AC-T or CMF that is the question

Hubby
Hubby Member Posts: 325
edited March 2014 in Breast Cancer #1
Oncologist #1 was today. He recommends the AC-T, but is open to my wife opting for CMF. He said it is controversal which may be better for triple- . He told us at the end of the appointment that his friend who the Chief of Breast Cancer Medicine at Sloan in Manhattan is the one who is an advocate for the CMF (for triple neg, small tumor size, stage 1).

He told us that only when he saw that my wife was leaning towards the CMF; I think he told us so we wouldn't think she was contemplating something crazy.

Oncologist #2 is tomorrow. She would have to say something pretty convincing to sway my wife towards the AC-T. Either way, she will be starting the week of the 21st.

Comments

  • greyhoundluvr
    greyhoundluvr Member Posts: 402
    Hubby -
    I'm sure some of the triple neg ladies will jump on here. My only experience is what I have seen on here and a friend of mine who was triple negative. She said that the oncologist at her cacer center only recommended the AC-T so that is what she had and did very well....
  • Hubby
    Hubby Member Posts: 325

    Hubby -
    I'm sure some of the triple neg ladies will jump on here. My only experience is what I have seen on here and a friend of mine who was triple negative. She said that the oncologist at her cacer center only recommended the AC-T so that is what she had and did very well....

    Oncologist #2
    Okay, well Oncologist #2 STRONGLY recommends the AC-T, and she thinks that the Sloan guy in the City who likes CMF for triple negative is, to quote her "an idiot". She knows who he is, and respects him, but thinks he is dead wrong. She said don't do CMF, it's unethical to recommend it. Her opinion is that the side effects of CMF linger and make you more miserable. She said if she had a second choice after AC-T it would be TC; but please don't do CMF.

    I said in my last post that Onc #2 would have to say some pretty convincing things to sway us, and she did.

    After that, I brought her over to a breast cancer support group.
  • MyTurnNow
    MyTurnNow Member Posts: 2,686 Member
    Hubby said:

    Oncologist #2
    Okay, well Oncologist #2 STRONGLY recommends the AC-T, and she thinks that the Sloan guy in the City who likes CMF for triple negative is, to quote her "an idiot". She knows who he is, and respects him, but thinks he is dead wrong. She said don't do CMF, it's unethical to recommend it. Her opinion is that the side effects of CMF linger and make you more miserable. She said if she had a second choice after AC-T it would be TC; but please don't do CMF.

    I said in my last post that Onc #2 would have to say some pretty convincing things to sway us, and she did.

    After that, I brought her over to a breast cancer support group.

    Hubby, it just amazes me
    Hubby, it just amazes me that 2 oncologists can have a totally different treatment plan. I wonder what they base their recommendation on. Is it a kickback from the medical supply companies or what? I am glad that you have had multiple opinions and have been given one by a doctor that you trust. Wishing the absolute best for your wife as she starts her treatments and "thanks" to you for being her loving caretaker. Keep us posted.
  • 24242
    24242 Member Posts: 1,398
    MyTurnNow said:

    Hubby, it just amazes me
    Hubby, it just amazes me that 2 oncologists can have a totally different treatment plan. I wonder what they base their recommendation on. Is it a kickback from the medical supply companies or what? I am glad that you have had multiple opinions and have been given one by a doctor that you trust. Wishing the absolute best for your wife as she starts her treatments and "thanks" to you for being her loving caretaker. Keep us posted.

    Please tell me
    I guess I don't understand new terms so what is the AC-T and CMF??
    Guess I would just like to understand this thread more.
    Tara
  • Hubby
    Hubby Member Posts: 325
    24242 said:

    Please tell me
    I guess I don't understand new terms so what is the AC-T and CMF??
    Guess I would just like to understand this thread more.
    Tara

    A-Adriamycin, C-Cytoxan,
    A-Adriamycin, C-Cytoxan, T-Taxol is AC-T; C-Cytoxan, M-methotrexate and F-fluorouracil is CMF. Both are different chemo cocktails; CMF is the older one that almost nobody uses anymore. AC-T is the one that most women these days seem to do. The A drug has the potential to be very toxic.

    Anyway sometimes you hear what you want to hear, so Onc#1 saying that his friend the Chief at Sloan; NYC liked CMF, we heard that, and he wasn't so overboard insistant on his first choice AC-T, but AC-T was his first choice. But now that Onc #2 was so addiment against CMF; it kind of throws cold water in your face.

    Let's just say it was one of those long night with very little sleep. I'm sure you've all been there.
  • cavediver
    cavediver Member Posts: 607
    Hubby said:

    A-Adriamycin, C-Cytoxan,
    A-Adriamycin, C-Cytoxan, T-Taxol is AC-T; C-Cytoxan, M-methotrexate and F-fluorouracil is CMF. Both are different chemo cocktails; CMF is the older one that almost nobody uses anymore. AC-T is the one that most women these days seem to do. The A drug has the potential to be very toxic.

    Anyway sometimes you hear what you want to hear, so Onc#1 saying that his friend the Chief at Sloan; NYC liked CMF, we heard that, and he wasn't so overboard insistant on his first choice AC-T, but AC-T was his first choice. But now that Onc #2 was so addiment against CMF; it kind of throws cold water in your face.

    Let's just say it was one of those long night with very little sleep. I'm sure you've all been there.

    Taxotere?
    I have been on ACT cocktails....so far 3 cycles with 5 more to go.....Adriamycin, Cytoxan, Taxotere. Is Taxoter and Taxol same? I do know we are all different....but my cocktail shrank a 8.6 cm tumor to almost nothing after 3 cycles to allow surgery, so it was a definite right choice for me.
  • Hubby
    Hubby Member Posts: 325
    cavediver said:

    Taxotere?
    I have been on ACT cocktails....so far 3 cycles with 5 more to go.....Adriamycin, Cytoxan, Taxotere. Is Taxoter and Taxol same? I do know we are all different....but my cocktail shrank a 8.6 cm tumor to almost nothing after 3 cycles to allow surgery, so it was a definite right choice for me.

    They are different; I think
    They are different; I think they call both cocktails AC-T; and I'm actually not sure which one they would use on my wife. They seem to say AC followed by Taxol or Taxotere a lot. Are you doing all of these concurrently? My wife's would be AC x 4 then T x 4. She is really scared.
  • ms.sunshine
    ms.sunshine Member Posts: 707 Member
    Hubby said:

    They are different; I think
    They are different; I think they call both cocktails AC-T; and I'm actually not sure which one they would use on my wife. They seem to say AC followed by Taxol or Taxotere a lot. Are you doing all of these concurrently? My wife's would be AC x 4 then T x 4. She is really scared.

    When drs. can't agree you
    When drs. can't agree you feel like you are in a tug-of-war with you being in the middle, not a good feeling.
    I had ACx4 then Tx1.5 had to stop Tax. couldn't handle it. Went for pet scan cancer totally gone. The tumor was approx. 8cm.

    I know you are being bombarded with cancer info. but what does your heart tell you to do? Get in a quiet place and listen.

    Keep us updated take care
    Jennifer
  • Hubby
    Hubby Member Posts: 325

    When drs. can't agree you
    When drs. can't agree you feel like you are in a tug-of-war with you being in the middle, not a good feeling.
    I had ACx4 then Tx1.5 had to stop Tax. couldn't handle it. Went for pet scan cancer totally gone. The tumor was approx. 8cm.

    I know you are being bombarded with cancer info. but what does your heart tell you to do? Get in a quiet place and listen.

    Keep us updated take care
    Jennifer

    Wow!!
    That's amazing that your cancer is gone :)!!! In my wife's case, the tumor was small; 1.1 cm and is out; but they want to do the chemo because of the high Oncotype score of 47, and triple negative. My heart is telling me go with the AC-T; my wife's heart is telling her all kinds of different and scary things.

    She is scared of heart damage, possibility of lukemea, nerve damage and what she will look like without hair. She is scared she will never be the same or feel the same after chemo. Added to that is that we can't keep the house clean, catch up with the laundry, the kids have finals and regents and need to go to review classes and practice regents after school, or well after school; need to be driven and picked up; she's working; I'm working, and her birthday is in two weeks, so she will be having her first round of chemo the day before her birthday.

    I'm texting her about your tumor going away right now!!! Hopefully it will make her feel better. Are you triple negative or do was it a high grade tumor?
  • MyTurnNow
    MyTurnNow Member Posts: 2,686 Member
    Hubby said:

    Wow!!
    That's amazing that your cancer is gone :)!!! In my wife's case, the tumor was small; 1.1 cm and is out; but they want to do the chemo because of the high Oncotype score of 47, and triple negative. My heart is telling me go with the AC-T; my wife's heart is telling her all kinds of different and scary things.

    She is scared of heart damage, possibility of lukemea, nerve damage and what she will look like without hair. She is scared she will never be the same or feel the same after chemo. Added to that is that we can't keep the house clean, catch up with the laundry, the kids have finals and regents and need to go to review classes and practice regents after school, or well after school; need to be driven and picked up; she's working; I'm working, and her birthday is in two weeks, so she will be having her first round of chemo the day before her birthday.

    I'm texting her about your tumor going away right now!!! Hopefully it will make her feel better. Are you triple negative or do was it a high grade tumor?

    Also, Hubby, check into
    Also, Hubby, check into "Cleaning For A Reason". It's a service offered to chemo patients to have your house cleaned for free once a month while on chemo. I didn't know about it when I was going through chemo but there are several ladies on here that took advantage of this. This would be just one less thing to worry about. Good luck!!
  • Mariannemm
    Mariannemm Member Posts: 136
    Given the same options
    I too was given the same options and I chose AC followed by Taxol. I had 4 rounds of AC and then 12 weekly doses of Taxol. I am on my 10th round of Taxol. I am having side effects but I am so glad I made the decision I did. There is more success with this type of treatment. I was at a stage 3 with 12 positive nodes, I have a bilateral before beginning treatment. I will begin 6 weeks of radiation the 1st week of July. Plus I will begin 10 years of Tamoxifen too. There just wasn't enough data on the other route and my onc said I needed to take an agressive route.
  • Hubby
    Hubby Member Posts: 325
    MyTurnNow said:

    Also, Hubby, check into
    Also, Hubby, check into "Cleaning For A Reason". It's a service offered to chemo patients to have your house cleaned for free once a month while on chemo. I didn't know about it when I was going through chemo but there are several ladies on here that took advantage of this. This would be just one less thing to worry about. Good luck!!

    Thanks for the tip
    I just went on there web site and registered. They accept 50 applications a day starting at 1:00 central, so the timing was perfect. I just need my wife's doctor to send in a note!!! I'm not sure how my wife will feel about me playing the cancer card, but I think she will be happy about it.
  • carkris
    carkris Member Posts: 4,553 Member

    Given the same options
    I too was given the same options and I chose AC followed by Taxol. I had 4 rounds of AC and then 12 weekly doses of Taxol. I am on my 10th round of Taxol. I am having side effects but I am so glad I made the decision I did. There is more success with this type of treatment. I was at a stage 3 with 12 positive nodes, I have a bilateral before beginning treatment. I will begin 6 weeks of radiation the 1st week of July. Plus I will begin 10 years of Tamoxifen too. There just wasn't enough data on the other route and my onc said I needed to take an agressive route.

    I had CMF in 1994 for an
    I had CMF in 1994 for an estrogen neg cancer. back then they did not test for anything other than that. I had a local recurrance a year later. then fine. I now have an estrogen pos, prog pos, her2neg cancer. I had adriamycin, cytoxan, and taxol. I had many side effects, but am glad I did it. CMF is easier, but hardly ever used. I also had it for 6 months as well. Unless there is new literature that says it works better, I know the big center in boston I go to uses AC -T I know your wife is afraid and it is so scary, but she needs to fight this cancer with everything. I am on tamoxifen, which she will not be on, and taking zometa twice a year IV. a new study has shown it to prevent all forms of mets. I was afraid too, I went on disability, and we all hunkered down to weather the storm. My husband had to do everything, and I hated being bald, but it passes and you get through.
  • Hubby
    Hubby Member Posts: 325
    carkris said:

    I had CMF in 1994 for an
    I had CMF in 1994 for an estrogen neg cancer. back then they did not test for anything other than that. I had a local recurrance a year later. then fine. I now have an estrogen pos, prog pos, her2neg cancer. I had adriamycin, cytoxan, and taxol. I had many side effects, but am glad I did it. CMF is easier, but hardly ever used. I also had it for 6 months as well. Unless there is new literature that says it works better, I know the big center in boston I go to uses AC -T I know your wife is afraid and it is so scary, but she needs to fight this cancer with everything. I am on tamoxifen, which she will not be on, and taking zometa twice a year IV. a new study has shown it to prevent all forms of mets. I was afraid too, I went on disability, and we all hunkered down to weather the storm. My husband had to do everything, and I hated being bald, but it passes and you get through.

    I'm so sorry it came back.
    I'm so sorry it came back. Did the CMF give you a more of a crummy overall feeling? That's what Onc #2 said it does.

    Another weird thing; they both said that they would put her on Tamoxifen. They both thought that she might have some benefit; and that part of her tumor may be ER+ (even just slightly) because of all of these conflicting results. The rulebook just keeps on changing.
  • Skeezie
    Skeezie Member Posts: 586 Member
    Hubby said:

    I'm so sorry it came back.
    I'm so sorry it came back. Did the CMF give you a more of a crummy overall feeling? That's what Onc #2 said it does.

    Another weird thing; they both said that they would put her on Tamoxifen. They both thought that she might have some benefit; and that part of her tumor may be ER+ (even just slightly) because of all of these conflicting results. The rulebook just keeps on changing.

    I'm triple neg...
    Tumor 2.7 cm, Nodes Clear. Had simple, single mastectomy last 9-09. I received 4 cylces of C/T. My onc did not want to use A because of possible heart problems. But I was 66 yrs old at the time. I also did not want A unless it was necessary.

    But I got to tell you, there is absolutely no way I would use an old chemo when typically all of the newer ones are being used. But that is my opinion. When considering chemo's I want the newest there is and I would not choose based on being sicker on one or the another. When you read long term side effects they all are scary. But that is not the norm. My intent was to get rid of the bc the best way it could be done. I did not have to have rads because the pathology came back from my mastectomy showing no cancer cells in the remaining breast.

    I don't feel not taking Tamoxfin and the other hormone suppressing drugs is a bad thing. They have side effects and also, I don't have to worry about hormones posing a threat to recurring bc. So there are two ways to look at it.

    Last summer I was sick to my stomach when it became clear I would have to have chemo, all of our lives growing up we learn that has to be the worst thing that can happen to us. I'm the biggest chicken there is and like everyone else was terrified of chemo, but I made it thru, we all make it thru. It's doable. Not the most fun, but doable.

    Quit worrying about keeping the house clean right now. I don't know how old the kids are, but unless they are babies they can pitch in, even if they just pick up after themselves. paper plates are wonderful too. Housework always waits. You guys need to take care of yourselves and let the little things go.

    I hope you come to your decision quickly because once you do you can get started and the sooner you do that the closer you are to the finish line. Also, once you get into active treatment you will feel so much better to have this particular stress behind you. You can then put all your energy into fighting the beast.

    Keep us posted.

    Hugs, Judy :-)
  • cavediver
    cavediver Member Posts: 607
    Hubby said:

    They are different; I think
    They are different; I think they call both cocktails AC-T; and I'm actually not sure which one they would use on my wife. They seem to say AC followed by Taxol or Taxotere a lot. Are you doing all of these concurrently? My wife's would be AC x 4 then T x 4. She is really scared.

    all together
    I was given all 3 together..... 3 cycles before surgery, and I Monday I start the jouney for 5 more incjections of the 3-part mix.... given every 3 weeks. I know we are all different and can have different side effects...but mine were not as bad as I had thought. I was super scared the first treatment..still in shock about it all. But, I was fatigued, had good pills to avoid the nausea, had the day after shot each time which only gave me aches like I had the flu. Week after infusion I would get severe intestinal cramping...which I got antibiotics for... my eyes became very dry and blurred vision which comes and goes, runny nose, and and a few other minor side effects. Tell your wife it won't be as bad as she imagines......... Of course the hair loss occurred just as I started the second infusion...... I chose to shave my head rather than watch it fall out all over the place. I shocked myself every time I passed a mirror..... wear scarves or hats when I go out. All I knnow is the Cocktail truly worked!!!! From the 8.6 cm tumor to almst nothing after 3 cycles....had the mastectomy with clean margins.... and now I just have to get through 5 more cycles. Again, from what I read, we can all have different reactions to the same cocktails. But, the stuff works so it is all worth it!
  • Hubby
    Hubby Member Posts: 325
    Thank you all
    I think everything is settled; at least for tonight. AC-T starts the 23rd after some muggascan thing next week, and getting all the preauthorizations...

    I've gotten incredible advice from all of you. Judy's advise not to pick the chemo based on the side affects, somehow makes perfect sense today, although two days ago I don't think it I would have gotten it. And I'm relaying the stories of how well this regiment has worked on some of you.

    Although I think she was happiest when I told her that I signed her up for Cleaning for a Reason!!!
  • carkris
    carkris Member Posts: 4,553 Member
    Hubby said:

    Thank you all
    I think everything is settled; at least for tonight. AC-T starts the 23rd after some muggascan thing next week, and getting all the preauthorizations...

    I've gotten incredible advice from all of you. Judy's advise not to pick the chemo based on the side affects, somehow makes perfect sense today, although two days ago I don't think it I would have gotten it. And I'm relaying the stories of how well this regiment has worked on some of you.

    Although I think she was happiest when I told her that I signed her up for Cleaning for a Reason!!!

    yes the advice was good. CMF
    yes the advice was good. CMF was defiantely easier for me. I felt worse on the other but everyone is different and she may feel fine withthe AC-T. there are lots of drugs to help alleviate symptoms and people here to help.you will have to circle the wagons and let life slow for a bit, but before you know it life will return to normal. It is important to me to know Ihave done everything to fight with the newest and best weapons we have. keep us up to date, hugs to your entire family.
  • Hubby
    Hubby Member Posts: 325
    bumping up for mom2cjm

    bumping up for mom2cjm
  • Mythreesonsthree
    Mythreesonsthree Member Posts: 3
    Hubby said:

    Thank you all
    I think everything is settled; at least for tonight. AC-T starts the 23rd after some muggascan thing next week, and getting all the preauthorizations...

    I've gotten incredible advice from all of you. Judy's advise not to pick the chemo based on the side affects, somehow makes perfect sense today, although two days ago I don't think it I would have gotten it. And I'm relaying the stories of how well this regiment has worked on some of you.

    Although I think she was happiest when I told her that I signed her up for Cleaning for a Reason!!!

    It is many years later doubt

    It is many years later doubt your still on here curious how your wife is. As far as the  CMF the Sloan Dr wasnt wrong CMF has shown promising resurlts with TNBC. MY Dr is

    from MD Anderson and I have TNBC and I am taking CMF now.