First Chemo not Gem/Cis?

First-time poster Bob here. My mother-in-law is getting Gemcitabine plus Abraxane (paclitaxel) as a first-line treatment. Curious if anyone else has been given, or offered, this protocol.

Any information welcome.

Bob

A lot will depend on how “traditional” your onc is. I started with gem/cis but my onc went to gem/carbo after one treatment because she was worried about my potential hearing loss.

It seems that gem and a platin is the accepted first line chemo treatment. You might be hard-pressed to find an onc who will go against that right out of the gate. looking back I would recommend getting genetic testing as soon as possible if for no other reason than to find out what you are fighting and to look for trials. Then it depends on your onc as to how he/she feels about trials. Some seem to view it as as last ditch effort without hope for long term success and might not support it until all other efforts have failed. Also, some trials seem to require some indication that chemo is no longer working. But, having identified potential trials, you can keep an eye out for things that are under your control that might otherwise exclude you from a particular trial. For me, many require a platelet count above 100,000. Haven’t seen that in a long time. Knowing what these exclusions are might make you go for a trial earlier than later.

Once you get past the platins, there seems to be little agreement about what the “right” thing to do is. Some oncs seem to have their own preferred secondary treatment plans. This is where second and third opinions can help or possibly add more confusion to the issue. My potential replacement onc has rejected opinions from the Mayo Clinic and MDA. “They are not supported by hard evidence.” My guess is that his is not either, other than his own experience. Add to that that individuals respond differently. And it certainly depends on where you are starting – I was initially diagnosed as Stage IV with mets to the liver, lungs, and distant lymph nodes. My options were limited.

Sometimes I think it’s all a crap shoot and I’d get better odds in Vegas. But that’s my dark side speaking.

Make an informed decision and go with it and don’t look back.

Duke