chemotherapy dose reduced

[Kiara-52]

hello first of all Happy New year to you all.

I am now on my 4th Chemo and have just had my dose reduced due to low white blood count. It has been low for cycle 2 and cycle 3 was delayed , for cycle 4 my oncologist reduced the dose. I was just wondering if this has happened to anyone else. I am a bit worried that it won’t work as well as it’s a reduced dose. Does anyone have any experience of this? Thanks

[SuffolkJen]

Hi Kiara-52

Happy New Year

Although for different reasons I had my dose reduced. Mine was due to neuropathy.

The taxol was reduced by 10% for 2nd dose but the damage was done by then unfortunately. I then had it reduced again for dose 5.

Before dose 6 , I had an appointment with my Onc who advised removing taxol completely and only having carbo for last dose. He explained that if the chemo was a ‘pie’, for me the taxol was the smallest slice and he was confident it wouldn’t make any difference.

Unfortunately it didn’t make any difference to the neuropathy, as it’s just as bad 11 months post chemo. I think I was just unlucky with the neuropathy.

I hope this puts your mind at ease that a reduction in dose is quite common and there’s leeway in the dose for adjustment.

Best wishes Jen xx

[Caleda4 in reply to SuffolkJen]

Hi, I had carbo/taxol approx 8.5 years ago, and the taxol was reduced after the first dose by 20%, due to stabbing pains in my legs. I also only had 4 rounds of carbo/ taxol,as my Oncologist said it would not make a great deal of difference if I went on to have the other 2 rounds. I was worried as I have high grade serous, but following this I went on to have 4 5 years without chemo . Since 2020 I have had 2 recurrences, but I feel fine, and have been on watch and wait since August 2022., having a scan every 3months. We are all different. I wish you well for 2024.x

[Kiara-52 in reply to Caleda4]

Hi Caleda4

Thank you very much for taking the time to reply to me. My taxol is still at 100% but my carbo has been reduced by 20% it’s reassuring that you went on to have 4.5 years without chemo, I know once my chemo is finished that will be my next worry about recurrence as it’s so high with this. Sorry to hear you have had two recurrences I am glad you are feeling fine. Wishing you all the best for 2024 and good luck in your journey with this x

[Kiara-52 in reply to SuffolkJen]

Hi Suffolk Jen

Thank you for taking the time to reply to me. My chemo was yesterday and that’s when I found out my dose was reduced my oncologist hadn’t informed me I am guessing due to the time of year. I am going to contact him just for clarity. My taxol is still at 100% it’s the carbo he has reduced by 20%. I think I just panicked a bit as I was thinking the worst that it would not work as well. It’s reassuring to hear it’s happed to others as well. I am lucky I have not had neuropathy as I was a bit worried that would be a side effect that I would have as it sounds painful and I’m sorry to hear you are still having issues 11 months on fingers crossed it starts to improve for you. Wishing you well on your journey with this horribe disease. Take care x

[BadgerBright]

Hi Kiara-52 I have had several dose reductions during in chemo both taxol ( due to unbearable leg pain) and also carbo in later sessions due to very low haemoglobin. For which I had several blood transfusions.

I was fine with all of this as my consultant oncologist was reassuring about the strength of the carbo on its own. When the taxol was stopped completely. I also had low neutrophils for which I had to have injections over 7days between cycles. So there were some delays also.

As has been said everyone has different experiences of chemo so do not worry ( very difficult as we all know) but trust your oncologist but also asks questions.

I was diagnosed in 2020 it will have been 4years on 6th Jan I have had and am still having some ups and downs but I am very happy to say I am still standing.

So I hope you can take some comfort from this. Very many good wishes for 2024. Love BB.

[Kiara-52 in reply to BadgerBright]

hi Badger Bright,

Thank you for taking the time to reply to me. It’s the carbo that I have had reduced by 20% . I have had low neutrophils since cycle 1 so I’m guessing that’s why he has reduced it for cycle 4 which I had yesterday. Iv also had delays due to the low count which I also was a bit stressed about the nurses on the chemo ward said it was my oncologist who had reduced the dose to save any further delays. I am going to contact him just for clarity and explanation as it was a bit of a shock yesterday. I think we all just want it over and done with with no bumps in the road but that’s wishful thinking. It’s good to hear I’m not alone I will ask him about the injections you mention to see if that’s something I can try to save any further dose reductions I have just 2 more to get through. Really appreciate you taking the time to explain your experience it helps me a lot. Wishing you good luck for 2024 and best wishes for your journey with this. X

[bananayo]

Hi, I had my 4t, 5th and 6th chemo doses reduced (can’t remember if by 20 or 25%), I also had the injections each time to try and boost neutrophils as they were very low causing delays of a week, sometimes two having chemo. Think it is quite common for this to happen.

[Kiara-52 in reply to bananayo]

Hi bananayo,

Thank you very much for taking the time to reply to me. My first 3 chemos were at 100% , chemo 4 yesterday taxol is still at 100% but the carbo was reduced by 20%. Your situation sounds very similar to mine as it’s the neutrophils that’s Iv had an issue with since chemo 1, Iv always failed as too low 0.8 etc and had delays. The nurse explained that’s why my oncologist has reduced the carbo by 20% to try to avoid any further delays, I am going to ask about the injections you mentioned to try to save any further reductions. Although not glad it appears to be common it’s quite reassuring that I am not the only one if you get what I mean! Wishing you good luck for 2024 and best wishes for your journey with this x

[bananayo in reply to Kiara-52]

The injections were called filmgrastin, good luck with the rest of your treatment and best wishes for 2024 x

[SopSinger]

Yes, I had my 5th and 6th doses (of carboplatin only) reduced because of neutropenia (low white blood cell, specifically neutrophil, count). Still here, nearly 18 years later, no recurrence.

[Kiara-52 in reply to SopSinger]

Hi SopSinger

Thank you for taking the time to reply. That is very reassuring as it’s the Carbo that I have had reduced for 4,5 and 6 cycle. For exactly the same issue. Excellent news that you are nearly 18 years with no recurrence! Long may it continue! All the best for 2024! X

[Greenme]

Hi Kiara-52,Life with cancer and chemo is full of anxious times! I am a nurse, and a 6 year survivor of stage 4 ovarian cancer. I can remember the times that a low white cell count required delaying my chemo infusions. With all of the viruses around these days, we need to keep our immune systems as strong as possible, so it's important to keep our white counts up!

Rather than decreasing the dose, my oncologist went with a different plan. She prescribed an injection of a drug (filgrastim) that stimulated the bone marrow to make more white cells...like some others here have described. It's injected for a few days, starting the day after chemo. Once I started the injections, I never had that problem again, and was able to complete the chemo at full dosage without delays. I would suggest that you ask your oncologist about that. It's always good to discuss concerns and available options with your oncologist. Good luck, whatever course your treatment takes! Wishing you a healthy and happy new year!