Search Results for '5fu'
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Search Results
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In reply to: Mum on chemo (only Gemzar)
Hi,
As always,this is for information purpose only,consult doctor before any change of treatment plans is a must.
Gemzar or gem/cis do not seem to offer an advantage for ductal cancer
(eg hilar CC) patients as for intrahepatic CC patients; 5FU is another alternative of chemo treatment commonly used. So it is ok to use 5FU instead of Gemzar. It is not stronger than Gemzar;it just works differently. 5FU can be combined with other chemo agents like cisplatin and it also comes as an oral dosage form called capecitabine (xeloda).
Again, systemic chemo is only one of the ways to due with CC;other option for ductal CC included radiation treatments like PDT,EBRT,SBRT and clinical trial.
If you can, get a 2nd opinion on using radiation as treatment opinion may not be a bad idea because your mom is only 47 years young.
CC is a long and winding road that requires patient , courage and knowledge to navigate .If you look at CC as a CHRONIC disease,then you will feel more positive about the situation and have more energy to help your mother in the long run.
God bless.In reply to: Hello Again Everyone
Hi,
Anything suggested here are for information purposes only,CONSULT your doctor first for any change of treatment plans .
my guest is that your brother has ductal CC. the treatment is DIFFERENT if your brother has intrahepatic cc.For ductal CC. PDT,SBRT, EBRT are suggested .(all are radiology procedures); all are palliative treatments.
“Systemic chemo like gemzar/cisplatin may not offer an advantage for patients with ductal CC.;alternative choices include 5Fu or supportive care.
In two small randomized studies indicated that biliary stenting with PDT therapy can prolong survival, compared to stent placement alone. clinical trial is another option .”(Tushar Patel Gastroenterology & Hepatology vol.8 April 2011)
How old is your brother?
What is his diagnosis ?
What stage was he when the diagnosis was made 2years ago?
Was the biliary drainage using stents inside the biliary tree,common bile duct to drain the bile internally or just surgically drainage to the outside .I suggest strongly get a 2nd opinion by an interventional radiologist.(a radiologist who performs special procedures like I suggested above-PDT etc.) to get a better idea of your brother’s situation.
God bless.Hi,
From what I learn so far from the ASCO 2011 conference as a PATIENT,I will make sure and remember where (which hospital) I got my biopsy or resection done ;so that I can retrieve my tissue sample from the FFPE -the slide from the pathology lab that make my CC diagnosis-.This will be very useful for future biomarkers assay to improve the treatment outcome if needed.
(most hospitals in U.S. will keep your FFPE for 5-10 years. ) ;AS far as I know,only M.D.Anderson and Massachusetts General will automatic perform this kind of test for cancer patients.
There are a lot of companies will perform the tests for you if your doctors requested for you.The diagnostic companies will do all the work for you but you have to know where your FFPE were.Most of the time the laboratory in your hospital will coordinate the whole thing for you because some of tests may require serum or blood samples instead of tissue from the FFPE slide.Inostics from Hamburg,Germany;Surexam from Guangzhou,China;Panagene from Daeieon,Korea;Quest diagnostics and bioTheranostics in US to name a few.
If the insurance companies won’t pay for it; Most of them will accept your private payment.I check with one company just for info.A colorectal cancer biomarkers Assay which included TYMS mRNA,ERCC1mRNA.VEGFR1 mRNA, VEGFR2mRNA, KRAS mutation,BRAF mutation,P13K mutation and UGT1A1 SNP costs under 900 U.S. dollars. The tests will tell you whether you will be resistant to platium-based chemo or sensitive to Avastin/sorafenib/cetuximab/irinotecan and 5FU.
Of course,the quality of each lab which perform the tests will be different and require careful selection; but the future of personalized medicine is already here and as patients, we should prepare accordingly to increase the odds of our survival now.
Please read the article”ASCO 2011-the challenge and progress of the genomic eara” provided by our Gavin under the” web site forum ” on this CC web site.In reply to: Very high CA19-9 numbers?
Quick update:
Since last I posted and the switch to GTX from gem/cis, my brother’s CA19-9 number increased to ~39000 on a blooddraw from 5/19. (the last CA19-9 number of ~24000 was from 5/13)
The CT from 5/19 show no changes as reported above.
In our visit to Dr Fisher of Stanford for a second opinion, among some of his comments, he explained that CA19-9 numbers do “spike” after initiating chemo. Furthermore, he stated that a good response indicator of chemo treatment is the “good feel” factor, where my brother feels better after the chemo treatments and the pain in the liver decreased. Dr Fisher’s review of the CT scans did not review any changes, but he did caution that CT scan results usually take longer than weeks to reveal.
The 3 liver function metrics (Alkaline Phosphatese (Total), GPT, GOT) have all returned to nominal ranges as of blooddraw from 6/3.
We are waiting for CA19-9 numbers from the 6/3 blooddraw, before his second GTX application.kamnbelle, after 1 GTX application, my brother is not showing any major side-effects. His fingers and toes are drying out and “blackening” but not very significant right now. Taxotere does cause some allergic reactions and my brother has been infused with Benedryl during the same infusion. He is not having nausea and only slight diarrhea. As he is continuing with GTX, I will report back.
Also, Dr Fisher (during the second opinion review) thinks gem/cis is NOT shown to be not effective from the evidence in this case, so he thinks we can go back to that at a later time. Folfox (which I found out is 5FU + oxaliplatin) is next on the table if GTX is not working.Thanks for everyone’s kinds words.
I hope reporting on my brother’s progress will provide helpful info to others.
My brother is approaching only 2 months since diagnosis, and has be a big emotional roller coaster ride.In reply to: My father’s bile duct cancer?
It seems cancer in my father has not metastasized but spread close to an important blood vessel so whipple is not an option now. They will give him gemcitabine to try to kill some of it and re asses in 2 months. Starts tuesday. RWJ said it was CC but Sloan says pancreatic. Treatment the same. They said the 5fu wouldn’t help with this type of cancer. I don’t even know what it is but I asked. has gemcatabine alone helped anyone with this?
Son- I am a 2 year CC survivor and I had all of the above. My chemo was IV gemcidabene, 5FU 24 hours -7days a week for 6 weeks chemo pump while doing 6 weeks of 5 days a week of radiation and then about 5 months of XELODA (about 16 pills a day) while waiting for transplant.
I have been told Sloan-Kettering is starting to refer patients to my doctor, Dr. William Chapman at Barnes-Jewish in St. Louis MO.
This cancer wreaked havoc in my life but didn’t win!! All my chemo and radiation treatments were all doable, no major problems and all problems were fixed with medications and lots of rest.
You can read my story at thetelegraph.com under christmas miracle.
Lots of prayers-CathyHello – Thanks to everyone who posted a response to my Mom’s inquiry about the benefits of chemo after major Liver resection. She has since seen 4 different oncologists in the Washington DC area and like that old joke, has received 5 different opinions. Two of those opinions – which I must mention came from the ‘older’ physicians – included fairly lengthy course of 5 day week radiation possibly including chemo such as Xeloda or 5FU –
Has anyone who has undergone a ‘successful’ Liver resection with seemingly negative margins also had heavy duty radiation?? Does it make sense to radiate the entire region of the surgical site without a known tumor??
This question – of radiation + chemo vs. chemo alone has us all very confused.
BTW – The MDs who recommended chemo alone – one suggested Gemzar + Cisplatin the other recommended FOLFOX – any feedback on the chemo is certainly appreciated as well.
Thanks again.
MomfromtheBronx’s Son
In reply to: need drug info: growth inhibitor drugs
Hi,
I do not think in the same way as your oncologist with regard to the term “NECESSARY”. in the regimen unless he/she is eager for you to participate in one of the clinical trial like the #25 and #28 on this web site under “clinical trial”
# 25 is currently under study at Ohio University and the other ,#28 is at Univ. of Pennsylvania.If you are accepted,they will work with you to submit the claims and fight for the approval of “off label use “for Avastin or cetuximab and you will know beforehand your financial responsibility.
But please remember any doctor in their specialty can use medications off the label indication for his or her practice and this does not mean they are wrong.
Except for erlotinib,most of the APPROVED chemo regimens related to treating CC with molecularly targeted agents such as Avastin are still under clinical trials for their efficacy and side effect burden.
GEMOX+Avastin ,Erlotinib+ Avastin or GEMOX+cetuximab these three regimens are still on clinical trials.;as well as Gemzar+Xeloda+Avastin and others.
The first -line systemic treatment is either 5FU or gemcitablne base with the addition of cisplatin(the platium group) , or irinotecan or docetaxel.(the taxol group).
Depending on the type , the size and the locations of the CC ;you still have other options like radiation,ablation.chemoembo,PDT,SBR beside systemic chemotherapy.
2nd opinion of oncology consultation is recommended.
God bless.In reply to: Hi everyone!
Hi,
If I may suggest-
If the liver lesion is 6.5cm after neoadjuvant chemo like your father had;liver resection can be performed if not contraindicated due to location of the lesion or other metastasis;Radiation like PDT,EBRT,SBRT are choices too; if your father’s CC is ductal ;5FU or gemcitabine chemotherapy are options.
If you can find out what are the drugs in your father’s “chemo cocktails”,
It may be of interest and benefit to the CC patients here.I personally appreciated if you can do that for this web site.
Ask the doctor to prescribe anti-depressants if you dad wants them- like Prozac,Paxil ,Remeron,etc.
One of the POSITIVE side effect of anti-pressants,esp. the newer ones like Remeron is gaining weight.
CC is a long and winding road and require knowledge and courage to due with it.
Your dad is the lucky few to be in the ” partial response” category to his CC.
But will not be out of the wood completely soon. You will be with him on his CC journey for quite sometime to come. and he will definitely need your help in prolonging his life or cure his CC. And please forgive me to be so frank in suggestion
God blessIn reply to: Very high CA19-9 numbers?
I was interested in the fact that your brother was prescribed Taxotere, right after Cisplatin. PubMed had some info on increased side effects from previous Cisplatin. My dad just had his first follow up at MDA after four rounds of Gem/Cis. No change in tumors, no new growths, the CT scans looked eerily the same as the ones in February. (Background: Dad has several retroperitoneal tumors, but no primary although cholangio is suspected). I took that as good news. However, his CA19-9 had increased from 1600 to 2100. They want him to do 5FU and oxaliplatin. Any thoughts?
Much hope and good thoughts to your brother.In reply to: Italian CC in search of hope!
Hi,
Do not worry,as far as I know,Italy is in the forefront of treating and researching in the cholangiocarcinoma. Try to check out the web sites of the Fatebenefratelli hospital in Milan or the medical oncology dept.,A.O. San Carlo, in Potenza or the oncology unit at Azienda Ospedaliera Giovanni Paolo II Sciacca at Palermo Italy. All of them had done research on CC.You are the first one that I encountered with a Precise diagnosis stage(T3,N1,M0) and you also indicate what type of CC.(Hilar CC);This helps me a lot in trying to find good information and answer for the problem for you.
According to
ESMO(European society of medical Oncology) guidelines;
Options included PDT (with chemo if a large mass is visible radiographically) ,palliative chemotherapy alone or concurant chemoradiotherapy. chemotherapy .
NCCN(the National Comprehensive Cancer Network) suggested the use of 5FU-based chemoradiotherapy with conventional fractionation radiation therapy (EBRT).Conformal treatment planning is preferred if available.For recurrent CC, EBRT, brachytherpy,
stereotactic radiotherapy(SBRT),PDT(photodynamic therapy) and systemic chemo.
PDT shows good results for ductal CC;Chemoembolization with RFA show comparative good results for spots in the liver smaller than 3-4cm .(as compare to liver re-resection).
So,do not worry too much,there are still a lot of treatment options for your mom compared just 5 years ago;and Italy is a good place to start for CC treatment.You are in good hands in Italy .
I hope the info. helps.
God bless.In reply to: 11 months in and just found this site
Hello skb! My sister had similar findings as your husband. She had a whipple with what the surgeon thought were good results that he to did not often get to give. She had clean margins everywhere but a questionable one in the liver also two nodes positive. she had radiation with 5fu and gemzar chemo. Her ct scans were every three months whipple in nov of 09 and cc returned in feb of 2011! She is now under going gem/cis chemo. Good Luck!
JackieHi,
Thanks this foundation for providing me the opportunity for attending this conference. I have learned a lot and next time I will have a better strategy to spend my time between speaker sessions and the poster sessions. I did not have enough time for the poster sessions because I think I can read them later.(I have marked down 20+ of the posters that I want to check out,but I have only time for 2 of them.)
The following is one of the few I have come across that is of interest and relate to CC.(It received DDW poster of distinction award)
Do not worry about the title,I will try my best to explain it in layman’s terms.Title; Prognostic impact of Thymidylate Synthase(TS) Expression in Adjuvant Gemcitabine plus S-1 chemotherapy after surgical resection for Bile Duct cancer.
Authors:Hironori Kobayashi MD and 9 other Md from the dept. of Surgery,Div. of Clinical Medicine Science,Graduate school of Biomedical sciences,Hiroshima University.
Objective:The aim of this study was to investigate whether the TS,DPD, or OPRT expression can predict survival of advanced CC patients treated with gemcitabine(GEM)+S-1(a novel oral 5FU combination including tegafur,which similar to Capecitabine-also a prodrug of 5FU,DPD inhibitor and OPRT inhibitor.
Study Samples included 106 CC patients (stage II,III,IV)who had R0,R1 resection between 1989-2010 at Hiroshima hospital.(single location,not multi-center study)
Conclusion: Low intratumoral TS expression was associated with INCREASE overall survival in CC patients who received adjuvant GEM+S-1 chemotherapy after surgical resection.
TS therefore is a relevant PREDICTIVE MARKER of benefit from adjuvant GEM+S-1 chemotherapy in resected CC patients.Following is my thinking about this study:
TS,DPD and OPRT are emzymes that related to the metabolism of the drug 5Fu and thus the effectiveness of the 5FU prodrugs like capecitabine and the like.
The study indicated if TS marker is high(that is 30% or higher in expression)the 5 year survival rate is 25% as compare to low TS expression is 81% when CC patients are on the GEM+S-1 chemo treatment.(If that is true, and if my TS marker is high,I will suggest to my oncologist to change Gemcitabine and Xeloda and use a different chemo agent that is different in chemical structure to Gemzar and 5 FU. Again this is my personal point of view only and it can be wrong in terms of outcome. Remember this study is the forefront of reseach and not the final phase III clinical trial or approval of a drug or marker.)
The study also indicated that there is NO significant difference in overall survival between the high TS group treated with the GEM+S1 and NO adjuvant chemo treatment group.
Therefore the TS marker may be of value in choosing the appropriate chemo treatment before it starts. and it may be of value in future drug development as well.
DPD and OPRT expressions were also mentioned in the study but they did not make any conclusion about them as potential markers for CC patients.So I presume both of them( the DPD and OPRT inhibitors in the S-1 regimen is not of value as markers at this point .)
I will also try to find out where and how to get the TS marker test done if available. I appreciate if our Gavin can provide his valuable research skill on this thymidylate synthase marker(TS).Gavin is an important resource and asset for information on the internet for this foundation.
I hope this is of interest to you in the research of treating CC .
God bless.Mom, Welcome and sorry you had to find us. I am a CC survivor. I had 2 liver transplants, I will be 2 years cancer free May 24, 2011!! My clinical trial involved chemo and radiation. My chemo drugs were IV gemcidabene and 5FU chemo pump while doing radiation. (Radiation was 5 days a week for 6 weeks). I then took Xeloda an oral chemo while waiting for transplant. I never lost my hair and my naseau was controlled with meds. My biggest sympton was tiredness but naps and rest made it bearable.
You can read my story at http://www.thetelegraph.com under christmas miracle, it is full of hope.
Lots of prayers-CathyI can’t believe I just found this site. My husband was dx with extrahepatic cholangiocarcinoma 11 months ago. I did every search you can imagine and never saw this site. The only thing the Doctors gave us was the Pancreatic support sites. But now I am here and will get started.
My husband has been a very healthy man throughout his life. He did smoke and drink but quit smoking nearly 18 year ago and drinking 21 years ago. The drinking was selfmedicating for PTSD. Last winter he seemed to be aging before my eyes and had no energy. Things came to a head in June. Urine turned dark, stools light, no appetite and itching. I had thought his sclera was a little yellow but they never seemed very white so didn’t really get concerned until he mentioned itching. By the way, I am a nurse.
I called his primariy care at the VA on Monday June 14th and they instructed us to go to the ER. Well 10 hours later we were told he had a tumor and they were going to do a CT scan that night. The next morning we were told he had pancreatic ca and that a referral had been placed to see the GI doctor. On Thursday they did the first ERCP and obtained brushings. The next day they did another ERCP with needle biopsys and placed a stent. We were told they couldnt definitly say it was cancer but their experience told them it was and a request was sent to the chief of staff for a fee basis surgical referral since the VA did not have anyone qualified to do the surgery. Over the next 24 hours, all his jaundice and symtoms went away with the stint in place.
The oncologist told us he had 6 to 12 months and really got things moving. . We saw the Dr. DelCore at KU and he did a whipple on July 27th. The CA was in the pancreas but all margins were clear and only 2 out of 10 lymph nodes were positive. He has followed up with 1 cycle of Gencitibine, 28 radiation tx with 5FU and then 3 more cycles of Gencitibine. He had his last Chemo last week with a followup scan. We are now awaiting results of that scan. Oncologist says they will followup every 2-3 months and she would expect it back in 2 years.
This year has been difficult. I remember in June and July, every time we were driving to the Dr. or hospital, we would hold hands and say we felt we were driving to the gallows. I am hoping that now his tx’s are over he will get to feeling better and we can do some things to enjoy our life together.
