Topic: Weekly taxol teatment for Stage 1 Her2 Positive BC

Forum: IDC (Invasive Ductal Carcinoma) — Just diagnosed, in treatment, or finished treatment for IDC.

Posted on: Jan 9, 2022 09:08AM - edited Jan 12, 2022 01:30PM by Sylvie24

Posted on: Jan 9, 2022 09:08AM - edited Jan 12, 2022 01:30PM by Sylvie24

Sylvie24 wrote:

UPDATED: I met with the oncologist this morning and asked her about TCH. She agreed that it might be a better option with similar survival rates as the ACTH while removing potential heart damage risk and blood clotting. It will be 6 treatments, once every 3 weeks. I think I am more comfortable with this treatment than the ACTH. Thanks everyone for your replies!

Looking for some feedback on treatment options with those who have similar diagnosis:

I was diagnosed with breast cancer in November. I underwent a lumpectomy on Nov. 18th, and had a few complications with the surgery that has delayed chemo. I met with the oncologist to discuss treatment plan. Given my age (48), ER- PR -, HER2+, grade 3 and diagnosis stage 1 (tumor 1.7cm, no lymph node involvement), she recommended a treatment plan that consists of AC (doxorubicin and cyclophosphamide) every 2 weeks for 4 treatments, and then paclitaxel (Taxol) and Herceptin every 3 weeks for another 4 treatments (and then Herceptin to finish off the 1 year treatment plan).

I expressed my concern about the toxicity of the treatment as I am a single mom (widow) with 2 young children and family who lives 1200km away. We then looked at an alternative option which is the 12 weekly Taxol treatments with Herceptin every 3 weeks, followed by Herceptin to finish off the year. She mentioned that she had considered this last treatment, but given that it is a fairly recent treatment option, we don't have long term results for it.

I meet with the oncologist on the 12th so we can decide which treatment plan to proceed with. I have done endless research on overall survival rates with the 12 week Taxol (plus Herceptin) treatment and have not found anything concrete. I would love to hear from those with a similar diagnosis what treatment you are on. Also, I was wondering if anyone here has been NED 10+ years with just the 12 weekly Taxol treatment plus Herceptin for a year plus radiation. If yes, what was your initial diagnosis and how long have you been NED?

Thanks in advance

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Jan 9, 2022 12:11PM aram wrote:

Hi Sylvie24, I am sorry you are here. Do you know why you weren't offered TCH? That one has been shown to have similar results as ACTH. I had ACTHP myself. The Taxol and Herceptin is very new, so I am not sure if you might find anyone with 10+ years.

Dx at 40, BRCA1 Dx 2/5/2021, IDC, Left, 1cm, Grade 3, ER-/PR-, HER2- Dx 2/5/2021, IDC, Left, 3cm, Grade 3, ER-/PR-, HER2- Chemotherapy 3/10/2021 AC + T (Taxol) Targeted Therapy 6/2/2021 Perjeta (pertuzumab) Targeted Therapy 6/2/2021 Herceptin (trastuzumab)
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Jan 9, 2022 01:01PM melbo wrote:

I was also curious why you weren’t offered TCH. (Taxotere, carboplatin, and herceptin). I had that treatment (plus Perjeta since I had a bigger tumor and a positive node). Of the three option, my understanding is that ACTH has the worst side effects (for most people), TCH is slightly easier, and Taxol is generally the “easiest” of the options. That being said — they are still chemotherapy and different people react differently to each one.

Diagnosed right before my 42nd birthday. One husband, two dogs, one cat and no kids. Dx 7/16/2020, IDC, Left, 2cm, Stage IIA, Grade 3, 1/7 nodes, ER-/PR-, HER2+ Targeted Therapy 8/6/2020 Herceptin (trastuzumab) Targeted Therapy 8/6/2020 Perjeta (pertuzumab) Chemotherapy 8/6/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/20/2020 Lumpectomy; Lumpectomy (Left); Lymph node removal; Reconstruction (Left); Reconstruction (Right) Radiation Therapy 1/31/2021 Whole breast: Breast, Lymph nodes
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Jan 9, 2022 01:56PM minustwo wrote:

I'm wondering why you didn't have neoadjuvant chemo with a HER2+ diagnosis. I had 6 rounds TCHP before surgery but did not have a complete response. So I was scheduled for 4 rounds AC after surgery - but could only tolerate 3. Then I had radiation followed by more hercepin for the rest of the year. I was almost 70 and while the treatments were not fun, I managed totally on my own. Drove myself to every chemo & every radiation and only had help for a day or two after the surgery I think the fatigue was the worst part, and the general weakness. Make sure you nap every day while the children are in school.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 9, 2022 03:33PM sarahnh wrote:

I have the same type of cancer as yours, but larger and in the nodes. I haven't started treatment yet, but I have read a lot about treatment protocols and discussed them with the oncologists I've seen.

My understanding is that for larger tumors (over 2 cm), it is standard to have chemotherapy before surgery. But it seems that for smaller tumors (less than 2 cm, not in the nodes, etc), it is standard to have surgery first and then chemo afterwards

Also, my understanding is that AC-TH has a worse profile for serious long-term problems like heart failure and leukemia, but that THP can be rougher in real-time. There is definitely a trend toward using THP more, and AC-TH less.

Personally I am a less-is-more person when it comes to medical treatment, and I am willing to sacrifice some survival benefit to have a better quality of life. So if a simple TH regimen were a reasonable option for me, I would choose it. But that is just me - a lot of people would choose the regimen with the best proven survival benefit.

(Putting this info here until the website is fixed) *** DIAGNOSIS:*** Mixed IDC and ILC (with DCIS and LCIS). Right breast (between 2.5 and 4.5 cm). Right axillary lymph nodes (at least 2). *** PATHOLOGY:*** ER negative (0%), PR negative (0%). HER2 positive. IHC 3+ (100% of cells). FISH positive (ratio 16.1). Grade 3. *** TREATMENT:*** TCHP (Taxotere, Carboplatin, Phesgo, with Neulasta Onpro) 6 cycles. Lumpectomy (4.5 cm) and targeted SLNB (7 nodes removed, 3 intentionally) (pathologic complete response) *** HOSPITALS:*** Dana Farber Cancer Institute. Massachusetts General Hospital.
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Jan 12, 2022 01:59PM - edited Jan 12, 2022 02:00PM by violetkali

I am of the same mind as you. I made it through 4 rounds of TCH and said NOPE after that. 2 blood transfusions and bloody diahhreah made my Nurse brain think "You know, chemo will kill me before stupid cancer will."

I WISH weekly taxol was an option, or rather I wish I would have demanded it.

I had the double mastectomy, NO LVI, NO Lymph nodes, so I decided quality of life was my "Hill to die on" I was grade 3 too..I refused anti-hormonals after QOL issues.

I am 7.5 years a survivor!

My tumor was 1.7cm, 10% of it was noted to be DCIS. No family history of cancer at all. Discontinued Chemo d/t uncontrollable side effects which caused hospitalizations, blood transfusions, and poor quality of life. I am doing well! Dx 6/19/2014, DCIS, Stage 0 Dx 6/19/2014, IDC, 1cm, Stage IA, Grade 3, 0/10 nodes, ER+/PR+, HER2- Surgery 8/18/2014 Mastectomy; Mastectomy (Left); Prophylactic mastectomy; Prophylactic mastectomy (Right); Reconstruction (Left): Tissue Expander; Reconstruction (Right): Tissue Expander Targeted Therapy 9/15/2014 Herceptin (trastuzumab) Chemotherapy 9/15/2014 Carboplatin (Paraplatin), Taxotere (docetaxel)

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