Can someone tell me the difference between weekly taxol and 3 weekly please?

[sasha1970]

Hi All

I was initially diagnosed Sept 11 with stage 1a, following surgery and was prescribed 6 sessions taxol/carbo 3 weekly. After 3 sessions I was admited to hosp with high temp and low white blood count, at this point saw different Dr who stopped the taxol as due to the early stage she said it wasn't needed.

All well until my second 3 monthly checkup and ca125 had risen to 54, subsequent CT showed recurrance in two lymph glands and a small nodule on my small bowel. I have recently undergone 2nd surgery as part of desktop 3 trial and all visible disease removed.

Next week I will begin a second round of chemo, Onc has again prescribed 6 treatments of taxol/carbo, this time all being well I will have the full course.

My question is, I see a lot of ladies on here who have weekly taxol rather than my 3 weekly, I thought as it's my second time round I would have had a variation in treatment to the 1st time. I mentioned about weekly treatments to my Dr but she just seemed to dismiss it and said I would be on 3 weekly. Is there any benefit to either treatment or are they as effective as each other?

Many thanks in anticipation of your help xx

[Hidden]

Hi Sasha,

As I understand it you are having combination chemotherapy i.e. Carbo/Taxol which is thought to be good treatment if your cancer responds well and is not platinum resistant, this is the reason why they are using Carboplatin, weekly taxol is a relatively new approach.and I think is probably used as a single agent ...I don't know whether weekly Taxol is used with another agent or not.

I had a course of three weekly Carb/Taxol for a second time after a recurrence, which has put me into remission for a second time... they must think that this regime worked well the first time so they would give it again...try not to worry they are giving you what they think is best for you.

You could give the Ovacome helpline a ring and speak to Ruth Payne tel [phone]

she might explain this more clearly best wishes love x G x

[Hidden in reply to Hidden]

I just realised that after three chemo's they stopped the Taxol so maybe they think that Taxol on its own wouldn't be the way forward for you, giving you the combination does give them the option of stopping the Taxol and you will still have the Carb so not stopping your treatment... xx

[sasha1970 in reply to Hidden]

Thanks Gwyn, yes, that makes sense, at least this way I have one drug to fall back on if the other causes problems. Two drugs for the price of one I say. xx

[Whippit]

Dear Sasha

What I would say is that if your oncologist appears to dismiss something you've asked you should ask again until you receive a reply. It might be helpful to take someone in with you to make sure the replies are understood and even to take notes so you have a record of what was said.

There are currently trials going on which are giving women weekly taxol and this can be on its own or with another chemotherapy. Some women have posted on this site to say having it weekly doesn't give you a break. It would be helpful to know why the 2nd doctor decided to withdraw the taxol. Did they think the side-effects were adding to existing problems? It certainly has a lot more side-effects generally than carbo-platin.

Please don't feel that the lack of taxol the first time may have brought about an early relapse. This disease and its treatments are at the leading edge of research and people really don't know how each one of us with respond to the therapies available.

I really would urge you to ring the oncology nurse in your local hospital where your notes are kept. This will give you the explanation as to why exactly Taxol was dropped last time and it might well reveal why you are being offered 3-weekly taxol this time and why weekly taxol appears to have been dismissed out of hand. There is a school of thought that believes it may for some women extend remission by a few months.

I would urge you never to take the view that doctors just know best or to accept their decisions without understanding exactly what is going on. Having said that I'm not suggesting you ignore all their advice. It's a balance. Whilst they do know more than us and have years' of experience in dealing with chemotherapy it is vital that you understand the choices and are involved in them.

You sound as though you're coping really well with all this. I hope you get a satisfactory answer before next week and that you are happy with the reasons for your prescription.

with very best wishes. Annie xx

[Hidden]

Ummm... So far as I know, single agent carboplatin is recommended for stage 1a. Taxol might have been withdrawn because of the side effects you were experiencing. There's a diversity of opinions amongst oncologists, some believe carboplatin alone is effective, some who prefer the combination.

As for weekly taxol, this is a regime lasting for 18 weeks that is given often to women who are platinum resistant after combined therapy has failed. As yet, you don't fall within this group.

Dose dense taxol, also given weekly, is a different protocol. That essentially is a lower dose of taxol given each week for three weeks rather than a larger dose given once every three weeks.

A study in Japan showed superior survival figures for women who had dose dense taxol as part of their initial treatment. At the moment ICON 8 is trialling dose dense taxol and also dose dense carbo & taxol against three weekly administration.

I think all the above is correct. It might be worth asking for dose dense taxol instead of three weekly, but weekly taxol is a completely different regime that will perhaps be considered later. But hopefully the treatment you are on now will work and you won't need it.

[Hidden in reply to Hidden]

Hi Chrystinh,

I think you are right that the Taxol was withdrawn because of Sacha's low white blood count and high temperature, and like you say she was also stage 1a so probably thought there was no need for the taxol considering it was caught early, and because of her low white blood count and high temp they would be reluctant to give the dose dense taxol as they had stopped it the first time.

I also read about the success of weekly taxol, but I think it does depend on the individual and whether she would fit the criteria for a trial....for instance when I had a recurrence I didn't fit the criteria to go on a trial... but second line Carbo/Taxol worked for me.... Love x G x

[sasha1970 in reply to Hidden]

Thank you all for your kind information. The Dr who stopped my taxol did so because she said it is very hard on the system and due to the early stage of my initial disease she probably wouldn't have prescribed it in the first place. Basically she disagreed with the original prescribing Dr which concerns me a little. On my recurrance I was initially referred to the Dr who stopped the taxol but before I saw her to arrange my second upcoming chemo the appt was cancelled and I was given an appt with my original onc who prescribed taxol/carbo the first time! To add to that when the appt came I didn't see her as she was off sick and saw her registrar! I feel like I want to get both Onc's together to make sure they both agree with what treatment I am having. You would think that it would be a standard treatment and that all Dr's would follow the same route but I feel that I am being torn between the two lol.At least I know what to expect with the 3 weekly and hopefully will get 2 good weeks between treatment as I did last time. xx

[Hidden]

As I understand it, Taxol for 3 hrs and Carboplatin for 1 hour given every 3 weeks for 6 cycles is the text book start treatment for everyone. Taxol you will lose your hair, carboplatin you tend not to. If some people find taxol causes problems then weekly taxol for 1 hour for 18 weeks works out to be the same as 3 hourly every 3 weeks for 6 cycles. My wife coped quite well with the text book dose but struggled to do the weekly taxol for more than 12 weeks when prescribed 3 years later. I also think they like to use a platinum based drug such as carboplatin as soon as they can but it seems to be used as a 2nd agent with either taxol, caelyx and gemcitibine for those with stage 3+ OC. (I,m beginning to sound like an oncologist)

rgds Paul