Chemo for TNBC

Heatherbelle said:

Hi! Your sister's diagnosis
Hi! Your sister's diagnosis sounds alot like mine. Mine is stage 2, the tumor was 2 cm. I had same surgery, bilater, with expanders. Right now i'm halfway through treatment and reconstruction. My chemo treatment is 4 rounds of AC, followed by 2 rounds of T. I go every 2 weeks. Tomorrow is my 4th chemo treatment, and the last of my AC treatments. My side effects have been tolerable, the most prevalent ones being hair loss and fatigue. I have alot of pain in my back & legs, onc thinks it's either from the Neulasta shot i get after every chemo or a possible chemo side effect. The fatigue is getting worse the more treatments that I get! Nausea hasn't been an issue for me, they gave me a prescription for anti-nausea medicine to take on an as-needed basis & I think I've taken 5 through my entire treatment.
Best of luck to your sister, sending good vibes & prayers
*hugs*
Heather

Hi! Your sister's diagnosis
Hi Heather

I noticed in your message that you are having a lot of pain in your back & legs either from the Neulasta shot or as a chemo side effect. I, too, had a lot of pain from my first Neulasta shot, from my waist down to my toes, and it lasted about 4 days. When I told my PA about it, she said that she recommended that I take Claritin (regular, not the "D") because she had two other patients who took it and it helped them a lot. I took it after my second treatment, and what a difference. Still some pain, not nearly as severe, for one evening as compared with 4 days of pain. My PA isn't sure why it works, but it does, at least for some patients. You should, of course, check with your oncologist before taking any new medication.

Help4Sis said:

Thanks for your reply
Heather, Thanks for your reply and I'm glad you're tolerating the chemo well! Did you have more than one opinion before starting your course of chemo?

Hi & you're welcome I did
Hi & you're welcome I did not go for a second opinion. I did research that alot of women with similar diagnosis as mine were on the same chemo cocktail, i just never felt a need for a 2nd opinion, i guess! Tomorrow is #4 of 6 for me...almost there!
That's so great you are supporting your sister through this!
*hugs*
Heather

Two oncs, two opinions
My little Moopy was diagnosed 11/2008 with Stage IIIa TNBC, 6/15 nodes positive. Hometown oncologist suggested 4 rounds AC followed by 4 Taxol + Avastin trial. Our out of town "second opinion" oncologist at Siteman Cancer Center followed the "throw the kitchen sink" approach and prescribed 6 rounds TAC. We went with the "second opinion" and Moopy did the TAC. To our hometown onc's credit, he went along with our decision. Around round four, he looked Moopy in the eye and told her that she had "done everything right." Which was his way of saying that TAC was the right way to go. It's coming up on the two-year mark, and so far so good!

Unfortunately, there's no lock-cinch way of knowing what best to prescribe for any particular case. What works for one person may or may not work for another. Your sister is to be commended for getting a second opinion, and you are a wonderful support to her in coming here for advice. Please keep in touch and let us know how it goes; there are a number of TNBC survivors here who will be happy to lend a hand. If and when she feels comfortable, please encourage her to stop by too. I hope and pray that all goes well for all of you.

Joe (Aortus)

Which chemo protocol?
I was given Option #1. I had 4 rounds of A/C(Adriamycin/Cytoxan) every other week followed by 12 rounds of T (Taxotere)- once a week. I was diagnosed with Triple Negative Breast Cancer Stage IIa. No radiation. No hormones. A primary site was never found which happens in about 5% of breast cancer patients. 2 of 22 lymph nodes removed from under my right arm were cancerous. I also had a right mastectomy.

I think you are doing the right thing by becoming informed about this dreadful disease. It is easier to cope with it all when you have some idea of what to expect and know what questions to ask.

Everyone deals with the diagnosis differently. Some will talk to everyone they can and others keep it to themselves. Whatever you do, please don't lecture your sister. No matter how much you know/care it is HER body and her life. Mine lectured me and we are currently no speaking.

TC protocol for Treatment of TNBC
From what I've been told, the best treatment for TNBC is:

6 cycles Taxotere and Cytoxan (on a tri-weekly/every 3 week basis)
(as a form of "preoperative chemotherapy"/aka "neoadjuvant chemotherapy")

The reason for this is to avoid the unnecessary addition of the 'A" (adriamycin) to the
treatment protocol. Top research scientists have found it the protocol 'TC' is
equally as effective in treating TNBC as with the 'TAC' protocol - and this is good news!

Why take 3 drugs in an infusion cycle - when you could be dealing with 2 drugs which
taken together in an infusion cycle are equally effective, thereby avoiding
unnecessary side effects?

If you would like, I can provide the sources of my information. I am following this
protocol myself, have read comments from other b.c. patients who are doing same.
I am convinced this is the best way to go.

EllenInWonderland said:

TC protocol for Treatment of TNBC
From what I've been told, the best treatment for TNBC is:

6 cycles Taxotere and Cytoxan (on a tri-weekly/every 3 week basis)
(as a form of "preoperative chemotherapy"/aka "neoadjuvant chemotherapy")

The reason for this is to avoid the unnecessary addition of the 'A" (adriamycin) to the
treatment protocol. Top research scientists have found it the protocol 'TC' is
equally as effective in treating TNBC as with the 'TAC' protocol - and this is good news!

Why take 3 drugs in an infusion cycle - when you could be dealing with 2 drugs which
taken together in an infusion cycle are equally effective, thereby avoiding
unnecessary side effects?

If you would like, I can provide the sources of my information. I am following this
protocol myself, have read comments from other b.c. patients who are doing same.
I am convinced this is the best way to go.

i totally disagree with you!
i had 6 cycles of TC and when i was finished, had a petscan. it determined that the TC had absolutely NO EFFECT on my cancer - in fact it had spread. so then i had 4 cycles of TAC and when that was completed was able to have my mastectomy. i am triple negative as well as having inflammatory breast cancer.

EllenInWonderland said:

TC protocol for Treatment of TNBC
From what I've been told, the best treatment for TNBC is:

6 cycles Taxotere and Cytoxan (on a tri-weekly/every 3 week basis)
(as a form of "preoperative chemotherapy"/aka "neoadjuvant chemotherapy")

The reason for this is to avoid the unnecessary addition of the 'A" (adriamycin) to the
treatment protocol. Top research scientists have found it the protocol 'TC' is
equally as effective in treating TNBC as with the 'TAC' protocol - and this is good news!

Why take 3 drugs in an infusion cycle - when you could be dealing with 2 drugs which
taken together in an infusion cycle are equally effective, thereby avoiding
unnecessary side effects?

If you would like, I can provide the sources of my information. I am following this
protocol myself, have read comments from other b.c. patients who are doing same.
I am convinced this is the best way to go.

Amen, Heidi and JessiesMom
Thank you, ladies and sisters. I was late to this thread, and am so grateful for your forthright responses. If there were a one-size-fits-all chemo regimen, it would be called CURE.

EllenInWonderland said:

TC protocol for Treatment of TNBC
From what I've been told, the best treatment for TNBC is:

6 cycles Taxotere and Cytoxan (on a tri-weekly/every 3 week basis)
(as a form of "preoperative chemotherapy"/aka "neoadjuvant chemotherapy")

The reason for this is to avoid the unnecessary addition of the 'A" (adriamycin) to the
treatment protocol. Top research scientists have found it the protocol 'TC' is
equally as effective in treating TNBC as with the 'TAC' protocol - and this is good news!

Why take 3 drugs in an infusion cycle - when you could be dealing with 2 drugs which
taken together in an infusion cycle are equally effective, thereby avoiding
unnecessary side effects?

If you would like, I can provide the sources of my information. I am following this
protocol myself, have read comments from other b.c. patients who are doing same.
I am convinced this is the best way to go.

"Best treatment for TNBC" is Questionable
Hi, Ellen,

The treatment that you describe as the "best treatment for TNBC" is not the *preferred( protocol prescribed by the National Comprehensive Cancer Network for invasive breast cancer, though it is one possibility. You do not state what stage your cancer was, how many nodes were involved, if any, nor any other aspects of your cancer (receptor statuses, etc)--and those are extremely important factors that *must* be included in *any* treatment decision.

Fortunately for me, I conduct research in the medical field. Hence, even though cancer is not my area of focus, I am very well equipped to read the pertinent medical research and participate in the evaluation of treatments options for my cancer, which was also triple negative. After a great deal of literature research and weighing all the evidence presented in the research, my oncologist and I agreed that TAC on a two-weekly basis was the best choice for me. Notice that I say this was the best choice for ME--from your perspective and that of your chemo oncologist, it apparently wasn't the best choice for YOU.

For me and my particular situation, the addition of adriamycin *was* definitely *necessary*. In fact, to have chosen TC alone rather than TAC would have put me into the research trials comparing the effectiveness of TC alone to TAC, because my chemo oncologist is one of the researchers participating in that research. This was just this past spring, and those trials are NOT COMPLETE. My chemo oncologist offered me the choice to participate in that research, but she specifically stated that they do NOT yet know whether TC alone will be as effective as the combination. In order to be certain that TC alone is as effective as TAC, years of follow-up will be necessary. As triple negative breast cancer has a higher recurrence rate in the first few years, we decided that I was better off going with the full treatment every two weeks.

Thus, to answer your questions, "Why take 3 drugs in an infusion cycle - when you could be dealing with 2 drugs which taken together in an infusion cycle are equally effective, thereby avoiding unnecessary side effects?"

One would choose to take the 3-drug combination under the following circumstances
--when it has a KNOWN effectiveness and the 2-drug combination does NOT have a known effectiveness, and
--when, as a result of the effectiveness of the 2-drug combination NOT being known, it is therefore NOT known whether using the adriamycin is "unnecessary."

I am truly glad that you feel so confident and comfortable with your protocol. Ten years from now, we may indeed know that adriamycin is not necessary, i.e., that TC alone is just as effective as TAC--or we may find that patients who took only TC have a higher recurrence rate than those of us who took the e-drug combination.

Finally, it is always extremely important to recognize that treatment protocols MUST be individualized according to the multiple factors of each person's own situation.

Sincerely, Sandy