Understanding treatment protocols and changes

Hello ladies - I wonder if anyone can shed some light on the difference in drugs used and why oncologists might change the plan halfway through treatment. My friend was told she’d have FEC-T (3 of each). She really doesn’t like asking the same questions I have -which is entirely her prerogative, and I fully respect that, but I’m the sort of person who likes to know things inside out/back to front, for my own understanding.

She’s halfway through (3xFEC completed) and is having an MRI next week to check progress. Depending on the results, she says her treatment plan may be altered. What I’d like to understand is:

  1. What is the difference between FEC and Taxotere? Is it that FEC is used to target the main tumour, and Taxotere is belt and braces to zap the trace cells found in lymph nodes, which FEC might miss?

  2. Why would her treatment plan potentially be altered, depending on MRI results? If tumour has visibly reduced, wouldn’t it make sense to continue with FEC as that’s what is working? If tumour is unchanged, then I understand they’d think about trying a different drug.


Hi worried friend

I’m not an expert but from what I understand as I had 3 x FEC and then 3 x Taxotere (but no scan inbetween to see how I was responding and actually I could feel the lump visibly disappearing during the treatment so much so that I don’t think I could feel it by the end), there are probably a few reasons why each person’s treatment differs and also why treatment is changed half way through. It seems quite the norm for treatment to be changed half way through. FEC seems to do a good job for a lot of people but not all and some people do not respond to certain types of chemotherapy so a suitable alternative needs to be found.

Taxotere is often used on people whose cancer has spread into their lymph nodes. The Taxotere they say is the domestos of chemotherapies so where the FEC has done it’s job, the Taxotere finishes it off even if the person seems to be doing really well on FEC or the chemotherapy which they started. The tumour can become resistant quite quickly to the chemotherapy hence the change of regime.

Hope this helps a little.

Ruby x

I like that… Domestos. Makes some sense now… other than if they choose to continue with FEC instead of switching to Tax.

I had quite long discussions with my onc as was originally due to have 6xTax then changed to 3xFEC and 3xTax (for which I am profoundly grateful - the Tax is really tough). Her explanation was that FEC is best at preventing re-occurrence of early stage bc, but the Tax is better with mets.

Without knowing your friends dx it is hard to know what they are thinking, but I get the impression there is no one right way of treating - lots of factors to consider.

My son works in research, he explained simply that Fec and Tax work in different ways. Fec kills off the fastgrowing cells, the 21 days between doses gives the good cells a chance to recover and the bad cells less chance as they take longer. Tax works by preventing the fast growing cells dividing (this is how they grow). This is why they are the most usual treatment as they work different and attack the cancer from 2 fronts.