Gem/Cispaltin problems
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July 12, 2011 at 8:11 pm #51586pcl1029Member
Hi,Trevor,
The following is for your info. only,you must discuss with your oncologist before any change is made for your treatment plans.
Please make sure when you restart your chemo on Friday,if it is the same (Gemzar/cisplatin); make sure you ask the chemo nurse to give you pre-med dexamathsone and Zofran as an IVPB over 30 min before you actually receive the Gemzar and Cisplatin to prevent the nausea/vomiting.
You can also ask them for Ativan by mouth or Iv for your anticipatory N/V before the administration of the pre-med of Zofra and dex.
If they just give you the Gemzar only during the treatment cycle,if you do not like to have decadron, Zofran IVPB will be sufficient enough to control the N/V.
But you have to ask the oncologist first about not to put the decadron in the pre-med IVPB,since Gemzar alone is not a high emetogenicity chemo(10-30%) like cisplatin(90%) or oxaliplatin or irinotecan and carpoplatin(30-90%)
and be sure they will give you antiemetics after your Friday chemo if necessary.
Zofran by itself (alone)will not be as effective as when give with dexamethasone(about 25% more effective if Zofran is given with dexamethasone in controlling N/V for high emetogenicity chemo like cisplatiin);for other alternative nausea and vomiting treatments;please check the “side effect” forum in this web site.
The TPN you are receiving now will take care of your nutritional and electrolytes needs in the mean time.
God bless.July 12, 2011 at 6:34 pm #51585nancy246SpectatorTrevor, So glad you are feeling better. My husband lost 25-30 pounds in the beginning as well, but as mentioned put it back on with whey protein powder shakes. He finished chemo in May so thankfully his appetite is coming back and things taste better! The TPN treatments will get weight back on you!
Part of this is trial and error to find foods that you tolerate better than others.
The seas may be a little rough right now but I see calmer days ahead Captain!
Take care and I will be sending postive thoughts on friday.
NancyJuly 12, 2011 at 12:52 pm #51584mariaSpectatorTrevor
When I started with Gemzar+Oxaliplatin (almost the same, but I think Oxaliplatin has a little less side-effects) I experienced a lot of nausea, thoug no vomiting. Strange, but it got better! I allways refused cortison as I donJuly 12, 2011 at 1:37 am #51583marionsModeratorTrevor……you must be feeling much better due to the reduced periods of nausea and vomiting. I wish for this improvement to continue and for you to regain the strengths needed to be as you have said the Captain in the fight with this cancer.
Keep it up.
My warm thoughts and good wishes are with you,
MarionJuly 12, 2011 at 1:04 am #51582tnyjax34MemberHello everyone,
I am still in the hospital and started receiving TPN treatments today. My nausea and vomiting have improved since it has been 10 days since my last chemo treatment. I will be having another treatment Friday so I may be on TPN indefinately.
I have lost a significant amount of weight over two months, about 25 lbs. I have tried the marinol with mixed results. Zofran sublingual seems to work for me.
I know I have to put back on weight in order to effectively fight this.
Thank you everyone for your kind words. I have talked to fellow cancer survivors and they all say you have to be proactive in your treatment and be the ‘Captain’ in your fight.
We’re all on this together…
Trevor
July 11, 2011 at 6:24 am #51581nancy246SpectatorHi Trevor, Sorry to hear you are in the hospital but glad you are in very good hands at the Mayo Clinic. Even us up here in Canada have heard of the good results at Mayo Clinics. As Marion asked can you hold down liquids? I make my husband protein shakes with whey powder, fruits, juices and milk. When he is naseous he still seems to be able to take these well. These have helped him gain weight over the last several months. Also, he drinks “mom’s” old remedy – Ginger ale – when he’s not feeling well. Hope you are feeling better soon. Nancy
July 11, 2011 at 4:01 am #51580pcl1029MemberHi,Trevor
I am very sorry not to reply sooner;I did not check my email until now.
As you might already know;I am an ICC patient just had my 2nd liver resection done 2 weeks ago.My first one was about 2 years ago in June.BTW I am 60 years old ,I am a medical professional working in the hospital setting and I also communicate with my sister-in-law who has ECC via emails to help her about questions of her chemo treatment.She has stage IV ECC spreaded to her omentum ;and she got good results when she was on Gemzar+Xeloda and Avastin.Her carcinomatosis on the omentum shrinked “significantly” after only 8 weeks of treatment and that is why I suggested to you to see whether your oncologist will try it for you. It is much easier to take with regard to side effects of nausea and vomiting.However ,she is one of the few patients that developed the “Black Box” warning side effect of perforated colon contributed to Avastin because of her history of diverticulitis and had to stopped.she recovered and now she is on Gemzar+Xeloda.
If you noticed,I did ask you” are you on TPN in the hospital? ” the reason behind that is I want to know whether your intestine is fully normal and functional ,so that the Avastin can be used on you. GI abnormality may exclude you from the regimen that I suggested to you. Please consult with your Mayo clinic oncologist.You are only 24 years old,you have the age factor on your side to fight this CC.
You ask how I deal with my CC.All I can say is CC is a long and winding road,it requires courage,patience and up-to-date knowledge to navigate on it. I am also a Christian and I pray and read the bible daily.And praying activities has been proven in randomized studies that benefit cancer patients.(read CAM under alternative forum on this web site if you want to know more).I keep busy and I will go back to work in August . In short , live by the Grace of God and realize that keep on learning about this disease is important in searching for a more effective treatment and eventually a cure for you and others. Do not worry because we cannot predict our future no matter how hard we try. Through research during the last two years I know one thing for sure,that is if we can hang on for the next 5 years;I will not be surprised a couple more effective treatments for CC will be found and the cure will not be far away .
So, keep your fighting spirit high and keep learning about this CC disease to help yourself as well as others;keep busy and forget that you are a cancer patient;treat the CC as a CHRONIC illness and you will feel much better about yourself. That is what I am doing now. Emails me anytime and I will try my best to learn from you too.
God bless.July 10, 2011 at 9:29 pm #51579marionsModeratorJason…I am sorry to hear of your problems. I am wondering: are you able to hold down liquids or is it the solids only you are not able to digest?
I am rooting for you, Jason.
All my best wishes,
MarionJuly 10, 2011 at 8:54 pm #51578peonyMemberHi Trevor,
My husband has been on Gemzar/Cisplatin for 6 months and has had terrible nausea as a result. No medications seemed to work for him including marinol so now he will just be getting the Gemzar. As PLC mentioned cisplatin has a high rate of side effects.
Best of luck with your treatment.Peony
July 10, 2011 at 5:07 pm #51577pcl1029MemberHi, Please forgive me for my honest discussion below.
As always, this is for information purposes only,consult your doctor first is always a must.
I am sorry to hear the recent progress of your CC even after OTL on Dec.2009.
A CA19-9 of 9000 is indicative of unresectable CC in most cases.(sorry for my honest statement;but I am not a doctor,I am just a CC patient like you and like to read a lot about CC,so I could be wrong)
It is not uncommon for CC recurrence; the truth is that the recurrence rate is between 50-75% .But people can still live 5-10 years after that if they can find an effective treatment plan.
According to what I can understand so far,if the CC spread to the omentum, the clinical trial of Gemzar+Xeloda and Avastin may be a good alternative regimen if your oncologist think that may be of value to you .(it is listed under clinical trials on this web site.(The Rosewell Park Cancer Institite trial NTC0100755)
Because there is no cisplatin in the new regimen ,so you take away the chemo agent that is high up on the list (90%) to cause N/V. Please also check on the suggestion for nausea and vomiting on this web site under “side effect” forum for more info to control nausea and vomiting.
Zofran alone with Tigan suppository or Compazine suppository will not provide enough control for your nausea/vomiting symptoms if you still on the chemo.
Are you on TPN for your nutrition needs? and may I ask why?
Consult your medical oncologist and dietician now since you said you are still in
Mayo Clinics.
God bless.July 10, 2011 at 1:05 pm #5416tnyjax34MemberHey everyone,
Has anyone experienced problems with Gem/Cisplatin chemo? I have been experiencing extreme nausea and weight loss. (MY cc is also spread through my omentum).
Everything I eat I throw up. I dunno if its the cancer or the chemo. I am currently in the hospital being treated for nutrition, here at the Mayo Clinic in Jacksonville.
I am taking zofran and an anti-nausea sepository for the nausea, which works with mixed results.
I would like to keep my nutrition up so I can withstand the chemo and fight the cancer.
Any ideas?
Trevor
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