Is Taxol Old Treatment?

Taxol came on the scene in the earily to mid-90's along with a number of other cocktail chemo drugs in answer to increasing the effectiveness of chemotherapy. Some of these new chemotherapy drugs do permeate(pass through) the blood-brain barrier(the system that protects the brain from foreign substances by blocking their passage from the blood). Some of the others are Cisplatin and Carboplatin. I found out that in the case of ovarian cancer, metastasis to the brain had been so rare, it was almost none existent up until 1994. Since then, with the advent of these newer chemo drug cocktails that permeate the blood-brain barrier, there has been a mark increase in brain metastasis. With Lung and Breast cancers already more common to metastasize to the brain(than ovarian), think how many more of them are now happening because of the newer neurotoxic chemo drugs? If you heard that some expert MDs are no longer using Taxol for BC, I wonder why?

I was scheduled to have the taxol as well, only 12 weekly treatments of it. I did some research and found out that taxol is not proven to help unless you have mets elsewhere. My oncologist said that there is no proven evidence that it can prolong recurrence or anything else. She said that I did not have to have the taxol, it didn't matter either way. If I wanted it, it was there if not, she didn't care. The choice is always yours. I had one node positive and turned down the taxol. I was however strongly HER2 positive and am currently taking 52 treatments of herceptin. Only 42 to go! Take care and keep me posted on what you decide. Carrie

gdpawel said:

Taxol came on the scene in the earily to mid-90's along with a number of other cocktail chemo drugs in answer to increasing the effectiveness of chemotherapy. Some of these new chemotherapy drugs do permeate(pass through) the blood-brain barrier(the system that protects the brain from foreign substances by blocking their passage from the blood). Some of the others are Cisplatin and Carboplatin. I found out that in the case of ovarian cancer, metastasis to the brain had been so rare, it was almost none existent up until 1994. Since then, with the advent of these newer chemo drug cocktails that permeate the blood-brain barrier, there has been a mark increase in brain metastasis. With Lung and Breast cancers already more common to metastasize to the brain(than ovarian), think how many more of them are now happening because of the newer neurotoxic chemo drugs? If you heard that some expert MDs are no longer using Taxol for BC, I wonder why?

Hi GDPawel:
I believe that most of us here enter into treatment informed and well educated on the drugs as well as our "odds" of it being effective for our particular condition(s).

Your posts seem to consistently promote a
"no treatment" philosophy due to the side effects of chemo and/or radiation. Would it
be best, in your opinion, that everyone with
cancer (of any type) forego adjuvant treatment and take their chances that WE will
be that one person in a million who experiences a spontaneous and complete recovery?

You must realize that we are all different in
how we choose to approach our individual diagnosis and treatment recommendations. If we haven't any faith at all in our physician's and our own educational endeavors to assist us in making the best choices for ourselves, then we obviously would do nothing. Devoid of faith that anything could help us without killing us,
we'd just die from the cancer and forego any
fight.

I am happy to know that so many of us choose
to fight! Frightened, yet educated and generally cognizant of what we're taking and its side effects, we carry on in our daily struggle toward longer life. Quite a testament to our bravery, our spirit and our strength of character. It's a tough road to
travel, as you well know, and we benefit greatly from support and caring. Negativity, we don't need.

Have you tried visiting the "care givers" network? Have you received any bereavement
counseling? Our hearts are big enough to share the pain of your loss but I don't personally know how to begin to share the anger and negativity you bring to this site about treatments being so terrible for us and your feeling that chemo and radiaiton will only serve to hasten our deaths. I speak only for myself when I say that perhaps
your method of "helping" us is misplaced here. Care with us anytime but remember that we thrive on the positive, the love, sharing of experiences and caring which we all bring to this site. Do you care about us or are you on a personal vendetta of sorts
against doctor's, drugs and radiation therapy because they ultimately failed to save your spouse? We experience side effects every day, so there is little you could tell us that we do not already know from first hand experience and sharing of info. with our sisters who care so much.

Love, light and laughter,
Inkblot

pippi said:

Hi I am Pippi from Wellington New Zealand. I had a mastectomy in September of 2000 ( 2 Lymph nodes involved). I was offered AC, which I took but no mention was made of Taxol.
I inquired later about it and was told it is only used here for advanced cancer.
I actually thought that we were behind tne times.
Love Pippi

In the March 15, 2003 issue of the Journal of Clinical Oncology, there was an editorial by V. Valero and G.N. Hortobagyl (J Clin Oncol 21(6): 959-962,'03) which reviewed all of the large, prospective, randomized trials published comparing the newer, taxane-based chemotherapy regimens. These authors concluded that none of these regimens have increased either complete response rates or overall survival, with median survivals remaining at two years or less. This is precisely the same results which were being obtained 30 years ago.

In the September, 2002 issue of The American Journal of Oncology Review, there was a commentary by Lawrence N. Shulman, M.D., Vice Chair for Clinical Services/Adult Oncology, Dana-Farber Cancer institute (Harvard Medical School), Boston. His commentary described the complete lack of progress in the chemothereapeutic treatment of metastatic breast cancer since 1970.

The results of nearly 30 years of clinical investigation in the treatment of patients with metastatic breast cancer, neither standard or high-dose chemotherapy had done a great deal to improve the outcome of patients with this disease. For over the past 20 years, we relentlessly combined chemotherapy agents in various regimens with ever-increasing dose intensity and the survival for patients participating in these studies was exactly the same, less than two years. Not a hint of significantly improved survival.

Dr. Shulman noted that a retrospective comparison, well-characterized standard-dose database with a less well-characterized high-dose database suggested that there was increased early mortality for high-dose therapy. Highly selected patients whose tumors are responsive to chemotherapy can have long-term remissions from standard-dose chemotherapy. One large randomized trial showed no difference in survival for patients treated with standard-dose versus high-dose chemotherapy. The median survival for both groups was two years, and no subset of patients seemed to benefit from high-dose therapy.

Even if one were an optimist and concluded that the high-dose data suggested that a small subgroup of patients benefited from this approach, one must remember that the patients participating in these studies are already highly selected for age, performance status, response to induction therapy and other factors. At best, it must be helping only an incredibly small percentage of the patients with this disease.

Clearly, more effective therapies are desperately needed for women with metastatic breast cancer, and after 30 years of investigation aimed at intensified multi-agent chemotherapy, we should look for other avenues of study. The fact that regressions of breast cancer had no influence on overall survival must reflect the inadequacy of present-day chemotherapy. How the use of chemotherapy which induces responses in some patients, cannot have affect in overall survival? Does chemotherapy shorten survival of some patients, while prolonging the survival of others?

In an era of ever-increasing numbers of partially effective cancer therapeutics, there is an obvious need for technologies to better match treatment to a patient. In the field of chemosensitivity testing, there is substantial literature that has not been recently reviewed and which the vast majority of clinical oncologists are not familiar.

Approximately 10,000 individual patient specimens are currently being submitted for testing by more than 1,000 cllinical oncologists, surgeons and pathologists annually in the United States. The tests engender uninformed reactions and opinions from various clinicians within the referring medical centers. This is a timely and important topic for review, consideration and debate.

It is time (over-due) to set aside empiric one-size-fits-all treatment in favor of recognizing that breast, lung, ovarian and other forms of cancer represent heterogenous diseases, where the tumors of different patients have different responses to chemotherapy. It requires individualized treatment based on testing the individual properties of each patient's cancer.