The Ideal Combination for You

Your ideal regimen:

• attacks all the different kinds of cells in the particular breast cancer you have
• uses drugs that work in complementary fashion, without overlapping benefits or side effects
• works in a way that is too tricky for the cancer cells to "figure out" and overcome
• has level of side effects that's acceptable for you

After carefully reviewing the pathology of the cancer and your personal medical history, you and your doctor will decide which chemotherapy regimen, dosage, and duration is right for you. Make sure to review the risks/benefits of your choice.

Think carefully about choosing what you think is "the strongest" therapy if it has the strongest side effects. Wouldn't it be wonderful if you have a good response to a regimen that DOESN'T make you feel sick?

Your oncologist might choose a tried-and-true combination of drugs, with response rates ranging from 35–60%. These include AC, CMF, CAF, FAC, or AT (AT is six cycles of "A" for Adriamycin and "T" for one of the two taxane drugs, Taxotere or Taxol). Or your oncologist may choose a single agent such as Adriamycin, or either Taxotere or Taxol (with a response rate of 30–60%). Other combinations are also widely used, and may end up being the ideal chemotherapy combination for you.

For women with node-positive disease, a common treatment regimen is four cycles of AC, followed by four cycles of Taxol or Taxotere. Read more about different combinations of chemotherapy drugs. In women with advanced cancer, Taxotere has been found to extend survival longer than Taxol, but with more side effects.

A new chemotherapy called Abraxane contains paclitaxel, the same active ingredient that's in Taxol. Abraxane is made with a protein base instead of the Cremophor base of Taxol. Cremophor, a derivative of castor oil, makes paclitaxel more toxic and can cause serious allergic reactions. But Abraxane seems to be easier to tolerate for women with metastatic disease and women don't have to be treated with steroids before taking Abraxane, as they do before taking Taxol.

In the past, a combination of high-dose chemotherapy and a bone marrow transplant was used to combat the most aggressive forms of breast cancer. But then two large studies showed no clear proof that this treatment makes any difference in how long someone lives. In addition, the procedure of high-dose chemo and a bone marrow transplant is associated with more serious and life-threatening side effects when compared to standard-dose chemotherapy.