, it looks as if eventually C/T will be recommended without A. Some high-profile East Coast cancer centers are using it instead of A plus CT.

I did not have a choice and had TAC. I finished 6 rounds last April. If I had been given a choice, though, A would still have been included. For me, the tried and proven course gave/gives me most reassurance. I'm not a risk-taker by nature, and I figure my risk of death by BC is greater than death by heart failure.

Good luck with your decision. Both course of treatments have been effective, so in either case you are doing the most important thing, which is getting the chemo.

I, too, did the TAC route.
My oncologist explained it like this--we're gonna hit this and we're gonna hit it hard. I don't want this ever coming back to you! That was enough for me and I never looked back. I think as my breast cancer came from totally out of the blue, without warning, at one of the happiest, healthiest times of my life, I stopped doing the "what if" game with myself, decided to go with the treatments recommended by my experts and the rest is in God's hands.

Good luck with your decision, and good luck to us all for whatever choices we make.

Hugs, Renee

Marsha Mulvey

missrenee said:

I, too, did the TAC route.
My oncologist explained it like this--we're gonna hit this and we're gonna hit it hard. I don't want this ever coming back to you! That was enough for me and I never looked back. I think as my breast cancer came from totally out of the blue, without warning, at one of the happiest, healthiest times of my life, I stopped doing the "what if" game with myself, decided to go with the treatments recommended by my experts and the rest is in God's hands.

Good luck with your decision, and good luck to us all for whatever choices we make.

Hugs, Renee

Herceptin
Looks like you've had good response from others about your chemo options. I'd like to add something about Herceptin. Since you are HER2+ you will probably be on it for a longer period of time. The HER2+ types of cancer are very aggressive and Herceptin has been proven to be one of the best possible treatments for it. It is a targeted therapy, not a standard chemo drug. It too comes with the risk of affecting heart function, so you will be closely monitored via muga scans or echocardiograms. I am HER2+ also and would (if given an option) go full out, and go with the best weapons in the arsenal to attack this cancer. Best wishes. MM

winsomebulldog

Thanks
Thanks for all the advice and encouragement. Hubby and I were talking about it earlier today and we're starting to lean toward the most aggressive route. I think we are both still struggling to completely accept that the whole thing is real. I don't seem sick. I don't guess most of us did before the diagnosis. It's just hard to come to terms with it. But we're getting in gear and ramping up for the fight. Neither of us is a quitter. I'm so very grateful for this site and everyone here. It's already been a huge blessing for me. And I'm immeasurably grateful for my husband, who is my best friend and a die hard supporter and fighter. He is just so precious to me. I can't put into words how thankful I am for the support I have from him and my closest family and friends. I can't begin to imagine how much harder this would be if I didn't have them!
God Bless and thanks again!
Jenn

jackiejhm

winsomebulldog said:

Thanks
Thanks for all the advice and encouragement. Hubby and I were talking about it earlier today and we're starting to lean toward the most aggressive route. I think we are both still struggling to completely accept that the whole thing is real. I don't seem sick. I don't guess most of us did before the diagnosis. It's just hard to come to terms with it. But we're getting in gear and ramping up for the fight. Neither of us is a quitter. I'm so very grateful for this site and everyone here. It's already been a huge blessing for me. And I'm immeasurably grateful for my husband, who is my best friend and a die hard supporter and fighter. He is just so precious to me. I can't put into words how thankful I am for the support I have from him and my closest family and friends. I can't begin to imagine how much harder this would be if I didn't have them!
God Bless and thanks again!
Jenn

Oh Jenn
Your last post brought back a lot of memories. Surreal doesn't even come close to describing it, huh. I can remember an appointment with both my oncs (chemo/rad) They both laughed when my response to the 1,000th time being asked "How are you doing??" Well, I was fine 'til you guys started messing with me!!
I applaud and fully agree that aggressive sucks-but, it's the way to go. Hang in there! You have so many Blessings around you to help you through this. Please take care- and keep us posted. You're in my prayers. xoxo Jackie

chriskaput

AC
I completed 4 rounds of AC and so far have had 3 of 12 rounds of Taxol. My onco. said this was the most effective treatment for my DCIS stage 2b cancer. The head nurse told me that it is very dangerous for your heart to have more than 4 rounds of AC. How many are you scheduled to have? Either way if I had the choice I guess I would have gone with the agressive route too. AC is not easy, but you will get through it. All the best.

Christine.

winsomebulldog

chriskaput said:

AC
I completed 4 rounds of AC and so far have had 3 of 12 rounds of Taxol. My onco. said this was the most effective treatment for my DCIS stage 2b cancer. The head nurse told me that it is very dangerous for your heart to have more than 4 rounds of AC. How many are you scheduled to have? Either way if I had the choice I guess I would have gone with the agressive route too. AC is not easy, but you will get through it. All the best.

Christine.

I'm supposed to get 4
I'm supposed to get 4 rounds, every 2 weeks. Followed by T (not sure if it's Taxol or Taxotere, yet) for 4 rounds every 2-3 weeks. Then rads and eventually Herceptin. I've got 3 weeks or so before I start any of it, still recovering from the surgery. Hope the remainder of your chemo goes easy on you!

Jenn

Hubby

winsomebulldog said:

I'm supposed to get 4
I'm supposed to get 4 rounds, every 2 weeks. Followed by T (not sure if it's Taxol or Taxotere, yet) for 4 rounds every 2-3 weeks. Then rads and eventually Herceptin. I've got 3 weeks or so before I start any of it, still recovering from the surgery. Hope the remainder of your chemo goes easy on you!

Jenn

dose dense AC-T
This doctor at Sloan-Kettering in NY came up with this mathematical formula for giving the AC every two weeks for four cycles, followed by the Taxol every two weeks for four cycles, which sounds like what your onc is recommending. The theory is that by giving the treatments closer together, the cancer cells don't have time to recover.

It's a marathon not a sprint, but the finish line is out there somewhere around the bend and we're going to get there.

Bob

webbwife50

hi if
I did 4 rounds of a/c and then 4 of taxol. I'm 51, and I smoked for years. They did the mugga first, of course. And after I was done with chemo and about 6 months recovered I had a heart study done to make sure my heart had not suffered any damage. It hadn't. If I were 39, it would be a no brainer, but thats just me. I am terrified at times of a reoccurence, I had a scare a little over a month ago and it turned out not to be cancer but my onc. has told me that my type of cancer, TNBC, usually come back with a veangance if there is a reoccurence. I hope that was somewhat helpful?
Be blessed!\
Alison

winsomebulldog

webbwife50 said:

hi if
I did 4 rounds of a/c and then 4 of taxol. I'm 51, and I smoked for years. They did the mugga first, of course. And after I was done with chemo and about 6 months recovered I had a heart study done to make sure my heart had not suffered any damage. It hadn't. If I were 39, it would be a no brainer, but thats just me. I am terrified at times of a reoccurence, I had a scare a little over a month ago and it turned out not to be cancer but my onc. has told me that my type of cancer, TNBC, usually come back with a veangance if there is a reoccurence. I hope that was somewhat helpful?
Be blessed!\
Alison

Yes, we're leaning toward
Yes, we're leaning toward the A/C + T option, assuming tomorrow's Muga scan is clear. I think we were just caught off guard by the realities of Chemo when first given the options. It's just another part of this battle, I suppose. Take risks to get desired rewards. So I'm gearing up for the treatments, trying to plan as best I can for them.
Thank you for your input, and I pray you never have the recurrence you fear.
God Bless,
Jenn

Marsha Mulvey

winsomebulldog said:

Yes, we're leaning toward
Yes, we're leaning toward the A/C + T option, assuming tomorrow's Muga scan is clear. I think we were just caught off guard by the realities of Chemo when first given the options. It's just another part of this battle, I suppose. Take risks to get desired rewards. So I'm gearing up for the treatments, trying to plan as best I can for them.
Thank you for your input, and I pray you never have the recurrence you fear.
God Bless,
Jenn

Tomorrow
Good luck with the muga scan. AND keep the good attitude, it's so important.

MM

Heatherbelle

i love your bulldog pics!
Hi Jenn - I'm on the A/C, 4 rounds, followed by 2 rounds of Taxotere. I'm 34, and have stage 2 ICD with no lymph involvement -my onc recommended this treatment for me without really discussing any others -just that this combination would be the most effective for me. I had my first chemo treatment 5 days ago. I was expecting to feel fine for about 3 days, then feel like crap, and it's been the opposite -I started feeling crappy while I was getting the chemo, got progressively crappier over the next 2 days, then started feeling better. I woke up this morning feeling more normal than I have in a long time!
I have to point out to you (which I may have already done) - how much i LOVE your doggie profile picture! We're a big dog loving family and have always had boxers but ooooh how I love those bulldogs with their cute squishy faces! Best of luck to you!
*hugs*
Heather

winsomebulldog

Heatherbelle said:

i love your bulldog pics!
Hi Jenn - I'm on the A/C, 4 rounds, followed by 2 rounds of Taxotere. I'm 34, and have stage 2 ICD with no lymph involvement -my onc recommended this treatment for me without really discussing any others -just that this combination would be the most effective for me. I had my first chemo treatment 5 days ago. I was expecting to feel fine for about 3 days, then feel like crap, and it's been the opposite -I started feeling crappy while I was getting the chemo, got progressively crappier over the next 2 days, then started feeling better. I woke up this morning feeling more normal than I have in a long time!
I have to point out to you (which I may have already done) - how much i LOVE your doggie profile picture! We're a big dog loving family and have always had boxers but ooooh how I love those bulldogs with their cute squishy faces! Best of luck to you!
*hugs*
Heather

My bullies
We have two Bullies. My profile pic is of our girl, Katie, who pretty much rules the house. I've got a boy, too, named Briscoe, who is not the brightest bulb in the box, but he's very loving. They are so sweet and a constant source of amusement, too.