Now what - Taxol not tollerated - 1270421

clemclem44
Posts:36

I’m trying to make heads or tails of my mom’s current results. She has been on a full cycle of Taxol and did ok but the last few weeks she’s had headaches and her nausea was really bad. The dr. stopped the chemo for now until they could evaluate what the headache/nausea were from and feared a brain met. Though now she’s much improved and it was decided to opt out of the brain MRI for now.
Her scan results this go-round with a full cycle of Taxol shows potentially more dense plural cavity with “maybe” debris or mass but because she’s allergic to iodine she cannot do full contrast scans.
The bone lesions on her spine are continuing to “break down” (I assume the bone – she has had back pain).

We’re awaiting an appointment on the 22nd to explore Nivolumab or Taxane as the next step. If Taxol didn’t really give us awesome results what are the odds that these others will? It seemed that Taxol was the drug that her Dr. wanted her to take and it was perhaps more aggressive. I’m just not sure what to expect.

She has lost a good deal of weight and probably is struggling to stay above 100 lbs. but thankfully has gotten her appetite back. Though just days after he last treatment she looked terrible. The worst I had seen her. It scared me. And reminded me that she’d been at this for a while.

When would radiation be put into the mix to slow or help with the spine mets? She has already been treated with radiation on each side of her chest for her 2 occurrences of breast cancer. Seemed they didn’t want to use it until it was used for palliative care. Not curative because she’s been so radiated already. Why is it that the brain isn’t scanned during these visits? I guess all along I thought this was a contrast PET scan and that he’s looking for the “lit up” area’s. I was surprised by this because I thought that it likes to travel to the brain and we probably need to pay attention to that area.

Thoughts?
what does this road look like?

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JimC
Posts: 2753

Hi Carrie,

I'm sorry to hear of your mom's problems with Taxol. It's not unusual for patients to need treatment breaks due to chemo toxicity, and the fact that she is feeling better tends to indicate that is the cause. If it were a brain met she would be unlikely to be feeling better.

Radiation for spine mets is generally used to prevent fractures and/or alleviate pain, so that would be a judgment call made in consultation with her doctor, based on a current evaluation of her pain and fracture risk.

If your mom had a brain MRI at the time of initial diagnosis, it's not typical to repeat that scan unless symptoms warrant it. A PET scan does not image the brain well, because the entire brain "lights up" under normal conditions.

Finally, even if Taxol is not effective or cannot be tolerated, since she has responded to previous lines of chemo, she may respond to another agent, such as the Nivolumab or Taxotere recommended by her doctor. Although both Taxol and Taxotere are taxanes, there is evidence that a patient may respond to one after progressing on the other. And Taxotere is specifically approved as a second or later line of therapy.

Good luck with your appointment.

JimC
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