Search Results for '5fu'

Hi,
The key to Chinese Herbal medicine is to find an experienced practitioner(very important);please read about this under our experience forum title under “Complimentary and alternative treatment”

HCC is relatively chemotherapy-refractory tumor .Systemic chemotherapy is usually not well tolerated by ptients with significant underlying hepatic dysfunction(ie: liver cirrhosis,hepatic B or c involvement).
In general, monotherapy like 5FU,gemcitabine,irinotecan and thalidomide have been used;combination therapies of cisplatin with other agents like 5FU,,Xeloda,gemcitabine,doxorubicin have been done also. GEMOX and FOLFOX and XELOX are regimens that can be of use.
Summary: The efficacy of cytotoxic chemotherapy is modest in patients with HCC.— “Systemic treatment for advanced HCC”– from uptodate.com literature review version19.3 sept.2011.
Targeted agent like Nexavar( ie:400mg twice a day) provide some benefit to patients and the treatment is well tolerated(side effecgts included diarrhea,hand-foot skin reaction) the treatment outcome depended on the health status of the patient(ie:degree of liver cirrhosis) at the time of diagnosis.
Other targeted agent like Avastin,sunitinib(Sutent),erlotinib,cetuximab have been used for HCC as clinical trials when used in combinations.
Hormone therapy like tamoxifen,megestrol and octreotide have been studied in advnced HCC but cannot be recommended outside the context of a clinical trial.
If there are no spread or mets outside the liver, 2nd opinion or consult by interventional radiologist is recommended to consider other radiation treatments like RFA or radioembolization is of value to the patient.
I hope the info helps.
God bless.

Hi Melissa,

We live in Uniontown, Ohio which is about an hour south of Cleveland. So believe me, if this hospital wasn’t great, we sure wouldn’t drive that far. Lauren lives at home with us and our son, Ryan. As far as the chemo goes, I think the combination of those 3 are pretty powerful and very rough on a lot of people. Lauren might have an easier time because she is young and healthy. The main thing to remember with chemo is to keep up with your nausea meds. Lauren takes them around the clock for two days after chemo. You will probably be given Zofran and Compazine for nausea. Zofran gave Lauren headaches so she only takes Compazine. If she takes it once she is really nauseous, she will usually throw up, so take it at the first sign of nausea, not when it is full blown. With the three chemos, Lauren would feel like she was run over by a truck for a few days after. After she had 12 rounds of chemo, Dr. Z took her off the Cisplatin for a while to give her kidneys a rest. It is the hardest of the three to take because Lauren feels fine after chemo with only the other two. It also lowered Lauren’s platelet count quite a bit and she had to skip a few chemos because they were low. They have to be over 100,000 to receive chemo. The 5FU is administered in a pump that is hooked in to the port. Your Mom will wear it home for 48 hours, then have to go to the hospital to have it disconnected. It is put in a pouch that your Mom can wear like a fanny pack or over her shoulder. It is kind of a big pain for sleeping and all. Since we live so far away, a visiting nurse came out once, didn’t know how to unhook it and Lauren freaked out. After that, I asked if I could be trained to do it myself, and a nurse educator at the hospital trained me to do it and I have done every one of Lauren’s disconnects with no problems. That could be an option for you if you wanted to do that. Theraspheres is not real common. I know Dr. Sonnenday thinks it is a really good treatment option. Radioembolization is when millions of tiny, I mean like smaller than a fine grain of sand, glass beads of radiation are shot directly into the liver tumors to kill them. They are put in through the groin in an artery. Lauren had a practice run with dye on Thursday to see if she is a good candidate for the procedure. She is scheduled for the procedure on May 16. They are called Theraspheres or Sirspheres. Two different companies. They come from Canada. They are not approved by the FDA in the US. They have some promising outcomes though. Well it is getting late. I need to go to bed. Any other questions you may have, feel free to ask away. If I don’t know the answer, there are so many very bright and helpful people that will know. Take care and all the best. Maybe we will both be there for treatments one day and can meet.

Love, -Pam

Oh my gosh Melissa. Now I am thrilled to meet you. You live in Ann Arbor. How lucky you are to be that close to the hospital. My daughter’s name is Lauren. She just turned 26 in March. She was diagnosed on Aug. 29, 2011 after a liver biopsy ordered by Dr. Sonnenday. My daughter, Kristen, is 3rd year anesthesia resident at the hospital and she spoke with Dr. Sonnenday about Lauren and that is how we found him. He is the most wonderful doctor we have ever met. He gives us hope. Dr Zalupski is great too. It took us a little longer to warm up to him. Being an oncologist, I think they are taught to give the bad news and keep a distance. He has come around though and I really think he loves Lauren. He really cares so much about her. Lauren is doing really well. She is in a clinical study where she received Gem/Cis and 5FU. She had one large tumor and a few small tumors. The large one was the size of a canteloupe. It has shrunk at least 4 cm. The small ones have as well. We spoke with a radiologist a few weeks ago and her large tumor is now 50% necrotic (dead). She just had a mapping procedure this week to see if she is a candidate for Theraspheres. In a nutshell, this a form of radioembolization where tiny glass beads of radiation are shot directly into the tumors. If this kills her tumors, she might be able to have a resection. When we first started out, I think everyone thought Lauren’s future looked mighty grim, but with the help of these wonderful doctors, things are looking better. She feels great most of the time. Her back hurts, but that is about it. Chemo is hard on people, but she has had an easier time than most with it. She did lose her hair. Cisplatin was the hardest drug for Lauren to handle. Her platelets would go pretty low and she had to miss a few treatments because they have to be over 100,000 for treatment. She is only on Gemzar and 5 FU now because Dr. Z wanted to give her a break from it for a while. It is hard on the kidneys. If you have any questions at all, feel free. I have learned so much from this site. I felt lost when I first joined and had not a clue about terminology or anything. This site has been such a blessing to me. I hope it will be for you as well. I wish you and your Mom all the best and I can say she is in the best hands at U of M. God bless.

Love, -Pam

Dear THennesy,

I would like to welcome you to this site. Some will say chemo does not work. I can tell you that it has worked for my daughter. She has been on Gem/Cis and 5FU since Sept. 2011. Her tumors have shrunk and her large tumor is 50% necrotic (dead). She is now getting ready to have a radioembolization procedure. Everyone thought my daughter’s prognosis was very grim at the beginning. We have never given up hope and never will. She feels better now than she did before the chemo. So, go into this with a positive outlook. It makes all the difference. God bless you.

-Pam

Hi,
welcome to our small world.
1. Gemcitabine and Cisplatin are the current standard of choice of Tx for cholangiocarcinoma(CCA). there are still many other regimens to choose from if this one is not suitable for your mom in the future.
Gemcitabine is easy to take,minimum side effect like low platelets count is one of the the most stand out side effect. Nausea and vomiting,loss of hair,fatigue,body ache,nephrotoxicity(kidney);hypomagnseium and hypopotassium are side effects of cisplatin. Nephrotoxity is accumulative and therefore ,depending on the health of the patient,after certain # of cycle(ie: 6 cycles) ;review of the regimen may be a good way to protect esp. the kidney if the side effects cannot be tolerated well.
To start the chemotherapy each time overnite is a good idea and I don’t know why we cannot do this here in the States. It is less anxiety to the patient and they can sleep thru some of the unwanted side effects of the chemotherapy.
2. 63 years young and otherwise healthy individual after left liver resection, (even had a lympth node positive involvement )has a good chance to live long enough for the next new thing to come in radiation oncology or/and medical oncology to extend our lives with much less side effects and enjoy God’s mercy for those who suffer. I do not see a “magical pill “will be discovered in the near future like penicillin for infection that provide a “CARE” for us.
3. Continue to pursuit other options such as radiation treatment ;read and learn about it and other development of treating this CCA is the way to handle this disease. I am a CCA patient for 35months,like your mother,I had the left lobe completely resected;on gemcitabine for 14 months;off the chemotherapy for 6 months,CCA came back;RFA and chemoembolization; then re-resection again.Now is only on Xeloda(pro-drug of 5FU);and the rest is up to God’s mercy.

what I am trying to say is this; CCA is a long and winding road to navigate ; it require courage,knowledge and patience; it is not easy but it can buy time for your mother.
keep in touch,
God bless.

Mymom-I took XELODA for 5 months while waiting for transplant, I had no side effects. I did receive a weekly phone call from the Xeloda company nurse.
I also had radiation with a 5FU pump prior, for 6 weeks with no major side effects. I did become extremely tired at the end of treatments, just competely wiped out, I just climbed in my recliner and stayed there for a while.
Lots of prayers and HOPE-Cathy

Hi,
there are no standard protocol .normally is 6 cycles and scan for progress of the treatment and determine the next step to go forward or change to another treatment for the cycles that is recommended for that new chemotherapy, Kris is right on her assessment about the treatment plans for CCA. In short, they are trying what they think is good for the patient at that point of time (the time of appointment). I still don’t think chemotherapy is the way for finding the cure fast enough for most of us who suffer for CCA.
Most of the chemo regimens is for 6-8cycles and scan for results ;as you can see on this web site there is not uncommon to be on Gem/CIS more than 6 cycles.;not to mention Gemox ; Gemzar or 5FU monotherapy which the manufacturers indicated ” till disease progress or side effects intolerable.” as the criteria to stop the use of the drugs. that means if the drug works , the therapy can be used for life.(what kind of quality of life is that?).

My suggestion is that you are always prepare psychologically the CCA will be back,(>65%);do not expect otherwise. so if this is what you believe and agree; then “to stop the treatment and wait “may not be the best option; but I also know patient are tired of chemotherapy(I know, I am on Gemzar,the easy one for 14 month and I hated it.)
So the logical choice here will be just have the Xeloda 2 or 3 tablets twice a day,but make sure you talk to the oncologists first and he agree,he is the doctor and i am only a patient .I think in that way ,the patient still have chemotherapy to control the CCA but can avoid the harsh side effects of oxaliplatin or cisplatin . The patient will have both sides of world -less and tolerable side effecte and stil have chemotherapy to keep the CCA under control.
Yes, there are side effects on Xeloda,but I think if your want both the worlds(good and bad); Taking Xeloda by mouth is my choice under you circumstances.
God bless.

Hi,
unless your are using the infusion pump like 5FU 48 hr pump for longer duration of infusion per cycle.
the current protocol for Gemox do not called for such infusion scheduled use of the chemotherapy.
Gem/cis is less tolerable than Gemox. and most of them is 1 week with both drugs and the second week just give Gemzar.
but as you know physicians can use the referrence protocols any way they like .
If you can tell me what you mean by High dose eg.give me like I will be on Gemzar 1000mg/m2+25mg cisplatin or Gemzar 1250mg/m2+50mg or 75mg of cisplatin and is that regimen give once a week or twice;then I can have some ideas.
the following web site may be of some value to you even it does not have the most up-to-date regimens on bile ducts cancer as on our chemotherapy web page.
http://www.chemoregimen.com

God bless.

Tiffany,
I was on xeloda for 19 months. Three pills in morning and three at night. The only trouble I had was feet peeling and numbness, but nothing I couldn’t handle.
It got to be a little too much after a year, so he cut me down to 4 days instead of 7. I never got the mouth sores or any other side effects. I was on this with Gemzar for 19 months, then had to switch to 5fu/oxilaplatin which I’m on now.
Best wishes to you on this new treatment. My prayers are with you.
Jtoro

Tiffany-I had gemcidabene, 5FU and XELODA. I had the 5FU pump 24/7 while doing 5 days a week, for 6 weeks of radiation. My main side effect was extreme tired!!
Lots of prayers-Cathy

Hi Lorraine,

If your Mom is still getting headaches, it could be from the Zofran. My daughter took Zofran the first few times after chemo and had migraine like headaches. We stopped the Zofran and use Compazine instead and no more headaches. She takes Ativan at night to help her relax, but has also taken it for nausea. My daughter’s chemo regimen has recently been changed. She had been on Gem/Cis and 5FU for 12 rounds of chemo. Her doctor decided to take her off the Cisplatin and just use Gemzar and 5FU for awhile because Cisplatin was causing her platelets to drop and about every 4th time she had to miss chemo. He feels that she will be able to get her chemo every time because she won’t have this problem anymore and he feels the benefits of having chemo regularly is better than having to skip with the Cisplatin. Cisplatin must really be the rough stuff because this week she only had the 2 chemos and felt like a million bucks. Every time she had the 3 chemos she would be really tired and achy for 3 or 4 days. This time she never felt bad and went shopping all day wearing her 5FU pump and also went on a 2 mile walk!! I have worries that her chemo won’t be as effective, but the doctor said he will add oxaliplatin if things start getting worse. I am not a doctor, so I have to trust that he is doing the right thing. When Lauren had her 3 chemos it was always Gemzar first, hydration, Cisplatin, hydration, and then pump hook up. The Cisplatin is what made for a very long day. This time she was in and out in about 2 hours compared to 6-7 before. I wish your Mom all the best in fighting this disease. Take care and God bless.

-Pam