My sister

[NanaJoni]

Kathleen - my doctor didn't ever mention or consider the AC-TH. I was stage one and one of my small tumors was triple negative, the other was er-/pr-/HER2+++. With the double mastectomy and clear margins, TCH seemed to be the best option. I did follow up with the radiation because triple negative cancer doesn't respond to the hormone treatments like tamoxifen. I had a pretty rough time with each of the 4 treatments I did - potassium crashed on first one, infection, and then I threw 3 pulmonary emboli after the 4th. The blood clots were from all the multiple surgical procedures I had (3 for ports) and my onc decided I'd had enough. Some newer research shows that 4 TCH is as effective as the standard 6 so I'm okay with it. I know this all sounds terrible but at my age and with some other health issues I've had (autoimmunine-lupus, genetic clotting disease called Leyden mutation Factor V, etc) - I really think I did fine and have had a fantastic outcome. I've lost 40 lbs and now have lovely white hair. Your sister will lose her hair for sure on either regimen so start collecting scarves and/or baseball caps. I found out I look great in hats - I jokingly told my husband that I must have looked like hell before I had cancer because now people tell me I look wonderful. LOL You've had a lot of responses on another thread from folks who've had AC-TH and TCH so you should have some good info to digest. I agree that some of the pre-meds (especially the steroids) can be tough but they are necessary and make the treatments more tolerable. My cousin did the AC-TH and did very well - she's almost at the 5 year mark now and no recurrence or other problems. I had the TCH every three weeks with the Herceptin weekly. After the last TCH, I did herceptin for the next year. That's pretty standard. Herceptin is easy and is every three weeks for the 52. I had the runny nose side-effect and some thinning of my nails along with some mild fatigue during the few days after a treatment.
All that being said about treatment, you may also need to be sure your sister is staying healthy emotionally. That was a huge part of this journey for me. I did find a wonderful counselor who helped me deal with all the changes we were going through-physically, financially, spiritually. It's really hard to deal with so much and still be feeling your life is in the balance. She will surely never be the same - it changes you to face cancer. I feel I am a better, stronger, happier person now and get some pretty strange looks when I say how blessed I am to have had cancer. I've gone on way too long here so I'll finish now - you are both in my thoughts daily.