Chemo #3 Postponed

I went to Stanford today for my third chemo session. Blood test showed that my WBC (white blood cell) count was 32. Way too high. Normal range is 4-11. Taxotere lowers my WBC, and I get a Neulasta shot to raise it back up. Dr. Caswell thinks I'm a hyper-reactive to Neulasta and recommended switching from Taxotere to Taxol so that I can skip the Neulasta.

Dr. C has recommended Taxol in the past. I refused because Taxol is given weekly and I would have to fast every week. But I said yes this time. I will modify my fast to two days instead of four, but I will have to limit my fasting diet to simple vegetarian soups and broths, no nuts.

There are advantages and disadvantages to switching to Taxol. First the disadvantages:

• Weekly infusions instead of every three weeks. That means six more chemo sessions instead of two.
• I have to fast more often and with a limited choice of food but for a shorter period.
• I will be given Benadryl to prevent allergic reactions, and it will probably make me drowsy. I hate feeling so drowsy. And I won't be able to drive myself to the chemo sessions.
• Because my last chemo session will be on approx. Feb. 22 instead of Feb 4, surgery will be delayed by at least 2.5 weeks, most likely in April instead of March.

Advantages:

• Fewer medications to take. While I'll be given dexamethasone at the infusion, I won't have to take it for three days at home. I can limit Zofran to once a day, which should minimize the accompanying constipation. I can also skip Ativan, Neulasta and Claritin.
• Milder side effects. Or so I'm told. 
• I had read in the past that Taxotere works better than Taxol. But the recent DAPHNE trial showed 55% pCR (pathologic complete response) using Taxol. 
• Taxotere can permanently block tear ducts and cause permanent hair loss. Taxol doesn't have these side effects.

I'm still waiting for my insurance to approve the switch to Taxol, but my next chemo is tentatively scheduled for Tuesday, Jan. 19.