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Oncology (General Cancer)/WBC low threshold for Taxol administration



My mother has Stage IV metastatic lung cancer. She has been through other chemo protocols, but her oncologist is now of the opinion that Taxol administered every 3 weeks is the best treatment plan.

However, she has not received treatment yet (going on a month) due to low WBC counts. Her WBC is 1.6. The normal range for this lab is 4-10. Due to this the center will not administer the Taxol.

I can't help but feel like this particular center is being too cautious, and given the fast moving nature of this cancer, it would be behouvious to give the Taxol.

Is there a general accepted low threshold for WBC counts when it comes to a "go-no-go" decision for Taxol administration?

I would be concerned as well with a white count that low.  Has your mother had a trial of Iressa, which is a pill that usually doesn't affect the bone marrow?  Your oncologist could also give taxol along with a drug like Neulasta, which increases the white blood cell count.  The real question, though, is whether there is anything likely to work if she has been through "other protocols".  Generally the third attempt at controlling lung cancer is very unlikely to work at all.   I don't know your mother's case of course, but it might be time to consider palliative care and not worry about chemotherapy, which at this point may be likely to produce toxicity without benefit.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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America's Best Physicians, last 14 years

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