I am due to start chemo within the next couple of weeks and I have read that dosing is based on an estimation of body surface area, but generally capped at 2m squared. I am very overweight and using a typical dosing algorithm I work out my surface area to be more like 2.47m squared.
I have read that it is now thought that dosing should be based on actual weight but most of the reports seem to be from the US. I am worried that I may be going through chemo for nothing if the dose isn’t going to be high enough to be effective, but still high enough to make me lose my hair and risk side effects.
Are there any other overweight ladies out there who have encountered this issue? Did your oncologist talk about dosing? I would be grateful to hear from anyone with experience of this. Thank you.
Emxx
Yes, I am very overweight and I encountered it in Germany. I was in a study for women with negative nodes trying both the usual mixture of epirubicin etc. for 3 sessions and taxol for 3 sessions. My reactions were ‘normal’ to the sick-making combination (it wasn’t too bad nor was I dreadfully sick), but when I had the first taxol dose, which doesn’t make you sick, my blood count went right down to the level where you are supposed to stay away from other people and I was totally exhausted. I walked to the market, normally 5 minutes, and it took me 20. I didn’t quite reach the stage where I needed a chair in every room, but I was not well. The oncologists were shocked and said that this was useful information that they should dose me like a person of normal weight. They reduced the amount by 25%, I think, for the second and third sessions. I was rather shocked that oncologists who went to a conference in the USA every year, or any oncologists, would not know this - chemo has been around for quite a while. This was in 2008.
Has your reading indicated what kind of chemo might be relevant? because I think the first chemo was OK, although I couldn’t tell you what the doses were. It might be in my documents - I have a little booklet where all my treatment was recorded.
Hi Zeppa
Thank you so much for your reply. The oncologist said she thinks I will be having 6 cycles of Fec75. I know that will be easier than the FEC-T that you had, and leaves out the drug that made you so ill.
I was reading that cases of neutropenia are much reduced in overweight people receiving chemo, and that this is down to the fact the dose is relatively too low to cause problems. I suppose the idea is that if you dose according to actual weight then side effects should be statistically equal to those in ‘normal’ weight people.
If the FEC drugs are tolerable at the higher dose, then I will be confident that they will be effective, but if the dose is capped then I will worry that they aren’t going to work and I wonder if there is any point in having the chemo? I don’t want to be ill but neither do I want to have it at all if there isn’t any point.
I hope you are doing well now. Thanks again for the info.
Emxx