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by secondary breast cancer

Research. Support. Education.

Paclitaxel: Patient Experience

3rd October 2021 by Angela Brant-Segarceanu Education

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As part of our series looking at different chemotherapy treatments for secondary breast cancer, Angela Brant-Segarceanu shares her experience of Paclitaxel (Taxol) this week.

 

When were you diagnosed with secondary breast cancer?

 

I was diagnosed in January this year after 6 1/2 years cancer free, following an emergency hospital admission for chest pain. I was 37 1/2 weeks pregnant at the time and had been using crutches to get around for a couple of months.

 

Where are your mets located?

 

I have extensive bone mets throughout my skeleton the worst of which involves my hips and spine. I suffered from collapsed vertebrae and spinal compression immediately after the recurrence was first discovered. I also have small areas of disease in the lymphatic system of my lungs.

 

What treatment line are you on?

 

My disease is currently stable so I have chosen to have no active treatment at the moment apart from denosumab injections to strengthen my bones. I am instead under close surveillance - I see my oncologist monthly and have bimonthly scans. When I was taking paclitaxel I had a weekly IV schedule.

 

What is/was your experience of  Paclitaxel? 

 

When I started Paclitaxel I knew there was a good chance it would be gruelling. I was treated with Docetaxel, another taxane chemotherapy, for my primary and that wasn’t fun at all! This time my oncologist gave me a choice between Paclitaxel and Capecitabine, a generally kinder oral treatment. I plumped for the former to give the disease a pummelling and reduce my tumour burden. It was pretty awful to begin with - my hair fell out quickly, I was dog tired and I lost my appetite, something very unexpected for me! I also experienced flu-like symptoms from day 3 to day 6 every week (the pre-med steroids perked me up for the first couple of days). I never had nausea though, surprisingly, and didn’t need my anti-sickness medications at all.

 

I told my team about my symptoms and the dose was reduced to 75%. This improved things substantially and allowed me to be more functional. The symptoms never went away but it allowed me to continue almost to the end of my treatment. I was due to complete 8 cycles of 3 weeks. However, during the sixth cycle I developed neuropathy (reduced sensation and tingling/pins and needles) in my toes and the soles of my feet so the decision was made by my team to stop treatment to try and avoid permanent damage. I believe this is fairly common with Paclitaxel. That was in August and I still have the neuropathy, but I’m hopeful that it will reverse at least partially in the next few months. 

 

During my treatment I achieved partial remission - my bones started to heal and my lungs are in better shape with no pleural effusions. So a good result and worth the hassle of going to the hospital twice a week (once for a blood test, once for treatment). My energy came back very quickly after stopping treatment and I’m currently feeling pretty good, much better than when I was diagnosed.

 

As an added bonus, the chemotherapy appears to have cured my other chronic health condition. I’ve had Postural Tachycardia Syndrome (PoTS) for five years and have been unable to work. There is some suspicion that it is an autoimmune condition and it appears to have been in my case because my neurologist believes that the paclitaxel is responsible for it suddenly remitting. 

 

What advice, if any, would you give to someone about to start this treatment?

 

Take a blanket to treatment because the pre meds will make you sleepy! I often slept through my treatment but then again I did have a new baby at home. Be prepared with your wig or scarves or whatever you choose to cover your head with because your hair will unfortunately go quickly. Snacks, especially dry snacks like raisins, help with the loss of appetite should that arise - a meal often seemed impossible for me so I ate what I could when I could. MacMillan has tips for easy high calorie options if you start to lose weight. 

 

Make sure you stay in touch with your team regarding side effects because there are things that can be done to make them manageable, including dose reduction. I thought bad side effects were just part of having chemo but, especially with secondaries, your comfort is paramount. Also I found that trying to be active, talking to friends and family or busying myself as much as possible helped keep my mind off the symptoms. Try and work a nap into the days when your symptoms are worst, I found there was a pattern and taking that time helped me do more with the rest of my day. Above all, take care of yourself, do what you can and don’t beat yourself up if you need to rest.