Paclitaxol and Peripheral Neuropathy

@Sister quite interesting - I wondered how they picked that number too. @kmakm told me that with the TC chemo after 4 cycles it gets too hard on the heart. Seems like they might choose the upmost figure the human body can handle. How is your neuropathy going. I got some at the end of my chemo and I have just noticed in the last week it seems to have improved thank god. Fingers crossed the same for u xox

With AC I believe that you can only ever have 6 doses maximum and that's why they start with 4, keeping 2 in reserve for future issues.  At this stage, mine is mostly in my feet and still comes and goes in intensity but gradually creeping up - so far the maximum is just a lack of sensitivity in toes and balls of feet but tingling in arches but each week claims a little more.  The doc will decide at next week's appointment whether to go ahead with the last chemo.  I'm glad yours is improving - to get these sort of side effects from treatment is just a slap in the face, isn't it?

My oncologist said much the same. There is a natural preference to give the maximum you can take (within reason of course!) as that is likely to be most effective but the impact on an individual can vary. My breast cancer nurses felt that 80% of the prescribed dose may in many cases prove to be as effective as the full complement. It's not a clear area. Like taking letrozole, the stats indicate that 10 years may be better than 5 but not if it's cumulative - don't know if your chances slowly build or if there's a sudden peak in year 8! 

@Sister I have five Paclitaxol to go. Peripheral neuropathy has been gradually getting worse. On Monday my white cells and neutrophils were very low (though not low enough to cancel chemo that day), and the oncologist said she's concerned about that, and my increasing fatigue (it was really bad last week), and the peripheral neuropathy (in case it becomes permanent). She raised the possibility of having a break from chemo and I reacted strongly. I said I want to push on. I can tolerate it, I said. She said the issue is if I become so weak it would be dangerous. So we'll see what happens next week - they may consider giving me a "booster" ???. A friend who is 2.5 years on said she was in the same situation at about the same stage of Paclitaxol and had four blood transfusions and felt much better after each one. So maybe that's what the oncologist is thinking of as a booster - or something else. So next Monday will be key.
I HATE the thought of having a break from chemo - for fear that it may reduce the effectiveness of the treatment, for the weird idea that I "should" be strong enough to just keep going and not give up, and because I just want to get it over with and get on to radiation and be done with all the treatment.
I don't like the idea of having permanent neuropathy; I guess I'd learn to live with it. My fingers tingle in a very uncomfortable way when I type. I'm finding it hard to believe that I'll ever feel "normal" again. It seems there'll always be some physical remnants of this whole deal - maybe very significant ones.
The tingling feet cause problems going to sleep and disturbs my sleep and the skin from arch to toes feels as if it's stretched tight. Someone mentioned warm foot baths; sometimes that helps a bit. Moisturising is a problem for me because I had an only partially successful knee replacement 2.5 years ago and have very little bend in left knee so I can't reach my left foot well enough to rub cream in properly. My fingers are constantly numb and/or tingling. My daughter has suggested that for safety I should stop cooking (I cut my finger last week). I'm taking that advice and have had a Coles delivery of lots of frozen ready meals. Friends who frequently deliver home-made portions will also continue to do so.
Oddly, I've had more nausea the past couple of weeks (about day 3) than I had on AC.
The one bright spot in this past few days, with worrying about all this, has been watching online live stream of the parliamentary commission of inquiry into the political scandal in France - at one stage I was so riveted I didn't think about cancer for three hours! A French political crisis = my mental health therapy. 

@Flaneuse I was really anxious about the idea of stopping short, too. In the end, I didn't have to but I decided that I would listen to what my onc told me and after he said that no-one knows if it's important to get to 12, I did feel much better about the possibility.  I have spoken to other women who have had a week off when symptoms got too bad and they say it helps.  The last thing you want is to push it into a permanent disability - that's what decided me.

@Sister Thanks for those thoughts - particularly your last comment. I shall listen. Fran

I am nearly six years on and still have problems with my feet. It's probably for life. It's not the end of the world but don't take the possible impact too lightly. A break may help. There is also some evidence that 80% of the prescribed dose may also be as effective as the full dose. I soldiered on and did all 12 treatments and I don't regret it but if you are advised by your medical experts to another course of action, I would take that seriously. Best wishes. 

@Afraser Thanks for those thoughts. I shall.

I had to stop after 3 of 4 rounds of AC, my decision as it was making me bed bound for days. My oncologist was fine about it. I'm now about to have the last of 12 Paclitaxel and the side effects have been cumulative but not as bad as AC - sore fingers and toes but no peripheral neuropathy. If they had been I would have had a frank discussion with my oncologist about how long to continue!