Hi all
My mum had her first dose of FEC 5 weeks ago, and as some of you may know, she developed neutropenic sepsis with a chest infection and was hospitalised 9 nights. Her chemo was delayed a week, then at consultant appt (just before 2nd chemo due a week late), they decided to delay a further week as high white cell count indicating infection and still a productive cough. She was given antibiotics and told to return today to see consultant and possible chemo. We got there today to find her consultant will be absent for 3 months(!!) and a registrar will be taking her place.
Last week the consultant said my mum would get antibiotic prophylaxis and the neutrophil stimulating injections, but a full dose of chemo as she is now already 2 weeks delayed. She said that she only likes to reduce chemo in palliative care. Today however, the registrar followed her advice on antibiotics and injections but also wants to reduce dose to 80%. I challenged him with what the consultant said the plan was and he said it’s because my mum still has slight productive cough. Of course we are worried about reduced dose and NICE guidelines say that neutrophil stimulating injections should only be given of part of chemo regime or if maintaining chemo dose (which he isn’t). I think I’m worried as consultant was wanting to keep it high due to my mum missing doses. Registrar said If she gets continued infections they may stop chemo altogether. Couldn’t get a second opinion as chemo was due to start but I got her to ask nurse, who checked again but still reduced dose. Can’t understand where the consultant has disappeared too and not as trusting with a registrar as they are consultants in training and not as experienced.
Anyone else had reduced FEC (I’m guessing this is FEC60 as opposed to FEC75?
Xx
Hi Daisy,
So sorry I can’t help, I am still waiting to start my chemo, but I thought I would bump the thread for you.
Su
XX
Thanks Su
Maybe i went on a bit too much! Just wondered if many others had to have a reduced dose.
Hope your chemo goes smoothly.
Daisy
Xx
Keep bumping into you Daisy!
I had my first FEC on 31st October, number 2 was delayed by a week because of an infection. But the onc reduced the dose because I was very nauseous the first time. No 3 was was delayed by 2 weeks because of another infection. So I’m now 3 weeks behind. The oncologist said he might do a ct scan as reassurance and also suggested putting in a 4th FEC before changing to taxol. But after FEC 3 he decided to stick to plan.
I guess they have parameters within which they can prescribe and start high so they can reduce if necessary. The registrar will be working to the guidelines. You can ask for a ct scan to reassure you both.
Keep in touch x
Hi daisy, both second and third werecreduced dose he said it won’t affect the outcome. I was nauseous for 5 days after 1 and 2 but extra meds with 3 so felt better - just very very tired. Also had bad constipation with second dose, had movicol with first and third. Had to take double dose for a few days to get things moving!
X
I would be interested to know what my type of fec is called. The dose is 800mg each of fluoracil and cycloph whatsits and 160mg epirubicin. This seems a huge dose, i thought fec 100 was based on epirubicin being 100 so this seems way over. Having had 2 and suffering abnormal ECGs and neutropenia i am really feeling rough. Is this the standard dose?
Lankylass its based on your height weight and surface area. I was on F and C 500 mg/m2 and E 100mg/m2, which equated to 825mg of FC and 165mg of E. Only the E got reduced to 75mg/m2 - 130mg. Hope that makes sense!
Still dont get the sums. I’m 5’2 and less than 9st wet through size 8
Ok I get it, something called the DuBois formula so my dose rounded up is accurate. Onc is considering reducing dose for round 3
Yes I think there are set doses for weight ranges rather than adjusting per lb/kg of weight. My mum has been losing weight and they are aware but didn’t reducin dose further.
My mums doses of 800 was reduced to 650.
Lankylass I’ve had 10 weekly taxols after 3 fec. I missed one as my head was messed up with this whole BC thing. My last is on Friday. Worst se is fatigue, sweats and the most revolting taste buds!
Hi Daisy,
Firstly I hope that your mum is responding well to her treatment, and secondly, sorry for taking so long to find your thread. I was on a reduced fec regime. I was borderline for chemo, and when my numbers were crunched by the oncs, they decided that a full compliment of fec (fec100) would be too strong, so opted for fec75. I had 130mg of epirubicin and 1100mg each of cyclophosphamide and fluorouracil. I finished my chemo last July and followed it with 19 sessions of rads. I continue to do well and have had no lasting effects from the chemo (apart from a little belated chemo brain!!!). I had two friends who went through chemo the same time as me and both had fec100. I actually asked to go onto fec100 because I was worried the chemo wasn’t strong enough to do its job. They utterly refused and I continued on fec75 throughout my treatment. I hope this helps to allay your fears that a reduced regime isn’t always a bad thing! Wishing you and your mum the best from her treatment. Take care.x x x
Thanks Weeannie
My mum had her last chemo a few days ago. Suffering from constipation but other than that doing ok. I discussed the reduction again and he said that she may not have completed chemo had they not reduced it. Also that as her tumour has shown shrinkage, he believes it should destroy any micrometastisis. I know it’s not that straightforward but clearly it can be as effective.
Do you know how many lymph nodes where involved? We’re yet to find out as it will be post surgery.
Daisy
Xx