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All TopicsForum: Chemotherapy - Before, During, and After → Topic: When is dose dense chemo recommended?

Topic: When is dose dense chemo recommended?

Forum: Chemotherapy - Before, During, and After —

Regimens, side effects, and support from others going through chemo.

Posted on: Jan 23, 2013 09:42PM

michellej1980 wrote:

I see a lot of women are getting chemo every two weeks rather than three and I've read that research has shown it to be more effective. I wasn't offered this and I wonder why. Is there a particular reason why some women are treated this way? Grade? Lymph node status?

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Jan 24, 2013 12:03AM toomuch wrote:

Michellej - The only chemo regiments that are approved for dose dense for BC that I'm aware of are AC and Taxol. There is a lifetime limit of Adriamycin (A) that can be given and I assume that you reached that limit when you were treated with it in the ABVS protocol that you received for Hodgkins. Taxotere is not given dose dense secondary to concerns about toxicity so this is probably why you were not offered dose dense treatment.

"Every trial endured and weathered in the right spirit makes a soul nobler and stronger than it was before" Dx 7/13/2010, ILC, <1cm, Stage IIa, Grade 2, 2/12 nodes, ER+/PR+, HER2-
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Jan 24, 2013 09:17AM PeggySull wrote:

Dose dense is typically given as a standard protocol when you have triple negative breast cancer--neg for estr, progest, and Her-2. I am triple negative and wish I wasn't for several reasons.

I have just finished the AC cocktail and will be starting dose-dense taxol on Monday.

Good luck with your treatment!

Peggy

Dx 10/2012, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2- Dx 4/9/2013, IDC, 1cm, Stage IIa, Grade 3, 0/4 nodes, ER-/PR+, HER2- Surgery 09/09/2013 Reconstruction of my left breast: Nipple reconstruction; Reconstruction of my right breast: Nipple reconstruction Surgery 04/02/2013 Mastectomy of one or both breasts: Mastectomy of my right breast; Prophylactic (also called preventive) mastectomy of one or both breasts : Prophylactic (also called preventive) mastectomy of my left breast ; Reconstruction of my left breast; Reconstruction of my right breast Surgery 11/26/2012 Lymph node removal (also called dissection): Sentinel lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my right side Chemotherapy 12/03/2012 AC + T (Taxol): Adriamycin and Cytoxan, plus Taxol
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Jan 31, 2013 08:35PM michellej1980 wrote:

Thanks both for your replies. I thought I had seen people getting dose-dense Taxotere but can't be sure now. But what you said explains a lot.

Age at diagnosis: 31. Hodgkin's Disease stage IVB November 1996 - ChVPP (1996-1997); ABVD (1997); radiotherapy to neck, chest, abdomen & pelvis (1998); BEAM followed by allogeneic bone marrow transplant (2000) Dx 7/18/2012, IDC, 4cm, Stage IIa, Grade 2, 0/3 nodes, ER+/PR-, HER2- Dx 10/10/2012, DCIS, Grade 3 Hormonal Therapy 03/08/2013 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Surgery 08/01/2012 Lymph node removal (also called dissection): Sentinel lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my left side Surgery 09/18/2012 Mastectomy of one or both breasts: Mastectomy of my left breast; Prophylactic (also called preventive) mastectomy of one or both breasts : Prophylactic (also called preventive) mastectomy of my right breast ; Reconstruction of my left breast: DIEP flap; Reconstruction of my right breast: DIEP flap Chemotherapy 11/07/2012 Cytoxan (chemical name: cyclophosphamide), Taxotere (chemical name: docetaxel)
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Feb 1, 2013 08:10PM NancyHB wrote:

I received 4 x dd AC - I guess I didn't know that AC could be given in three-week increments, I've only known women who got dd AC.  I am part of a clinical trial that is looking at the efficacy of 6 x dd Taxol vs. 12 weekly Taxols; I was radomized into the dd Taxol arm of the trial.  I was made aware before joining the clinical trial that the dd Taxol is actually slightly LESS effective than the 12 weekly Taxols, but there is a convenience factor in doing dd.  I decided it was worth the minimal risk to me to participate in the clinical trial. 

I am pathologically ER+/PR+ and HER2- but Oncotype ER+(barely)/PR- and HER2-, so I am not doing Herceptin.

I have no idea how the decision is made to do dose dense or tri-weekly treatments.  I never really thought to ask - it's an excellent question!

Oncotype=42, ki-67=50% SWOG S0221 participant Dx 11/22/2011, IDC, Left, 1cm, Grade 2, ER+/PR-, HER2- (FISH) Hormonal Therapy 10/19/2012 Aromasin (chemical name: exemestane, class: aromatase inhibitor) Hormonal Therapy 06/07/2012 Tamoxifen in pill form (brand names: Nolvadex, Apo-Tamox, Tamofen, Tamone, class: selective estrogen receptor modulator (SERM)) Chemotherapy 01/19/2012 AC + T (Taxol): Adriamycin and Cytoxan, plus Taxol Radiation Therapy 06/12/2012 Whole-breast radiation Surgery 12/05/2011 Lumpectomy in one or both breasts: Lumpectomy in my left breast; Lymph node removal (also called dissection): Sentinel lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my left side Hormonal Therapy 12/28/2012 Tamoxifen in pill form (brand names: Nolvadex, Apo-Tamox, Tamofen, Tamone, class: selective estrogen receptor modulator (SERM))
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Feb 1, 2013 08:30PM Wonderland wrote:

I did 4x dd AC and 4x dd Taxol in 2007. I was given the choice of TAC every 3 weeks or the dd method. Onc said different clinics favor one over the other. She used as example Duke and Chapel Hill. Duke likes TAC every 3 weeks and Chapel Hill likes dd. I made my choice of dd because I like Chapel Hill (my son was a student there at the time and Carolina "hates" Duke). That's how I made my scientific decision! Tongue Out

"Put on your coat. It's easier to stay warm than it is to get warm." George the Llama Man Dx 11/2006, IDC, <1cm, Stage IIa, Grade 2, 2/36 nodes, ER+/PR+, HER2- Hormonal Therapy 09/20/2009 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Hormonal Therapy 09/22/2007 Surgery 11/27/2006 Mastectomy of one or both breasts: Mastectomy of my left breast; Lymph node removal (also called dissection): Underarm (axillary) lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my left side Surgery 09/09/2009 Reconstruction of my left breast: DIEP flap Radiation Therapy 06/05/2007 Chemotherapy 01/02/2007 AC + T (Taxol): Adriamycin and Cytoxan, plus Taxol