Second opinion chemotherapy

Going through breast cancer treatment Chemotherapy monthly threads
1

Hi everybody :wave:t6:

I would really love your advice please.

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? I’m an NHS patient and trust my team but I also want to make sure I’m advocating for myself as I have a high chance of recurrence.

Thank you so much for your help with this. Extremely worried :face_holding_back_tears:

2

Out of curiosity is this instead of Pax x 4?
Or for all of it ( EC x 4 + PAX x 4)
X

3

Sorry some clarification: they agree on the EC 4x2 weeks apart. They differ only on Paclitaxel where they suggest the 12 x 1 weekly sessions

4

My unit is giving me dose dense paclitaxel fortnightly as I am high risk…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.

5

@sharlou has explained it perfectly

It’s much the same but dose dense is more “powerful” as it dose loading

6

Hi, I am so sorry you are in this position. It’s 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.

7

Thank you Shade, your response is much appreciated. I will bring that up with my oncologist and hopefully get to a resolution. Really worried.

8

(post deleted by author)

9

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