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Breast Cancer Blog: Dose Dense Chemotherapy And Survival?

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Dec 7, 2005

Dose Dense Chemotherapy And Survival?

Dose Dense Chemotherapy And Survival?
What is dose dense chemotherapy for breast cancer? Conventionally adjuvant (post-operative) chemotherapy for early stage breast cancer is given once in three weeks. This three weeks frequency is chosen because of the biological effect of the chemotherapy drugs. It takes about three weeks for the white cells in the body to recover from a standard dose of chemotherapy drug. It is thought that the cancer cells recover much less in these three weeks compared to the normal cells.

A little while ago some smart researchers like Larry Norton from Memorial Sloan-Kettering Cancer Center in New York and his colleagues developed a strategy to reduce the frequency of treatment from once in three weeks to once in two weeks. They thought, if the patient is subjected to chemotherapy once in two weeks this would probably mean hitting the cancer cells harder when they are more vulnerable. These researchers developed a clinical trial in which the chemotherapy was administered once every two weeks instead of three weeks. They used white cell growth factor known as neupogen (filgrastim) to stimulate the white cells so that they recover in two weeks leaving the cancer cells susceptible to the effects of chemotherapy. What a smart idea?

These researchers used three drugs for the treatment (adriamycin, cyclophosphamide, and taxol) and this regimen is now known as dose dense chemotherapy. After all, the gut feeling of these researchers proved to be right. The dose dense regimen showed improved survival. More surprising was the finding that once in two weeks chemotherapy caused fewer side effects compared to once in three weeks chemotherapy. Do you know why? Use of the white cell growth factor decreased the risks associated with low white cell count. The rest is history, dose dense chemotherapy has become a standard practice in the United States for patients with node positive breast cancer.

This is past story, now a group of Italian researchers were trying to duplicate the results of this study, and found no improvement in survival for dose dense regimen. However they found that once in two weeks chemotherapy was associated with minimal side effects.

There were some limitations in direct comparison of these two studies. The Italian researches used a different chemotherapy combination. The study was designed to look for 32 percent or more improvement in survival, and trial did not attain its planned enrolment and was stopped prematurely. These factors make the direct comparison of these two studies difficult, but I would agree that more studies are needed to resolve the issue.

Agarwal MD      

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Do You Read All Of Blogs?
Do you read all of the blogs published by Many of our bloggers are busy keeping you updated on the various health related topics. We publish the following blogs at this time.

Cancer blog: I manage the cancer blog with lots of help and support form other bloggers. Through this cancer blog my friends and I try to bring stories of hope for patients with cancer. The cancer blog often republishes important blog posts from other cancer related blogs at If you are searching for a blog that covers wide variety of cancer topics, this may be the one for you.

Breast cancer blog: Breast cancer blog is run by Emily and other bloggers and they bring you the latest stories, news and events that are related to breast cancer. Increasing awareness about breast cancer among women and in the general population is the main goal of this breast cancer blog.

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Breast cancer
Every year, more than 200,000 women are diagnosed with breast cancer in the United States. Breast cancer ranks second as the leading cause of cancer deaths in American women. Until recently breast cancer topped the list of leading causes of cancer deaths in women, but lately lung cancer has claimed the top position. If skin cancer is excluded, breast cancer is the commonest cancer among American women.

Breast Cancer Blog: Dose Dense Chemotherapy And Survival?

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