4 vs 6 cycles?

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I was diagnosed with multifocal invasive ductal carcinoma, HER2+ in July last year.  Two lumps - 10mm and 3mm and scattering of other bits which could become cancerous.  I had a mastectomy in October after complications with a nipple sparing mastectomy in September.  Cancer was found in two quarters of one lymph node and had another 13 removed - they were all clear.  CAT scan and PET scan all clear.

I started chemotherapy in December - Docetaxel and Carboplatin and phesgo for the HER2+.  My oncologist recommended 6 cycles, with a minimum of 4 and 18 phesgo with radiotherapy to follow the chemo.

The first two cycles were very rough and I've had two dose reductions and agreed that I will do 4 cycles rather than the 6.

I have since had a letter from my oncologist (who I am seeing today) stating that we'll see how I am and stating that my treatment plan is still to have 6 cycles.

I feel rather at sea.  I thought we'd decided on the 4 cycles with my 4th due in 2 days.  So close to getting my life back.

Yes, this last cycle has been 'better', but I'm still off work with horrible side effects and exhausted.

If 4 cycles are 'enough', why do 6? Am I putting myself in harm's way stopping after 4?

  • Hi Frendabroad

    Thanks for getting in touch and welcome to the Macmillan online community. I hope you’re finding it supportive.

    I’m sorry to read that you are having issues with side effects from your treatment. It is difficult when you thought a decision had been made and now that plan appears to have changed. We would encourage you to discuss this with your oncologist today and let them know how you are feeling about it.

    The decision about length of treatment is made by your team. They are looking at the best outcome for reducing the risk of recurrence, but also taking into account the impact of the side effects of treatment. As we do not have access to your NHS notes we would be unable to say if 4 cycles would be enough. This is something you would need to discuss with your oncologist.

    You may find the information on making treatment decisions helpful.

    The emotional impact of treatment can be difficult. We offer free specialist counselling to people with a cancer diagnosis. You may find this support beneficial.

    I hope this information helps. Please feel free to get back in touch if you want more information or support.

    Best wishes,

    Fiona M,

    Cancer Information Nurse Specialist 

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email

    Ref/GJ