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Breast Cancer (Expert Forum)
Importance of finishing chemo when faced with complications?
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
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Importance of finishing chemo when faced with complications?
by Bookwoman, Apr 27, 2003 12:00AM
I am a 45 yrs. old. One breast had a malignant tumor of .3 cm; the other 1.5 cm (no lymph node involvement). Since I had synchronous bilaterial cancer, I opted for a double mastectomy. My chemo regimen began the end of Feb -- 4 cycles of AC every 3 weeks. I also plan to have an oopherectomy soon as my tumors were strongly ER receptive and I cannot take Tamoxifen due to trouble with blood clots. Here is my problem: I developed an anal fissure which was excructiating (this was from percoset which caused severe constipation -- lesson learned, take stool softeners!) It was so excruciating that I had surgery after my second round of chemo; I was healing so well that my fissure surgeon and oncologist agreed that I could stay on schedule with my third round of chemo. Well,after this round, the chemo apparently saw this weakened area as a good place to attack with an infection. So, wallah -now I have a painful anal abscess. Neulasta and antibiotics helped prevent the infection from getting worse and hopefully the abscess will finally subside (it is draining, but still there after 12 days). The thing is - I really don't want to do the final round of chemo at this point. I am typically not a "quitter" but all of these complications have just worn me to a frazzle. I see my oncologist in a few days, but I was wondering what your experts might recommend. Maybe there is a lesser dose or oral form that I could try for the last round ?
Doctor's Answer
by CCF-RN,MSN-rf, Apr 28, 2003 12:00AM
Dear bookwoman: Unfortunately, as our treatments are based on research, the number of treatments is determined based on the best clinical responses - and 4 cycles was determined to be optimum. I don't think anyone can give you a "real" answer regarding the consequences of not completing the prescribed regimen. There is no oral form of chemo that is justifiable. Likewise, a partial dose of chemo would not be recommended - you should either complete the chemo (at the recommended dose) or choose not to complete it. I sympathize with all you have been through. I would recommend that you have a "heart to heart" with your oncologist and see what he thinks about the situation. Of course, it is always your choice.
Member Comments (2)
by surgeon, Apr 27, 2003 12:00AM
There's no doubt that chemo is most effective when taken for the full course. There's no way to determine who will get recurrance without it; or to what extent, for a given individual, modifying the dosage would be critical. As unpleasant as an anal fissure/abscess can be, recurrant breast cancer would be way worse. So if you can muster the will, the best advice in my opinion is to tough it out: the anal problems will resolve, one way or another.
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