37 year old - just diagnosed

ninica

Hi everyone, Just thought I would let you know I got my Prosigna test results back yesterday which suggest I fall in medium range (almost high range), my score is 38 and anything over 40 is high risk of re- occurrence. So my oncologist suggests ACT chemotherapy. I am booked in for my first treatment next Wednesday. Still nervous as hell about it.

There was also mention of TC chemotherapy to me by another oncologist and I am kind of doing some research at the moment to see what the real difference between ACT and TC is but struggling to find relevant info in terms of long term survival and side effects.

Anyone here has an advice or done an extensive research for ACT versus TC chemotherapy?

Afraser

Starting chemo is scary but look at it as a first step to being well! I can’t answer your question about comparisons, sorry - I was recommended to have ACT by my oncologist, and I did. However your query, which is perfectly reasonable, does beg the question have you asked your oncologist about his/her recommendation? Even in identical situations (pretty rare given the variability inherent in breast cancer), oncologists will have their own reasons for preferred treatment in individual cases - experience regarding effectiveness, tolerance, research etc. You and your oncologist are in this for the long run so you need to understand each other. Chances are his/her research may be answer your question. Best wishes for your first session. 

kmakm

TC is generally given for tumours under 25mm in size with no, or up to three positive nodes I believe. AC is usually given for larger or multiple tumours with or without node involvement.

But I'm not medical, so I agree with @Afraser, it's very important to ask your oncologist to explain their treatment choices for you. You want to be on the same page. K xox

Sister

Just joining the convo and I have to say that I think the nurse's comment about being too skinny is a bit bizarre.  For what it's worth, I stayed exactly the same weight throughout chemo without doing anything special (it's been after that's been the problem).

As for which one, as @Afraser and @kmakm have said, it's important to ask why the onc recommends that type of chemo.  I had AC-T but I know many others have TC - the reasons why my onc chose that one is forever lost to me although I did ask at the time.  I do remember that he preferred to use AC-T if nothing indicated a particular need for the other so maybe it just came down to preference.

Believe me that, while chemo for most is no walk in the park, it is manageable.  With AC, the first and the last treatments for many people are often the hardest.  Do a search on this forum for a list of things to have on hand to make life a bit easier.  If friends offer to help, have some practical things on hand to offer.  I think you said that you had young kids so maybe school runs, sports runs, play dates - stuff like that.  I had teens and pre-teens when I went through it and one of my childless friends went right outside of her comfort zone, drove across town to pick my daughter up from the hospital I was having chemo in, then drove the other side of town to take her to a swimming meet hanging around until I could get there.  It meant a lot to me as the meet meant a lot to my daughter.  These things can be way more important than a fridge full of food that no-one in the family really likes.  If you can afford it, get a cleaner.  Use online shopping.  Shortcuts in meals won't hurt anyone for a few months.

See if your clinic has recommendations for exercise classes during chemo - it helps a lot.  I was fortunate that my clinic was affiliated with a rehab exercise program and my health fund paid for it as part of treatment but depending on where you live, there may be other options (including getting a plan done by your GP) - just make sure that any place you go to is equipped for bc chemo folk.  There may also be the YWCA aqua program available in your area - the name of which escapes me at the moment ( @Romla?).  If you can't get into an exercise program, just walk each day - some days you may manage kilometres, some day metres might be an achievement - just do it!  Look up the Look Good, Feel Better courses as there may be one in your region (not exercise but something positive to help).

That's a lot of stuff for the future that you may or may not want to consider.  I'm sorry if it's a bit overwhelming when you're just trying to get your head around treatment but you also might be like me and like to know in advance what to plan for.

My other piece of advice is (and I offer this to everyone), if the medication they give you for the first few days doesn't cut it, don't hesitate to ring the clinic and ask for something better.  Find out who you ring if it's after hours.  I spent an utterly miserable first weekend because I needed better meds as the Maxolon wasn't working and I didn't know that I could contact my onc for something else.  Once that was sorted, I was okay.

Good luck on Wednesday!