I was diagnosed with grade 3, stage 3 breast cancer with spread to 2 axillary lymph nodes and 2 internal mammary nodes. I had a unilateral mastectomy, immediate reconstruction, fertility preservation and just finished my 3rd cycle of (2 weekly) 4x EC and then will carry on to (2 weekly) 4xPaclitaxel. Then back to surgery because of close margins (reconstruction & skin removal) and finally radiotherapy with hormonal therapy to follow.
I recently received a second opinion (through my medical insurance) from oncologists at well respected institutions in the US and Switzerland. They differ in the chemotherapy regimen and suggest 12xweekly sessions of Paclitaxel instead of the 4x 2 weekly.
Has anyone else had a difference in opinion such as this & if so how did you manage to communicate this to your team? Iām an NHS patient and trust my team but I also want to make sure Iām advocating for myself as I have a high chance of recurrence.
Thank you so much for your help with this. Extremely worried
My unit is giving me dose dense paclitaxel fortnightly as I am high riskā¦that is how it was explained to me anyway. I was told that they could move it to weekly if I struggle with side effects as the lower dose is easier to cope with. They said they would prefer me to stay on the fortnightly regime though.
Hi, I am so sorry you are in this position. Itās a very stressful time and quite rightly you want to optimise the treatment you receive. I believe 12 x weekly paclitaxel is statistically the best treatment to reduce recurrence but the NHS will use less resources giving the treatment on 4 occasions every 2 weeks and the statistical difference in recurrence rates between the 2 treatments I believe is small.
If you have a private insurer who would pay for 12 weekly treatments I would discuss this with your oncologist.
Hi Sharlou, thank you for your response! Been hearing conflicting information so getting more worried. You sharing your experience is very helpful, I will bring it up with my oncologist but I think they will advise to stay on fortnightly
Hi @niya44, my diagnosis was similar to yours and I had the same treatment recommended by the NHS. At the time I moved to private care and they changed it to weekly Paclitaxel x12. I was told that, according to research, the numbers were slightly better. It was also very manageable, despite the faff of going there every week (I also ended up wearing the cold cap 16 times!).
It sounds like you have been offered ādose denseā Paclitaxel. 4 rounds where all the Paclitaxel arrives in one hit, whereas 4 rounds where it is split into 3 doses. The latter is probably easier to bear, but takes longer, and is I think more common. Itās the same amount of treatment overall.
