Adriamycin is NOT the chemo of choice??? SINCE WHEN????

[lauren]

Where was I and where was my oncologist when the word came out that AC plus T is no longer the chemo protocol of choice when treating aggressive breast cancer in pre-menopausal women????

When I was diagnosed with Stage IIB breast cancer, her2 positive, er/pr positive, my oncologist told me that the proper chemo for me would be AC plus T (and H if I wanted it, which I did). She told me that the only other option was CMF, and that was NOT appropriate for women with my diagnosis at my age (although it used to be). This was in September of 2002.

Now I am reading on this board that AC is not effective against Her2 positive breast cancer???? WTF?????? I want to believe what my doctors say, versus what laypeople say on this board, but I have to admit it gives me a great deal of insecurity to hear women on here saying that it was a WASTE of my TIME to take AC which totally SUCKED BIG TIME and made me lose my hair and feel like CRAP.

Yes, I am upset.

Can someone address this please?

[Joe]

Lauren,
Each person is different. Have you ever read Christines' story on our stories page? She had two sessions of A/C and still progressed steadily.
The same for Barbara Bradfield and Ginger Empey. In all three cases Herceptin was their only hope and it worked.

The opinions expressed on this board are just that..Opinions. The ultimate source of information is your oncologist and if you question his opinion, you then get a second, or even third opinion from other oncologists.

I am aware that we do have some nurses who frequent our board,other than that to my knowledge, we have no medical professionals who are qualified to give medical advice. Therefore any medical advice that you read, should be suspect.

Warmest Regards
Joe

[lauren]

I think it's a given that some patients will progress while being given adriamycin, and some won't. Some will progress later, and some won't progress at all.

I just spent an hour poring through ASCO's 2004 abstracts, and I see, among other things, that dose dense FEC (similar to dose dense AC, I believe, but given more often in the UK) may actually COUNTERACT the negative prognostic factor of Her2Neu.

I think it is dangerous to make statements like AC is not effective against Her2Neu positive cancer. It just isn't accurate. That being said, everyone needs to understand that this board is comprised primarily of laypeople. So, any medical advice is, as you say, suspect.

I am still upset though.

[michele u]

lauren,
Did I miss something? Where did the AC remark come from? I also received AC then T. I thought that was the best thing out there also. I would like to read whoevers post that was from. There is a gal I know had 5fu 10 years ago for breast cancer. I wonder why they don't use that anymore?

[jeff]

lauren (and everyone),

Wow--this board is so active isn't it? That's an amazing thing. But it can also be a confusing thing. The main confusion that I see here almost always comes from the differences in treatment options facing women in the adjuvant setting versus women facing metastatic disease. One important thing I try to remember is that women with metastatic disease started this board and are it's lifeblood. Other boards deal with this issue by separating out postings for recurrence vs.primary.

I remember the comment about AC and its effectiveness and I'm pretty sure it came from someone who was given it in the metastatic setting. AC (+taxotere or taxol for node positive) women is, without a doubt, currently the standard of care, as they say, for primary breast cancer in the US. In fact, when the dose dense trial results (using AC+taxol) were released at San Antonio in December 2002 there was quite a bit of "chatter" in the months following that the benefit reported in that huge trial might indeed have been mostly due to strong responses from her2+ women.

Might the paradigm shift in coming years? No doubt. There are already trials testing out taxotere+carboplatin and herceptin for her2+ women in the adjuvant setting. Those trials might change adjuvant approaches for her2+ women. But they haven't yet.

And I can't believe I'm about to say this--given that I'm someone who loves to cuss and am trying to bring my kids up to know how and when to cuss properly and productively--but maybe we should try to keep even abbreviated cusses off the board?

All the best,
Jeff

[lauren]

Thanks for your response, other than your criticism of my abbreviated "cuss". If you don't like it, just ignore it. I will no more be sanctioned by you than I would be by a seatmate on a bus. Thanks, but no thanks.

[lauren]

I am sorry if that came off as harsh, but really, I was very offended by the criticism of my thinly veiled expletive.

[jeff]

Of course nothing I said was meant as even an attempted sanction. But if you re-read lauren's initial post you'll see that her swearing was directed right at another poster. And if you all go back and see who that initial poster WAS I think you'd be as concerned as I was.
Best,
Jeff

[Vicki]

Things are also different country to country. My treatment suggestion in Septmeber 02 was for FAC (5 fluro-uracil) not AC + taxol/txotere. No Herceptin offered or available. This is THE standard here, well was then (....I can't say what it is now). I was stage IIIb with 20/30 positive HER3+++, and I am doing just great. We do need to be careful in setting up (potentially false) expectations on this board.