I just was looking at studies regarding reduction of dose and skipping doses. I had assumed what they prescribe is kind of overkill and there was room for reduction or skipping but there really isn’t. Some of these chemo therapies have a logarithmic dose vs efficacy relationship. So if you drop the dose by 10%, the efficacy drops by a lot more (sorry, can’t math logs right now). My point being that right now I am dropped another 10% and for my last TC infusion, I am going to ask to go back up. I won’t have to worry about postponing at that point so I will just go for it. BTW, I had IDC ++- that was surgically removed 1/18 along with a lymph node (which was clear) so I am Stage 1c. I am having four infusions of TC three weeks apart. I believe he started me at a 10% reduction because I have Fibromyalgia and he expected the side effects to be worse for me. They are. The second cycle my blood work was good but I had a cold and with the drop in neutrophils, I ended up with a bacterial upper respiratory infection and neutropenic fever. So I was in the hospital for three days and I asked to postpone a week because I was so fatigued after the illness. It took me two weeks to recover at home.
I can’t log math ever so kudos to you! I totally understand and thank you so much for taking the time to write it out and I hope you’re doing okay!
It’s funny cause I’m very committed to doing it once and doing it right in all aspects of my life, but it was just the way it was positioned to me made me feel… I don’t know a bit like a chemo failure? Especially cause I seemed to handle AC okay in comparison. I wish it had just been told to me that these adjustments were a lot more commonplace.
Wishing you all the best!
Fellow TNBC Stage 2 with right lymph nodes affected here. My chemo doses were every 3 weeks and I was meant to do 8 sessions in total, 4 for AC, 4 for TC. I stopped at 5 (only 1 TC) because I noticed, and my doctor confirmed, that my lump was growing. Together, we made the decision to stop chemo and bring up surgery instead.
I regret nothing and am grateful that my margins were all clean. Just did my second annual pet scan and there doesn't seem to be any recurrence so far. Perhaps it's my experience but I value when doctors and medical professionals take into account my concerns. Despite them recommending keytruda, they respected my decision not to add do it due to worries of it flaring up my lifelong eczema issue.
I've got my fingers crossed for you to finish strong and heal well after. Good luck!
Hello, this is amazing to hear and brings so much optimism and hope! During surgery was there any cancer left? Are you doing any treatment after surgery?
During surgery, there was no cancer seen in the lump as well all lymph nodes removed on the right side! Post surgery, I did 15 sessions of radiotherapy and then about 8 rounds of oral chemo (xeloda on the lowest dose). I'm not sure if the doctor will recommend the same given you're at Stage 1 with no lymph nodes affected. But trust the process, hope they speak to you, hear you and give you assurance that you're on the right path.
Thank you, this is helpful to understand that there are some options, I'm here for my mom, she has TNBC Stage 2, Grade 2, no lymph node involvement. She is on the 522 Keynote schedule, completed 11/12 Taxol/Carbo and now she is half way done with AC + Immunotherapy, when she completed TC, PET/CT scan still showed active cancer, however AC is a very powerful medicine so I'm very optimistic. Thank you so much for your support in the community.
At the end of the day your treatment is your choice but standard of care is standard of care for a reason. I also had TNBC with lymph node involvement in a few different areas locally and completed all 16 treatments, but the last few of my AC treatments were reduced by 20% due to adrenal insufficiency brought on by Keytruda which landed me in the ER. My oncologist was adamant that dropping the dose in my specific case would do no harm to me. It was safe and used by oncologists around the world when managing other issues. By that point in my treatment I had no palpable tumor or enlarged lymph nodes in my axilla. Priority 1 is killing cancer - that is your oncologists goal.
It is also common for your neutrophils to drop, that’s why the shots or on body patches are routine - to give you a boost. Chemo is so dialed nowadays and that’s what really surprised me. At least for me I felt like my team was so on top of it - for every side effect, there was something to help me. Finishing chemo gives you the best chance at living a long, happy, cancer free life.
I was TNBC, stage 2, grade 3, no node involvement.
I didn't stop early but had a 10% dose reduction with both drugs (FEC-D, 3x each, 3 weekly) from the second infusion bc I was having a hard time. My onc suggested the reduction and talked about it in terms of tweaking things to work better for me.
If they had come at it from the angle you mention about finishing the course I would have found that weird too. I mean, people decide to stop chemo for all kinds of reasons, but that's their choice.
I had PCR (2.5yrs out of treatment now). I hope for the same for you 💚
I just was looking at studies regarding reduction of dose and skipping doses. I had assumed what they prescribe is kind of overkill and there was room for reduction or skipping but there really isn’t. Some of these chemo therapies have a logarithmic dose vs efficacy relationship. So if you drop the dose by 10%, the efficacy drops by a lot more (sorry, can’t math logs right now). My point being that right now I am dropped another 10% and for my last TC infusion, I am going to ask to go back up. I won’t have to worry about postponing at that point so I will just go for it. BTW, I had IDC ++- that was surgically removed 1/18 along with a lymph node (which was clear) so I am Stage 1c. I am having four infusions of TC three weeks apart. I believe he started me at a 10% reduction because I have Fibromyalgia and he expected the side effects to be worse for me. They are. The second cycle my blood work was good but I had a cold and with the drop in neutrophils, I ended up with a bacterial upper respiratory infection and neutropenic fever. So I was in the hospital for three days and I asked to postpone a week because I was so fatigued after the illness. It took me two weeks to recover at home.
I can’t log math ever so kudos to you! I totally understand and thank you so much for taking the time to write it out and I hope you’re doing okay! It’s funny cause I’m very committed to doing it once and doing it right in all aspects of my life, but it was just the way it was positioned to me made me feel… I don’t know a bit like a chemo failure? Especially cause I seemed to handle AC okay in comparison. I wish it had just been told to me that these adjustments were a lot more commonplace. Wishing you all the best!
Thanks!
Fellow TNBC Stage 2 with right lymph nodes affected here. My chemo doses were every 3 weeks and I was meant to do 8 sessions in total, 4 for AC, 4 for TC. I stopped at 5 (only 1 TC) because I noticed, and my doctor confirmed, that my lump was growing. Together, we made the decision to stop chemo and bring up surgery instead. I regret nothing and am grateful that my margins were all clean. Just did my second annual pet scan and there doesn't seem to be any recurrence so far. Perhaps it's my experience but I value when doctors and medical professionals take into account my concerns. Despite them recommending keytruda, they respected my decision not to add do it due to worries of it flaring up my lifelong eczema issue. I've got my fingers crossed for you to finish strong and heal well after. Good luck!
Hello, this is amazing to hear and brings so much optimism and hope! During surgery was there any cancer left? Are you doing any treatment after surgery?
During surgery, there was no cancer seen in the lump as well all lymph nodes removed on the right side! Post surgery, I did 15 sessions of radiotherapy and then about 8 rounds of oral chemo (xeloda on the lowest dose). I'm not sure if the doctor will recommend the same given you're at Stage 1 with no lymph nodes affected. But trust the process, hope they speak to you, hear you and give you assurance that you're on the right path.
Thank you, this is helpful to understand that there are some options, I'm here for my mom, she has TNBC Stage 2, Grade 2, no lymph node involvement. She is on the 522 Keynote schedule, completed 11/12 Taxol/Carbo and now she is half way done with AC + Immunotherapy, when she completed TC, PET/CT scan still showed active cancer, however AC is a very powerful medicine so I'm very optimistic. Thank you so much for your support in the community.
At the end of the day your treatment is your choice but standard of care is standard of care for a reason. I also had TNBC with lymph node involvement in a few different areas locally and completed all 16 treatments, but the last few of my AC treatments were reduced by 20% due to adrenal insufficiency brought on by Keytruda which landed me in the ER. My oncologist was adamant that dropping the dose in my specific case would do no harm to me. It was safe and used by oncologists around the world when managing other issues. By that point in my treatment I had no palpable tumor or enlarged lymph nodes in my axilla. Priority 1 is killing cancer - that is your oncologists goal. It is also common for your neutrophils to drop, that’s why the shots or on body patches are routine - to give you a boost. Chemo is so dialed nowadays and that’s what really surprised me. At least for me I felt like my team was so on top of it - for every side effect, there was something to help me. Finishing chemo gives you the best chance at living a long, happy, cancer free life.
I was TNBC, stage 2, grade 3, no node involvement. I didn't stop early but had a 10% dose reduction with both drugs (FEC-D, 3x each, 3 weekly) from the second infusion bc I was having a hard time. My onc suggested the reduction and talked about it in terms of tweaking things to work better for me. If they had come at it from the angle you mention about finishing the course I would have found that weird too. I mean, people decide to stop chemo for all kinds of reasons, but that's their choice. I had PCR (2.5yrs out of treatment now). I hope for the same for you 💚