I have HER2 positive breast cancer and had 4 x EC chemo and was due to then have 4 x Docetaxel. I was told earlier this week that due to a great response so far to the EC (I had midway ultrasound/mammogram), they now plan to just give me 3 Docetaxels rather than 4 if some more scans in a couple weeks show good progress again.
I was in for my second Docetaxel today and due to a mix up with my Filgrastrin injections (they went to give me ten instead of five which I queried) the nurse made a comment that it was maybe because I was on a higher dose. I asked her what she meant and spoke to someone else on the ward who told me that it was standard to start people on 75mg/m2 of Docetaxel to see how well it is tolerated etc and then increase the dose to 100mg/m2 if ok. I was a bit surprised as no one had mentioned this to me/discussed in advance that I was on a reduced dose the first time.
I suppose my question is if this is standard practice across the board? I’m in Scotland if this makes a difference. Just feel like it was something I should have been told as if I don’t know if I’ll have worse side effects this time so forewarning would have been good! Also slightly worried that I was on a reduced dose for one of them if I’m now also only getting 3 instead of 4 Docetaxels.
I was on 100mg Docetaxol for 2 of 3 sessions (3xEC 3 xT) my last one reduced to 80mg due to cumulative fatigue and I was told that dose reduction would not impair clinical effectiveness. Dose hadn’t been discussed until I asked as I’d read there seemed to be a variation in dose between different hospitals and health authorities.
I was on 7 Filigrastim for all 6 sessions
I’m in Scotland too.
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Thanks for letting me know. Yeah it seems to be different everywhere so hard to make sense of. Glad it shouldn’t make difference in effectiveness though! I feel a bit miffed as if I’d gotten the choice I’d have said to give me the 100 as I’m young, fit and healthy, don’t have underlying conditions and have tolerated EC well so I’d rather have started high then reduced if required like yourself. Just find the lack of communication is frustrating and more often than not causes me confusion! Funny with the Filgrastrim too as it’s either 5 or 10 where I am - I previously asked about 7 as I’d seen lots of people with 7 on here and that’s not a thing at my hospital 
I’m 65 - but fairly fit - tolerated it reasonably well, no nail damage or peripheral neuropathy. You should be fine. Just awful taste, really really tired and a bit wheezy on second and third cycles. Was told by oncologist that some hospitals just use the 75mg dose throughout.
Was yours neoadjuvant? Mine was adjuvant
I am Er+ but HER- suspect that’s why 3 + 3, response not monitored so I’m just hoping it’s worked!
Aw thats good to know 
I was ok on the first too - just a bit of a dodgy stomach and mouth ulcers that were painful and lasted a week but taste was gone anyway! Yeah mines is neoadjuvant as HER2+) no hormonal factors) and wanting to shrink before lumpectomy. I’m think I’m going to bring it up with my own oncologist at my next meeting next month too as just want a bit more discussion and clarity around it and wish they’d just tell me more about my own treatments 
Probably a bit late but suck ice cubes or frozen grapes during infusion-stopped me getting any mouth ulcers. Same principle as cold capping
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Hi belle1,
Thank you for your post.
It is good to hear that you have had a great response to chemotherapy so far.
As @jooliepie30 said there can be variations in dosing of chemotherapy. There are many factors that are taken into consideration when the oncologist prescribes the chemotherapy. These can include how you have tolerated chemotherapy previously, how the cancer is responding to the chemotherapy, the planned duration of the treatment and your weight. There is always a fine balance in order to maximise the benefit of the treatment whilst minimising the side effects.
Our docetaxel information suggests that the recommended amount of cycles are anywhere between 3 and 6.
As you mention in your post it will be useful to speak with your oncologist to clarify the reasons behind the dosing in your individual situation and discuss any worries you might have.
We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.
Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to more support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).
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Best wishes
Katie
Breast Care Nurse
Breast Cancer Now
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