Search Results for '5fu'

Hi,Fatema,

If I remembered correctly,you mentioned reduced dose of cetuximab may be used for your mom by her oncology because your mom also has radiation treatment. If so, then the acneiforn rash may not be as severely as it should be.(the dose in the Gruenberger trial is 500mg/m2 for cetuximab on day 1 and repeated every 2 weeks for 12 cycles.) 13% of the patient (pt.pop=30 pt) had Grade 3 skin rash and overall,in clinical studies of cetuximab, acneiform rash was reported in 76-88% of 1373 patients. Therefore you may be correct in the assumption of the “mild” rash may not produce the desire response it should be for your mom.

“There is a trend toward improved survival with increasing grade of rash,with grade 3 rash appearing to have a longer survival as compared to patients with less severe skin rash”–direct quote from clinical pharmacology on drug info. for cetuximab.
From the same resource,,when discuss about colonCA patient on cetuximab in combination with other chemotherapy,”No benefit was observed over chemotherapy alone in patients whose tumor expressed mutant K-RAS.— In contrast to K-Ras wide type patients showed significant improvement in efficacy endpoints over chemotherapy alone.”
You may have to look into whether your mom is KRAS mutant or not.
As you know GEMOX+C or P are clinical trials use for other tumors.
The one study below is for Squamous cell carcinoma and is not using GEMox;they use cis/5FU+cetuximab ,but the strength of recommendation is strong and level of evidence rating are high and date of review is very recent 11/09/2011 take a look ;1.Vermorken J,Mesia R etal. Platium-based chemothrapy plus cetuximab in head and neck cancer. N Engl J Med 2008;359:1116-27.
I had studied the article”Targeted Therapy for Biliary tract Cancer” by Junji Furse and Takauji Okusaka,that you have mentioned about 3 months ago;. I did not looked at the Franch study but I did looked at the Austria trial done by Gruenberger because it was cited most often in the States.

In my opinion, except the Gem/Cap+ Avastin that personally I have observed from my sister -in -law. with amazing results except the perfolation of the colon( I think patients who has diverticulitis are prone to this side effect if they take Avastin or other similiar targeted agents.);
Targeted therapy is still a long way to go . A well-known GI specialist who have done a lot of work on CCA at one of the most famous clinic specialized in CCA told me about Sorafenib may be of value to CCA patients;but I take a look at the old studies; sorafenib is not that special,but indeed as he said to me about 3 weeks ago, it is a targeted agent that target a lot of different signaling pathways in cancer cells. May be something is new on the horizon for that drug .
BTW,You may have read this too. it is by L.H.Jensen” Marker driven systemic tx of inoperable CCA: Panitumumab and combination chemotherapy in KRAS wild type tumors.”it is on the ASCO web site under ACSO 2011 poster abstract No. 4010.
I talk to the author Jensen during the 2011 ASCO convention, he said hopefully the results will be updated this year.
I still haven’t heard from the member’s response for the permission.I will keep you informed as soon as possible. But the side effects of his/her tx of the GEMOX+cetuximab is in line with the Austria trial .
The Austria trial did not tell us the “endpoint” (PFS or overall survival); however,he Poster #4020 will provide some insight on this front even it is not cetuximab.)
God bless.

Hi,
If my info is correct. S1 will be available in the States in a couple years.and is now under studied by the FDA for its effectiveness as compare to Xeloda.

Last year,when I attended the ASCO 2011 convention there was a poster about s1, and the gentleman on duty indicated that they will try to market S1 thru a larger drug company in the States. I will get more info about S1 in the up coming ASCO2012 convention.

Basically S1 is like the Xeloda (Capecitabine) that is current available in Europe and in the States. these are the prodrug of 5FU taken by mouth.
God bless.

Hi Jtoro,

I was on FOLFOX (5FU, Oxaliplatin and leukovoran) for 6 months before it stopped working. I don’t think it was that bad. The worse was having to wear a pump for the 5FU for 2 days… just an inconvenience really. I had some hand and foot syndrome, but not as bad as when I was on Xeloda. The results certainly made it worth being on it. Take care and God Bless,
Jamie D

Hi Jtoro,

My wife was on 5FU for six weeks, combined with radiation. The worst side effect from 5FU was hand-foot syndrome. You can find TONS of information about it by doing a google search:

http://www.google.com/search?q=hand+foot+syndrome

Re second drug: the name is oxaliplatin. Do another search of the old posts using the correct spelling. Hopefully you will find more posts.

Best wishes,
Eli

Hi,shar,

5FU/oxilaplatin is tough to take; I presume they do labs before each chemo treatment to see whether your mom can take the chemo or not on that day. If the hemoglobin or the WBC or the platelet counts are low,;the lab should be reviewed by oncologist or the PA first to determine your mom should or should not have the chemo on that that day. Even if so,as a patient you can refuse treatment at any time.
And as the right of the patient;he/she can refuse treatment at “the point of treatment ” too without being charged(What I mean is that if the chemo were made and your mom do not feel up to it and refused,she cannot be charged for the chemo that had already made even cost thousands of dollars to the hospital.( ie: the new drug “Yevoy “cost 50.000 average/dose to the HOSPITAL.,the pt. cost will be much higher)
Here is my answers for your questions.

1.”My question is would the quality of life improve (even if just for a few months) if we stop chemo?
for me ,that is not a difficult question for me to answer;but may be difficult for some people to understand if you do not keeping up and continue to do your research on this subject:
the answer is YES.but the consequence of the overall treatment will be UNKNOWN till scan time.( If I may, i will suggest your mom having scan every 3 month instead of every 6month for disease in the active treatment state,)
2. ” Can you start again once you have stopped? ” that will be determined by your oncologist.

My own opinion is that,for myself as a patient, quality of life is much more important than just laying on the bed and receiving the tender loving care by all those who care about me.
For example I will miss very much of my wife’s tender loving care who prepare each meal perfectly for me 3-4 times a day;pray every nite with me;and my son who always find time to talk to me at nite before going to bed;ask how i am doing during that day;and before going back to his room,he always give me a good hug each nite and say good nite before leaving;and he is a 25 years old christian who works late hours.
The point is as a patient myself, the KEY is try to PREVENT or IMPROVE my disease from getting worse.this is the most important point of seeking treatment,but if the outcome is to the contrary ;then what is the point or purpose of receiving treatment and seeing those who love me so much suffering each day inside but maintaining a uplifting face outside to please me,the patient.Don’t you think the caregivers are not suffering too?
Chemo and targeted agents still is a long way to come for prolonging life(i mean quality of life) and cure.
God bless.

Hi,Jtoro,
I hope you meant you take Vicodin tablet 5/500 or Vicodin ES,3-4tablet total per day,if you need stronger strength,switch to Norco 5 or Norco 10 because Norco contain less acetaminophen per tablet but equal in content of hydrocodone,the main narcotic ingredient for pain.
Back to the discussion, both reports indicated STABLE disease for the multiple low density liver lesions and omental carcinomatosis ,with the latest report of suggestin some of,but Not all of the low density liver lesions and omental carcinomatosis MILDLY or SLIGHTLY increased in size.

In my opinion,I will suggest to accept D.r Lenz” the 3 drug combo” for another cycle as Dr. Lens original decided, I think he was right on that.
as I also indicated in the last message, you need to rediscuss your concern with dr. Lenz if you are not 100% sure. You donot want to upset the doctor,most of them ,especially those who are of the highest regards may get offended by information patient get from the internet even the research infomation were done by their respected peers on the same field. It is totally depending on the personality of the doctor,some are open minded,some are not.Remember I am only a patient and not a doctor. And my suggestion cannot match the experience of Dr .Lenz for sure.
5FU/oxaliplatin may works too, but as always,you have to try it first to know whether it works or not. Again, as whenI first answered your message,I said,
“This is a difficult decision”,indeed it is.
As a Christian,during the course of my treatment,as you may know,I read a lot in addition to my understanding of my disease, therefore I have more choices to choose From. In such events,I always let the Holy Spirit guide me through, it sounds I am so undecided and needs Devine intervention and I am stupid,but as patient myself,I know ,for most of us, we cannot do much to help ourselves because of our health and time is not on our side, therefore the thinking process of the existence of us on this earth are always on the backs of our mind no matter what suggestion otherwise.our worry are very different than our caregivers ,our fear are in a very unstable situation ,our so call reasonable expectation become unreasonable ,and that is why ,especially me because of my knowledge of this disease may be actually a hindrance for me, I pray a lot ,I need the Holy Spirit to guide me. A study on the use of alternative or complimentary medicine(CAM) indicated patients who have higher education level ,most of them will seek CAM as treatment also. why, because as patients we are really think that ,the more we know,the best chance we can have,but sometimes it may not work that way .that is why I need the Grace of the Lord for guidance,until now His Grace is more than I could ask for.
If you are not a Christian,please forgive me for my venting.you know,sometimes tough and stupid man like me still need to talk out loud to relief the emotional burden even on the surface , I always present my best front to all those who know me.
If you are a Christian,Just leave all your problems to our Lord,Jesus Christ, on earth as in heaven, he will give his best for us. And for the others who think I am too religious and lost my marbles at this moment, my answer is NO. I just know that human limitations cannot provide the timely and urgent treatments that we need now for us,the patient.
God bless.

Hi,

2 things, which you may have known already.
1. AVOID cold drinks,use of ice cubes;touch of cold materials and housewares like cups.etc.
2. Felling fatigue is normal unless interfere with daily activities like dinning or reading a book or taking a walk .

Xeloda is a prodrug of 5Fu which your husband had before;except taken by mouth.
Oxaliplatin is the third generation of cisplatin (newer with supposed less side effects);but since your husband was on cisplatin before;please REMIND the chemo nurse on the FIRST treatment of oxaliplatin to watch out for anaphylactic reactions(such as difficult in breathing,shortness of breath,rash,itching and hypotension,it can occur within minutes of staring the oxaliplatin the FIRST time of treatment.) and make sure drugs as epinephrine,solu-medrol,antihistamine like benadryl injection are available ON HAND just in case.

the only other things you have to watch which may not be on the patient information list you got are ,

1.Make sure the time of oxaliplatin infusion will be around 2hours but NOt longer than 6 hrs to avoid acute toxicities.
2.Use of an injection port to avoid severe tissue irritation as comparing to each time of sticking a vein and increasing the chance of extravasation .
3. If the patient is on Lanoxin(digoxin) for heart problem;talk to the doctor to adjust the dose of digoxin if needed.
4.drug interactions with filgrastim,G-csf etc may occur and you should discuss with the oncologist.
God bless