[Becky]

Dear Tricia

You are such an inspiration to me personally. I have "cut and pasted" many paragraphs of many of your posts into a word document titled "Words of TriciaK" because some of the things you have said, I never want to forget.

I will make a treatment suggestion that you can discuss with your oncologist. It is abraxane (hopefully to be combined with Herceptin and/or Tykerb). Abraxane is the same active ingredient as Taxol but there is a huge difference in the way it is formulated that really cuts down on the possibility of allergic reaction. I will explain the differences.

Firstly, the drug active is very, very water insoluble so something has to be done formulation-wise to make an infusible solution. This is where the difference lies.

For Taxol - the drug is formulated with a surfactant (an ingredient that emulsifies water insolubles into water). The surfactant (aka emulsifier) for Taxol is a castor oil ethoxylate and it is this component of the formulation that most people are allergic too hence the steroids and benadryl that everyone has to take prior to infusion (the same is true for Taxotere - not the exact same active as Taxol but in the same family of actives as Taxol).

Abraxane, which I stated is the exact same active as Taxol, is slightly manipulated. They take the active and they chemically add sugar molecules (so the active molecule kinda looks like a comb). Sugar is water soluble so when they hydrate the active the sugar molecules pull the insoluble active into water - no need for emulsifiers as the sugar makes the active water soluble. No emulsifier - far less potential for allergic reaction.

Also, Abraxane can be used weekly (3 weeks on, 1 week off) so lower doses can be used. Also, in general, taxanes are better on the blood counts than other chemo drugs.

I don't know if you have used taxanes in the past but this might work for you. You might have used them and they didn't work for you - this I do not know but I wanted to make this suggestion to you to discuss with your medical team.

Many, many hugs and love to you.