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CPA · 07-02-2006, 08:12 AM

Have you ever had any cardiac problems or are you at a high risk? If so, the TCH is a perfectly legitemate choice.

If you are high risk for cardiac issues (diabetic, obese, family history, high choleterol, etc. or some combination of these) your onc may have weighed the two options and figured the risk of cardiac damage outweighed the benefit of the anthracycline chemo.

They are finding that the anthracycline chemo regimen is probably worth the risk for a certain sub-type of her2+ cancer (TOPO2 coamplification), but the test for this is performed at very few labs and I am not sure if it is covered by many insurances. Since the TOPO2 test is not widely available, most oncs are using the AC>TH treatment by default and are dealing with any cardiac issues only if they occur.

Like many things in life, the choice of a chemo regimen is not chiseled in stone as an absolute. The BCIRG study still has not presented final (5 year) results comparing the two and no other study is more mature with a larger sample size.

If I could give you one piece of advise it is to trust your doctors.

Fighting this disease with all of the physical and emotional trauma is very hard. If you cannot trust those treating you, it is going to be even harder. In addition to your friends and family, I highly recommend working to make your doctors part of your support system - not adversaries.

From your previous posts (I have responded to a few others), it appears that you are getting relatively standard treatments. It is perfectly legitemate to get second opinions and ask questions, but realize that treating this disease (and other conditions) is sometimes a balancing act with several possible treatment options based upon risks & rewards. Very rarely in medicine is there an absolute right and wrong treatment. Quite often risks & rewards cannot be quantified and decisions are made based upon experience, discussions with the patient and sometimes even based partially upon a "hunch".

BTW, my wife chose the TCH treatment option after a lengthy discussion with a consulting oncologist at a large regional center. She has a very strong family history of cardiac issues (mother/father/brother).

07-02-2006, 08:12 AM	#3
CPA Senior Member Join Date: May 2006 Posts: 93	Cardiac issues Have you ever had any cardiac problems or are you at a high risk? If so, the TCH is a perfectly legitemate choice. If you are high risk for cardiac issues (diabetic, obese, family history, high choleterol, etc. or some combination of these) your onc may have weighed the two options and figured the risk of cardiac damage outweighed the benefit of the anthracycline chemo. They are finding that the anthracycline chemo regimen is probably worth the risk for a certain sub-type of her2+ cancer (TOPO2 coamplification), but the test for this is performed at very few labs and I am not sure if it is covered by many insurances. Since the TOPO2 test is not widely available, most oncs are using the AC>TH treatment by default and are dealing with any cardiac issues only if they occur. Like many things in life, the choice of a chemo regimen is not chiseled in stone as an absolute. The BCIRG study still has not presented final (5 year) results comparing the two and no other study is more mature with a larger sample size. If I could give you one piece of advise it is to trust your doctors. Fighting this disease with all of the physical and emotional trauma is very hard. If you cannot trust those treating you, it is going to be even harder. In addition to your friends and family, I highly recommend working to make your doctors part of your support system - not adversaries. From your previous posts (I have responded to a few others), it appears that you are getting relatively standard treatments. It is perfectly legitemate to get second opinions and ask questions, but realize that treating this disease (and other conditions) is sometimes a balancing act with several possible treatment options based upon risks & rewards. Very rarely in medicine is there an absolute right and wrong treatment. Quite often risks & rewards cannot be quantified and decisions are made based upon experience, discussions with the patient and sometimes even based partially upon a "hunch". BTW, my wife chose the TCH treatment option after a lengthy discussion with a consulting oncologist at a large regional center. She has a very strong family history of cardiac issues (mother/father/brother). Last edited by CPA; 07-02-2006 at 08:17 AM..