TC x 4 what was your experience

Hi

I have posted a couple of times but things are finally becoming clearer and looks like I am heading to a July start of TC x 4 cycles.

I am a 49 yr old mother to 3 teens 18, 17, 14 and work as an EA/office hr operations manager.

I found the dreaded lump back in Feb shortly after my mil suddenly passed away.

I had a lumpectomy on my grade 2 with DCIS tumour, ER+ PR+ HER2-back in April but one of my nodes came back + after the SLNB and my margins were “close”. I had a re-excision last week (this was after a PET scan post lumpectomy which can back clear).

My PREDICT score puts me in the intermediate “grey” area of risk and we are now waiting for the PROSIGNA results to confirm.

My oncologist was very frank and said I may still get a result that puts me on the fence and they would sway towards chemo if so.

So, this takes me to those who have had TC x 4.

What were your side effects and what helped? There seems to be a lot of info so would love to hear from first-hand experience.

I have decided I want a port not a PICC too after researching both (I have a choice).

Also did anyone manage to work from home? I can’t afford SSP and my co has already given me 2 weeks for the lumpectomy on full pay and a week for the re-excision.

I was thinking I could work:
1 ½ days per week
1 day take it as annual leave
1 ½ days sick pay (ideally enhanced, I am negotiating)

My role is doable from home and I can dictate hours (within reason) but am I being unrealistic?

I am meeting the chemo team soon too to start getting in my head what I think is inevitable.

Any tips, advice and general support welcome.

TIA

Hey!

Taxotere/Docetaxel is a very tough drug for most. I can’t tell you about Cyclophosphamide alone as I had 3 x EC so it was combined with Epirubicin and then my Taxotere/Docetaxel is being administered on its own for three cycles.

All cycles have been hard. EC made me incredibly nauseous. I could have maybe squeezed a day and a half of work out of myself in the first week but a big maybe and not a fixed schedule as each day was a fresh surprise.

The second week I absolutely have worked 1 or 2 days and the 3rd week I’ve managed 3 or 4 days of work (am self employed) BUT it got harder to bounce back as it went. Bloods didn’t bounce as well either and bloods matter to keep on track with chemo.

On Docetaxel, I have been unable to work as I got neutropenic sepsis (it’s not as that rare too in our chemo group) and spent a week in hospital. The final week has been spent trying to recover enough to be allowed the next cycle this week.

Some people sail through the first drugs but it seems that Docetaxel takes no prisoners. Not nausea but significant bone pain and mouth ulcers etc. I would offer to try and also ask for flexibility based on what you’re capable of so that it’s not stressful. Stress is the enemy of chemo/cancer. As you’d know in HR, they have to be reasonable!

So much of it will depend on your schedule of steroids too. I can get sooooo much done on steroids. Once the steroids finish, you drop off a cliff for a few days (which usually coincides with G-CSF injections kicking in and causing enormous joint and muscle pain).

I’d maybe offer;

Week 1 - 1 day
Week 2 - 2 days
Week 3 - 3 days

That’s actually more than you were offering but I’d say it’s feasible. Whether your brain will work well is another matter as chemo brain is a bit of a shocker as it goes on but you’d be present and fairly able in that time.

Good luck and I’m sorry that they’re not being more supportive. I can’t imagine not supporting my employees more in this situation xx

Thank you for this

I will ask my oncologist about the sepsis as my understanding was TC x 4 every 3 weeks was “moderate intense” vs “intense” (which 4 x EC 4 x Pax every 2 weeks ) but who knows

Having a mini freak out but this whole journey seems to keep on giving :grimacing:

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Hi
I was ER+ PR+ and HER2- Grade 2/3 and Prosigna test of 68 so needed chemo. I was 54 when diagnosed. I had TC x 4 every 3 weeks. I worked from home all the way through. Only days off were the chemo days. I didn’t work a full day, my Company were really flexible so I did shorter days but managed between 4 and 6 hours per day depending on the fatigue.
The fatigue did build over each treatment but I only had about 3 really bad days. I felt a bit sick for the first few days but the tablets helped and I managed to eat normally. I had a couple of small nose bleeds and a slight earache a couple of times too. I had no issues with my mouth and my dentist said it was unlikely I would on the TC chemo. I had a horrible taste in my mouth most of the time though and some things did taste a bit off. I did manage a curry on a couple of occasions with no issues even thought I was warned not to lol.
Mostly it was the first week that was bad and then I slowly felt better during the following two. I did gardening and mowed the lawn once. It took ages but I did it :slight_smile: I felt really lucky that I tolerated the chemo so well. I hope that if you need to have it you will manage as well too. Sending lots of love to you at the start of this horrible journey :heart: :heart:

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Thank you
I’ve seen that taste disappears :face_vomiting:

I’m not ready for this but hey ho

Who is ? X

Do you need a port/picc at all for 4 cycles? I’m on my 5th and looking around the ward not loads of people have them. Just to put the idea in your head sorry!!

Oh good point
Adding this to my q list for my nxt appt

Thank you x

TC is Taxotere (Docetaxel) and not Paclitaxel. C is Cyclophosphamide. Docetaxel is less tolerated than Paclitaxel. Our current group are a mess on it. We’ve dropped like flies, one by one as we’ve all started it.

I think it’s rare to breeze through it hence why I suggested the staggered work across the weeks.

If you want to see the current experiences, have a look at the April Chemo group. It’s all positive and we have a giggle but it’s certainly not easy, even the lady who ran half marathons through EC is glued to a toilet this week and can barely open her mouth.

Always best to prepare for the worst and hope for the best. The first Doce is apparently the worst. I have my second in 5.5 hours and am dreading it after the neutropenic sepsis.

2 weekly is also hard going compared to 3 weekly so worth checking their reasoning. Some women end up having to change it to 3 weekly. Some don’t but find the cumulative effect hard.

I think your work need to let you do the first cycle and then revisit your plan once you know how you respond to it. The first is normally the worst but the fatigue gets worse throughout. The other symptoms you learn how to manage them a little better each time.

Then when you move to Doce/Taxotere, you could maybe have some time off to see how you go and assess your hours again. Some of us were joking tonight that our step counts barely get past 1000 per day on Docetaxel and brain fog is horrific. I couldn’t remember the word ‘hand’ today. Payroll that normally takes a short time now takes me 8 hours to complete and recheck. I have submitted that I’ve gone from being sharp as a tack to totally thick. :woman_facepalming:t2:

Thnx for this.

The regime I’m being considered for is TC (combo Docetaxel + Cyclophosphamide) x4 cycles every 3 weeks instead of every 2 weeks 4 x EC (Epirubicin + Cyclophosphamide) followed by 4 x Paclitaxel

I will spk to my oncologist about this as the reason I was leaning to it was due to TC every 3 weeks being “more tolerable” but doesn’t look like it is :frowning:

X

My first docetaxel was definitely the worst, have now had 3 out of the 4 scheduled and I’m on a 3 week cycle. I ended up in A&E with diarrhoea after the first BUT I think part of the reasoning was because I had constipation and took laxido during the first couple of days post-infusion which then caused it to swing too far the other way. I only ended up in A&E because it got bad on Friday afternoon/evening and I couldn’t get in to see my GP so they told me to go to A&E.

I didn’t take any laxido for the 2 following cycles and the diarrhoea has been much more manageable. I do make sure that I always have loperamide on my person if I leave the house though and I’ve gotten one of those radar keys just in case I need to urgently use a toilet - haven’t needed it though… :joy:

My treatment plan is 3 x EC and then 4 x Docetaxel, so your experience could be different if you’re going for TC together.

I think there are certain things you can’t avoid - like, everyone is going to get more tired and get some chemo brain fog as the treatment progresses. If you have a taxol (both paclitaxel and docetaxel), you’ll get diarrhoea at some point during your treatment but until you actually start, its very difficult to predict how bad it will be for you.

I wouldn’t agree on any specific schedule with work in advance because of that unpredictability but agree with them that you might need to adjust on the fly as you figure things out. For me, my days 4-5 post treatment are the worst and I make sure not to schedule meetings during those days and schedule in a nap, but then after that it gets better each day until the next round comes along.

See if you can get some sleeping tablets prescribed to you in advance, that’s one thing that isn’t standard protocol that I’ve found helpful. I had some serious insomnia during one of the rounds and it really impacted my mental state but once I got the sleeping tablets and actually got some sleep, things were way more manageable. I take the sleeping tablets during the first week of my cycle and then stop for the following 2, so I don’t get too dependent on them.

Also, one other thing to be aware of with docetaxel, not sure if you’re planning on cold capping or not but if you haven’t thought about it then I would seriously consider it because one of the wonderful side effects of docetaxel is permanent hair loss and cold capping has been shown to limit that risk.

Perm hair loss?
Oh my god

Why would they use this at all if that’s a risk?

Going to add this to my long list of q’s

X

I guess because someone has determined that the benefits outweigh the risks. I’d rather be bald and alive than dead with a full head of hair. I am doing everything I can to avoid it though… :slight_smile:

You can read more about it here: https://www.aheadofourtime.org/

Because the Taxanes have transformed recurrence rates beyond belief. Docetaxel and Paclitaxel are wonder drugs but very toxic. It’s very rare to lose it permanently.