Delays versus dose reduction in chemotherapy

Hello everyone!

My journey so far: 38 years, diagnosed last summer with breast cancer - one affected lymphnode, both tumors oestrogen receptive and HER+ Now going six rounds of neo adjuvant chemo (carboplatin, docetaxel, herceptin and trastuzumab).

BUT fighting a panick over delays and dose reductions (despite feeling gratefully good - not needing any nausea meds, strong appetite, yay). Still, due to low platelet count, round 3 was delayed by a week. Then my dose was reduced for round four (20% less docetaxel and carboplatin) as they said the treatment is more efficient when delivered on time, even at a reduced dosage. Today they phoned me to say my platelets are borderline again (98 - same as last round when I DID get an ok) and I have to wait another week (why always a week and not a few days if delays are such bad news?!), plus they are considering another 10% reduction.... I couldn't keep my tears in most of the day, feel so confused and frustrated.

The way I see it, I get six shots at having cancer cells systematically attacked throughout my body - two rounds / shots left. This is the treatment that maximizes the chance no cancer cells will stick around elsewhere in my body and avoid recurrence in the future. After that treatments are focused on one area (operation and radiation). So what happens now is surely of major importance for my future?! The nurse who phoned me was really lighthearted about it "delays are so normal" the oncologist said "no use beating up your bone marrow"...I don't find that reassuring at all!!!

Did anybody get a better view of what these adjustments to treatment really imply for their long term chances? Is it really thát "normal"? Do they make these reductions differently for each patient or are they simply following standard protocol - would that be good or bad?? Are there second opinions for this? From eight years working in customer service I took away their are always different approaches to a single situation. But nobody seems to explain the approach they are taking, other than "it is what it is" Maybe they are right....that seems to be the *** thing about cancer :P

So sorry for my moaning....hope someone might still feel like sharing their experiences with this. Thanks and my best wishes to everybody.

  • Hello Tenby

    I noticed that you'd not had a response to your post. It sounds as if you're really going through the wringer at the moment. Please feel free to moan away to your hearts content here on the forum - that's what we're here for! 
    I do wonder if you might find it helpful to talk things through with one of our team of nurses here. They may be able to give you some advice and support regarding what's been happening for you. They are available on 0808 800 4040 (Monday to Friday 9am to 5pm). 

    I hope that your next treatment is able to go ahead and all goes smoothly now over the coming weeks. 

    Best wishes, 
    Jenn
    Cancer Chat moderator

  • Hi Jenn,

    Thanks for your reply and advice. I did make that call and found it very helpful. The person I talked to was knowledgeable, kind and reassuring - just what I needed. And I am also grateful for just having been able moan a little on the forum :) 

    Thanks again!

  • Hello Tenby,

    I realise you posted this years ago but I've just come across this after frantically googling 'should I have a chemo dose reduction'!

    im on the same treatment as you with the same breast cancer / age. nurse / oncologist is recommending a 20% reduction in dose after round 4 was awful (my brain has already blocked if out!!) but I think it was so bad bc I had a chest infection brewing.

    I wondered how you are doing and how your treatment went with dose reduction etc. thanks so much and sorry if you are a million miles away from this time now!

  • Dear Pollylop,

    First of all a big hug from across the pond (now living in the Netherlands). It is hard enough going through chemo without all the added worries about the course a treatment is taking. I would definitely phone the team of nurses above mentioned as they helped me at least talk things through.

    In the end I had no options but to accept the reduction - my oncologist was adamant. And you do want your body to have a fighting chance too. I tried to consider the chemo as an ally to my body fighting for health, the survivable dosage being what I had to work with. So, I focused on relaxing into it and feeling positive about getting the most out of it. After all, stress is never healing! That said, you do know your body best. I have asked my oncologist for extra explanations on multiple occasions (she was not an easy person) and if you really think something else needs to be considered then make someone hear you.

    In March it will have been three years that they operated (after six rounds of chemo) and I am doing very well.  Today, in my new job nobody even suspects I went through this  (not that I hide it). I hope it helps to hear this and I wish you a lot of strength for the last few rounds. All the best!!