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why do different hospitals favour different chemo regimes???

18 REPLIES 18
raywitch
Member

Re: why do different hospitals favour different chemo regimes???

Hello Glenna,
What trial are you on prior to your lumpectomy? I was on a trial of neo-adjuvant femara prior to my lumpectomy. I can find anyone the same as me.
Rachel

evie2007
Member

Re: why do different hospitals favour different chemo regimes???

I agree glenna- as a midwife i see that with every different woman!

RE chemo regimes-

I have clear nodes, clear margins and "only" a 20mm lump but i will have chemo, radio and tamoxifen because of my age.

glenna
Member

Re: why do different hospitals favour different chemo regimes???

Hi folks
Might have some sort of answere for you as a nurse I have some insight but this is NOT my speciallity.

What I do know is medicine is not an exact science and everyone reacts differently.
e.g with me I'm going on a trial prior to lumpectomy, chemo and radio (oh joy) but 1st they had to see what hormones receptors my particular lump had, so although all may appear the same there can be small differences in the tumors and also differences in how they will respond to various treatments.

Also all doctors are people and I know for a fact 6 consultants can have 6 different oppinions on the best course of action for a patient. None of these oppinions are necessarily better or worse than the other just different, like taking different roads to get to the same place.
There are nationwide guidelines for a lot of cancer treatments but again I think there may be variations depending on the various results and reactions of the individual involved.

It is a part of ALL medical peoples code of conduct to keep up to date with treatments etc inorder to give the best possible care to their patients.

Hope this is of some help.

Lily200
Member

Re: why do different hospitals favour different chemo regimes???

Hi ,
Doodle sorry I didn't reply, lost the post! I had a port which was removed during the 3 weeks between my last chemo and rads starting. The cardio guy put the port within an inch of where my tumour had been and it was in the way. They made me have it done awake despite me wanting to be away with the fairies. So I never had to have a routine flush as only used for actual treatments. Yes my onc gives everyone scans, so I had a CT scan and full body bone scan during the first chemo weeks. I recently had my first mammos since dx, which were timed for a year after surgery finished. Thank heavens they were fine. Still being seen every 12 weeks. I finished chemo mid Oct 08.
Good luck with the next op for the port to come out
Lily x

starfish
Member

Re: why do different hospitals favour different chemo regimes???

I had 4 FEC & 4 TAX. 6 lymph nodes were involved. Followed by 12 rads. I have heard that if you ask two different Oncs they would each dx differently. I was 56 at dx. I had terrible side effects on tax. After three didnt feel I could take anymore. Onc said he would reduce. He did by 10%! I still had terrible side effects on 4th and last dose but he said we have to try and get as much of this into as possible. I think it also depends on your generaly overall health.

doodle32
Member

Re: why do different hospitals favour different chemo regimes???

I know Lily terrible isnt it lol. The injections i had were part of the trial i only had them while i was having erubicin 24 hours after each 1, district nurse used to come out and do them , it was a tummy injection. I go in june to have my ports removed cant wait. I havent had any scans yet so when my ports come out im gonna push for one. Did you have any scans?

Take Care

Leslee x

Lily200
Member

Re: why do different hospitals favour different chemo regimes???

Hi all,
Doodle well at least I don't think I went 2 times more than I need to lol!!! I didn't have any injections, my immune system stayed up right through so no problems there. I finished chemo mid October 08 and rads on new years eve 08/09. I am being seen every 12 weeks and have blood tests if it is the onc I am visiting. He alternates with the surgeon. Wishing you and everyone else reading lots and lots of luck
Lily x

doodle32
Member

Re: why do different hospitals favour different chemo regimes???

Hi Lily,

I did have 8 ive just checked my chemo diary dont know why i thought it was 6 (wishful thinking i think lol). I was on arm 2 same but accelerated are you having the injections after the erubicin? Im in Doncaster not sure about the standard treatment here but i did have node involvement 2/28 and grade 3. I know what you mean about tracking you forever, i finished my chemo last june and still go for blood tests for them and ive signed upto a few more trials because of the brca2 gene.

Take care

Leslee x

Lily200
Member

Re: why do different hospitals favour different chemo regimes???

Hi,
Doodle I was/am on the TACT2 trial too. I think they track you forever! I was curious why you only had 6 of cmf, I thought we all had 8. I was on arm one, the long and winding road!!! No-one else in myarea seems to get epi/cmf as our standard treatment is 6 x FEC or TAC. A group of us have been comparing notes and we think our Onc gives FEC unless you have any node involvement/spread or other extra risk and then you get TAC.
Lily x

doodle32
Member

Re: why do different hospitals favour different chemo regimes???

Hi,

My chemo regime was 4 Eruibicin and 6 cmf accelerated. They put me on the Tact2 trial. They were testing to see if giving chemo every 2 weeks with the erubicin would have less side effects and better results. I dont know the results as they dont tell you but the side effects were lessened i didnt have any sickness and only missed 1 chemo cos of bloods being to low.

Take Care

Leslee x

Vodka
Member

Re: why do different hospitals favour different chemo regimes???

Hi all

my onc told me that everyones chemo and treatment is tailor made to suit their type, stage and grade of cancer. Thats why if you didn't turn up for your treatment they couldn't use your chemo on anyone else. You just have to hope that your onc has got it right when working out what strenght of chemo you need.

everydaymatter
Member

Re: why do different hospitals favour different chemo regimes???

hi everyone

so hard to understand why everyone has different treatment. i had 6 fec and was supposed to then have taxotere but i never had that in the end, i am now on tamoxifen. i think we just have to trust they know what theyre doing. and hope for a good outcome.
x

Lily200
Member

Re: why do different hospitals favour different chemo regimes???

Hi,
I believe the oncologists from all over the world meet at annual conferences to hear about the latest results from research trials. They have said to me well you will have ? unless more evidence comes out that there is a better option from the June (I think) results. Some trials last years so only preliminary results might come before the main ones are published over time, as they track the patients progress. Then it is up to your onc/area what happens and how quickly. Mine (according to my research nurse)tracks them very closely and changes as soon as new evidence shows improvements in results. He prefers Femara, despite it being more expensive. I am still on Tamoxifen (well talked him into nolvadex to avoid hot flushes) and he will not let me shift to AIs until I have 24 months without a period. When I get to that point we will have our usual debate as to why he made that decision.He apparently is very successful in our field so I follow orders mostly. He is very pro chemo for all under 50 years old apart from a few exceptions. This is just meant as info and not a judgement on what should or should not be done. I think you just have to believe in your treatment and if you don't then ask for a second opinion and change oncs.
Lots of luck to everyone
Lily x

marble1966
Member

Re: why do different hospitals favour different chemo regimes???

hi sandra44,

glad your still posting as your diagnosis was almonst identical to mine. my onc offered me chemo, horm tabs & rads, but because i had
good stats of 85.6% without treatment, 90% with horm and 93% with
both horm & chemo, I stated to query why did I need chemo if rates of non recurrance so high. He gave me an alternative to think about Zoladex & Tamoxifen and told me to go away for a week and have a think about it. Week was up today and when I asked him for stats
for people who are having both these treatments instead of chemo,
he had none to give and still insisted chemo was favoured over just hormone treatments. Was you offered chemo, and if so, what were your reasons for turning it down? Im so bloody confused again.I was in front of you treatent wise, but had to have 2nd lump as one of my margins was unclear.

Im under Barnet, North London and they have offered my 6 x FEC, no mention of TAX. Have you all experienced hair loss or tried cold cap?

sarssquatty
Member

Re: why do different hospitals favour different chemo regimes???

I had 3 FEC and 3 TAX, and 4 weeks of RADS. The 1st TAX knocked me about so much that they reduced the strength of it for the 2nd one!

I suppose it is down to ONC choice and types of breast cancer, I do think that cost must come into it at some point as they always start you off on the cheaper drugs and then move you onto the more expensive ones, one example is the anti sickness drugs, if you are ok on the cheap one, that is great, I wasn't I was violenty sick so after that I had EMEND which were very expensive! It's the same as the drugs after, Tamoxifen is cheaper than Arimidex which is cheaper than Aromasin, not sure about Femara.

I'm sure Bright that you are getting the best treatment possible, also look at it this way if you can get it done in 6 sessions 18 weeks, why prolong it for another 6 weeks?

Sarah X

horace
Member

Re: why do different hospitals favour different chemo regimes???

I had 4xfec and 4xtax I think you get the same amount as 3x3 but spread into smaller doses.I suspected it may have been because I am overweight and on the old side for such aggressive chemo-it certainly hit me very hard.

sandra44
Member

Re: why do different hospitals favour different chemo regimes???

slight sideways take on your question......I don't think it's just chemo that there is a differing of opinion between hosps and oncs. Some women with exactly same diagnosis as me get offered zoladex plus tamoxifen yet I only got put on tamoxifen, did ask both at docs and oncologist why wasn't I getting zoladex and was it down to cost, nothing to do with money I was told,just depends on how up to date your onc is with latest studies and research and what their take is on the findings re % difference between different regimes, I don't think it is an exact science and keeps changing all the time re what treatment or mix of treatment works best for groups of similar cancers.

Ruby1
Member

Re: why do different hospitals favour different chemo regimes???

Hi Brightlight
Your question is something that went through my mind quite a lot as I had the same regime as you and then heard about other people having 4 and 4. I don't think it's about saving money because at the end of the day if they don't give you enough treatment then they risk not getting rid of it all and then you have to have more treatment after so making it more expensive long term - so why would they do that and take the risk? Who knows. I remember saying whilst going through the chemo that if I needed more chemo then I wouldn't have a problem with it. I also could see my response to the chemo which was very good so by the time I finished it, it seemed to have done its job and then I had a mastectomy after.
HOpe this helps.
Ruby x

brightlight28
Member

why do different hospitals favour different chemo regimes???

Hi ladies,

I am currently having 3xFEC and 3xTax - but other patients I know with similar diagnoses at other hospitals are getting 4 cycles of each regime. Whilst some are getting EC or AC and not FEC. Why is there such variation between hospitals... is it about saving money. Why do different hospitals favour different regimes - and more importantly is hospital choice going to impact on local survival rates.... Just wondering if I should ask onc for another cycle??

Bright x