Has there been any update at all on this study since 2007? I am scheduled to begin taxol and will not if it is truly ineffective in my type of cancer. I would appreciate any assistance with this question so very much.
I've looked for an update disputing this information, but can't find anything - which doesn't mean updated information isn't out there somewhere - simply that I didn't find anything. Take a look at this Web page from Komen for the Cure Web site; it cites that 2007 info. and not sure if it's an update (despite the page heading of "latest headlines.") I'd at least print out this article and bring it to your oncologist; see what s/he says, OK? Sorry I can't be of better help to you here - PJH
Thank you so much for your quick reply. Now, what would you do, knowing this information about that study, if you were hormone positive and her 2 negative, had a mastectomy because the cancer was muti-centric with one positive node,stage 2B, had the A/C part of the ACT, and scheduled for 12 weekly doses of taxol? Would you take the taxol?
1) Remember, I'm not a doctor; no medical training, so this is personal opinion.
2) I'd ask my oncologist what he thinks of the study;
3) I'd Google around and see if there's any updated information;
4) I'd ask if the Oncotype DX test is a possibility at this point, to help decide;
5) I'd ask my oncologist how much my recurrence risk would be lowered by doing taxol. 3%? 6%? 1%?
6) Then I'd go with my gut, and NEVER LOOK BACK. No second guessing. Taxol apparently isn't nearly as challenging as what you've already been through; many women describe it as a "piece of cake" after AC. However, it does come with the risk of neuropathy in the hands and feet, which many women find incredibly annoying... I know, tough decision. And only you can make it. Best of luck- PJH
I ha breast cancer 7 years ago and had a lumpectomy,chemo and radiation. I attended annual check ups and on my 6th year expected an "all clear" and discharge but the Gynocolist discovered thatI had an ovarian cancer with metastesies in my liver lung, and pelvic bones and it took 47 weekly infusions of Taxol and 2 of Carboplatinum to get my cancers into a stable condition- that is no activity and no more secondaries. I had all of the usual side effects including pins and needles in my feet and fingers and also loss of sensation in my toes, feet and fingers. It is now 11 weeks since my last chemo and my body is recovering but I still can't walk without my rollater or use my fingerstips, I don't know if they will ever recover but I am still alive and would like to stay that way for as long as I can. If I had known how severe the side effects were going to be would I still have accepted the treatment? The answer is " Yes" and I intend to make the best of my suitation. I am also taking complementary therapy- Vitamen B complex, Essiac Tea and various other herbs and vitamens to try to help my body and prevent the cancer from becoming active again.
It's good to hear that despite this new cancer, the treatments have worked. Trouble with nerve damage in the hands and feet is not unusual after Taxol, but it gets better with time for many. The B vitamins you are taking are often prescribed for nerve damage. Check with your doctors to be sure the dosages are appropriate for you. Some people find that exercise like walking or knitting helps the nerve pain. I wish you the best as you move on with your recovery.
I am currently struggling with whether or not to pursue 4 rounds of Taxol following 4 rounds of AC treatment. My tumor is < 1 cm, Stage IIB, Grade 1 with 1/11 lymph nodes showing 2.5 mm. My Estrogen and Progesterone receptivity is high -- 90+%. I have one more round of AC to go but when I broached foregoing the Taxol with my Oncologist she was not happy. I told her I had read the research on Taxol and I know that there are clinical studies currently recruiting women with my profile to study arms that do not provide chemotherapy but instead go right to radiation and Tamoxifen/AIs. I'm already concerned that I have done the AC when there is controversy about whether Adriamycin is even effect with HER-2 negative tumors. I'd rather stop the Taxol treatments and focus on lifestyle changes like losing weight and getting more exercise which have proved to be effective. I'm scheduled to go back and talk to her again in 2 weeks after the last AC but I'm really on the fence? Anyone else been in this scenario recently?
Tough one, Chris. Sorry you're having to make this decision. What it boils down to is, the data is in for how much extra protection the Taxol gives you, vs. AC alone. AC alone was the tried and true protocol up to a few years ago; Taxol is relatively new. So I'd think the data could be accessed, showing risk of recurrence with Taxol vs. without. And you're looking for absolute risk - not relative. Maybe the risk of recurrence without Taxol is 10% (I'm making this up); maybe with Taxol, it's 8%. That means the relative risk of recurrence with Taxol is 20% better than without. The ABSOLUTE difference in risk is only 2%. So make sure your oncologist is clear on that.
The other thing is, Taxol can come with lifelong side effects: neuropathy (pain/tingling in the hands and/or feet). It's not a given, but a significant percentage of women experience this. How much are you willing to risk in side effects for how much lowered recurrence risk? That's the question; and only you can answer it.
I've found docs are always willing to put us through the toughest treatments, those most likely to prevent recurrence; but they seem to have a hard time weighing the lasting side effects, and how they change your life. They figure, "Well,you're alive - isn't that good enough?" Yes, and... if the benefit of the particular drug was just 2%, I most probably would have been alive anyway, without the side effects.
As I said, tough decision. Do you feel lucky? Are you someone NOT into hindsight and second-guessing? Best of luck as you figure this out, and come on back here anytime you need to chat. We're here for you. PJH
Chris, I'm sure there must be data on how much adding Taxol to AC helps prevent recurrence. I'm in the first wave of non-metastatic patients who received Taxol. I'm pretty sure the studies that led to its FDA approval for non-metastatic use came out in 1998. As a person who believes Taxol was key to saving her life but who has neuropathy from it, I can sympathize with your decision. I wasn't eligible for any of the hormonal treatments, so Taxol was the way to go for me. You will want to run the numbers with your oncologist, but I think that because you have some other treatment options, skipping Taxol makes some sense. If part of your reason for skipping Taxol is that you have had lots of AC side effects, you should know that most people find Taxol easier to tolerate than AC.
Thank you PJ and Phyllis for offering your thoughts on my decision. I have had significant side effects with AC including 4 weeks of severe laryngitis and incapacitating Hand and Foot Syndrome (HFS) which has left three of my fingers without feeling -- I hope temporarily. I think getting HFS with AC is fairly unusual. Given that HFS is a noted SE of Taxol and it carries the potential for serious neuropathy coupled with the controversy about the benefits of Taxol for HR+ women, I think I've decided to finish the last round of AC next week and not pursue the Taxol. I did get a second opinion from an ONC who is older than my doc and has seen a lot of serious SEs over many years. He was much more concerned with my current SEs and concerned about what the Taxol might bring. Phyllis, if I were ER/PR- I would be thinking very differently about this decision. But I'm not -- and as we all know that has nothing to do with luck and everything to do with the nature of this disease. I feel good about my decision and eager to get into the next phase of treatment and better living. Thank you both again. I have really learned to treasure BC survivors like you who are so generous with their insights and wisdom.
Chris, for what it's worth - I would have made the same decision, in your shoes. In the 10 years since chemo, I've seen how it can affect your life permanently; and unless it was going to make a huge difference, I'd opt out - like you're doing. Best of luck to you - and I hope the path gets a little less rocky now... PJH
Have just finished 4 AC and had one T treatment. Had a rough time with it. Read your article and others noting that T is not effective for estrogen positive breast cancer and may even be dangerous neoadjuvantly. My tumor has shrunk so that it is not visible on ultrasound and we are waiting for MRI to go forward with surgery. I told my oncologist that I do not want to do any more T treatments. She said that I need to find another oncologist in that case. I was appalled. I am still having side effects form the treatment I have had, and still have a port in, and need some follow up care. I do not want to not have an oncologist, but cannot agree to any more chemo. What to do?
Delores, I'm surprised at your oncologist's attitude because ultimately she works for you. Please keep in mind that the date of the original article above is now four years old, so your oncologist may have new data not available at that time. It sounds like you need to have a heart-to-heart discussion with her about why she feels so strongly about your taking Taxol. She knows your medical history and should be up on the latest studies that apply to you. Perhaps she feels that if you don't have confidence in her suggestions, it is time to find a new doctor. If after she gives you all the reasons she thinks the Taxol is so crucial for your survival, you still want to skip it, then it is time to get a new oncologist--one who will support you in making your own decisions after you get all the information that applies to you.
hello there!
i was recently contacted for a reearch study on breast cancer as i was unable to participate and i thought to forward this info to ladies who may be interested. They are looking for ladies who have her2- and have taken or currently still taking taxol, taxotere, or abraxane. i have provided the contact and few details below. its pretty interesting, worth taking a look at.
Metastatic Breast Cancer research Study
New York NY and also Nationwide
60 min participation
All participants are paid an incentive $100-$150
elliottbenson.com
Hi - I'm trying to find out if this is legitimate; when I tried to click on links breastcancer.org and Komen had posted to it, they were broken - which makes me suspicious. So ladies, caveat emptor, but here's more complete information if you're interested - PJH
"We would like to invite patients of Metastatic Breast Cancer to participate in an important research study. It begins March 27th, 2012 and runs through April 10th, 2012. We are looking for patients who reside near New York, NY to participate in an in-person interview and patients who reside Nationwide to participate in telephone interviews. The research study will take approximately 60 minutes of your time. Each patient, who participates, will be provided an incentive in appreciation for their time and opinions. If you are interested, or know of anyone who may be interested, please contact Elliott Benson at 916.325.1670 or email invitation@elliottbenson.com. Elliott Benson is a Sacramento-based Market Research firm. For more information about our company, please visit our website at www.elliottbenson.com."
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The New England Journal of Medicine editorial comment made by Ann Moore of the Weill Cornell Medical College, could not have been stated with any more precision that the "one-size-fits-all" approach to breast cancer treatment is coming to an end, and should come to an end. Also, oncologists do have a responsibility to their patients to be aware of the University of Michigan report.
As we enter the era of "personalized" medicine, it is time to take a fresh look at how we evaluate treatments for cancer patients. More emphasis should be put on matching treatment to the patient. Patients would certainly have a better chance of success had their cancer been chemo-sensitive rather than chemo-resistant, where it is more apparent that chemotherapy improves the survival of patient, and where identifying the most effective chemotherapy would be more likely to improve survival.
The academic center-based oncologists are misguided in not recognizing that they continue to try and mate a notoriously heterogeneous disease into "one-size-fits-all" treatments. They predominately devote their clinical trial resources into trying to identify the best treatment for the "average" patient, in the face of evidence that this approach is non-productive. However, such unsuccessful experiments will never be viewed as such by the people whose careers are supported by these kinds of experiments.
The methods of cancer medicine during the last thirty some years are coming to haunt the "one-size-fits-all" establishment. Technologies, developed over the last twenty years by private researchers, hold the key to solving some of the problems confronting a healthcare system that is seeking ways to best allocate available resources while accomplishing the critical task of matching individual patients with the treatments most likely to benefit them.
Survival in metastatic breast cancer hasn't improved substantially in thirty years. Improvements in overall survival for all patients are owing largely to a marked trend for earlier diagnosis and surgical technique. Even this doesn't mean that many more patients are being cured. If you diagnose someone earlier in the course of disease, of course they'll live longer from the time of diagnosis. This is what's known as lead bias.
There have been truly minuscule improvements as a result of adjuvant chemotherapy and the net benefit to the community of breast cancer patients in the real world isn't all that clear. And the criticism remains: All of the clinical trials resources have gone toward driving a square peg (one size fits all chemotherapy) into a round hole (notoriously heterogeneous disease).