Is it reasonable to ask for another chemo dose reduction?

[Liz1tummypain]

Hope this won't be too long to read. I've got breast cancer and had 4 out of 6 planned chemo sessions. Coping ok so far. I had a scan about five or six weeks ago and they said the length had shrunk from 2.6cm to 1.6cm. Last week I had another scan and the radiographer said it had shrunk so much there wasn't much left to see at all. I'm fairly certain those were his words.

Seeing the oncologist tomorrow. Since my second session, the dose was reduced. It was 75% for the third and fourth sessions and 80% on the second. My neutrophil levels have not been high for some reason, despite the injections of filgrastim following every session.

So my question is, would it be a bad idea for me to ask if they can reduce the dose even more? Should I just leave them to make the decision? Blood tests are being dome first thing tomorrow. I suspect it will show neutrophil levels a little low again .

Any views, any comments please? The most recent session was pretty grim. They are every three weeks and I still have the metallic taste today, day 19. I can't find any food I enjoy. I'm probably being a big baby. Just wanted to hear others views on the possible idea of asking for a lower dose (again)

Are you have palliative or curative treatment as that makes a big difference?

Palliative treatment - your quality of life is most important

Curative - they will encourage you to throw everything at it so you are miserable in the short term but cured in the long term

It's very a very personal decision, I think. How much is it affecting you?How would you feel if the chemo was not successful - would you feel like it might have been had you had a higher dose? Would you be able to cope with that thought (because you'd never truly know)? These aren't questions you need to answer here, but they are the ones I'd be considering.

@AnnaMagnani it's hoped that it's curative.. they expect to do surgery and then radiotherapy after that. if the cancer is now very small I don't know how much more chemo they need to throw at it..

@AnnaMagnani and @Lougle thanks for your replies. At the back of my mind I suppose I know I will have myself to blame if it turns out not to be successful.. Perhaps that should be enough to stop me asking.

Presumably they don't ever reduce a dose only to later put it up again? I know I will cope. It's just a miserable thought , the anticipation of the weak and sicky days to come
Thanks for taking the time to respond

You aren't being a big baby. Im sorry for what you are going through. I can't really offer you advice other than to talk to the team who are caring for you. Maybe write it down before your appointment with all the questions you have and they can go through the pros and cons of doing this with you. I wish you the very best.

It’s rubbish I know. It sounds as though everything is pointing towards a complete pathological response where there no cancer cells detected after treatment. Then the surgery and rads.
If you’re not tolerating treatment well, there are things they can do.
I ended up getting my chemo weekly so it was a lower dose more frequently.
You can at least have the conversation.

Hi there. I had to respond to your post. Sorry you are going through this. This was exactly me last August. The chemo( red devil) was so difficult. I was very sick. They reduced it to 80% on week 4. After my planned surgery for breast cancer, they found more tumours than were first suspected. I'm not trying to frighten you whatsoever but I would be inclined to throw everything you have at it now. It's awful but it will end soon. In the meantime, I'm sending you love. DM if you want. X

When my wife was being treated for a breast cancer, one of her doctors told her that they aim to keep the patient as comfortable as possible by giving the minimum does consistent with destroying the tumour. It sounds like they can adjust the timing but I would want to understand the risks if you're thinking about reducing the total amount of chemo drugs taken.

Best of luck.

I finished chemo about 7 weeks ago.
I'm not in your position, but I would be leaning towards gritting my teeth and continuing with the original dose if you possibly can. The chemo WILL end eventually and if the worst happens and the cancer returns at least you can say to yourself that you did all that you could.
But, like others have said, it's worth having the conversation with your oncologist. Best of luck with it all, Liz1

Thanks to everyone who is answering. It's all helpful. Perhaps by tomorrow I will feel bright eyed and bouncy and even if not, I know there's no reason I shouldn't be raising the subject of the dose.

@weebarra that's an interesting idea .Wonder if they might consider giving me three doses and making them fortnightly. Hmm

Hi again, can I ask what the frequency was to start with? Did they change it so that the side effects were more manageable?

Thanks:)

OP do you feel confident they’re on top of your side effects and managing them proactively? Consider asking if there’s anything more to be done to make you more comfortable.
My mum had one of the more well tolerated chemo regimens but they encouraged her to get in touch if the side effects were not well controlled because they had other options and she didn’t just have to suffer.

It was every 3 weeks to start with. I had FEC and paclitaxel. It was the paclitaxel that was changed to weekly.

Hi OP, just to add my two cents… I’ve got BC and although chemo was unbearable at points and I had a panic attack, coupled with allergic reaction, mouth ulcers (counted 9 all at once), sickness, not being able to eat, I could go on and on, I think if you can grin and bear it, you really should.

i finished my treatment and it completely killed the cancer cells, none detected on scan and just had my double mastectomy and none found in them either, I had a total response. I really urge you to push through if you can.

its not easy, fingers crossed for you. What did they say today?

Thanks everyone, just posting an update

Also @Bangersndmash thanks for your interest and I'm glad you pushed through and had a total positive response . I did come to the conclusion that I shouldn't ask for any special easing off.

So I saw the oncologist. She had results of blood tests and I think this combined with the knowledge I really had struggled on last session, is perhaps why she says carry on as normal ( today actually).but slightly reduced dose. She didn't say exactly how much. I'm.feeling so good now. Had a lovely pub lunch with hubby yesterday and.feel a bit pathetic fory doubts now. So all steam ahead this afternoon.

Thanks very much to everyone who has responded..it has definitely been helpful to me 😄