New thread – am I getting enough????
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Fever is under control, her antibiotics are starting to work. Also, my CA19-9 was checked a week ago, it was 24.7. I’m guessing that’s a good thing, it was checked on 1/9/12 and it was 34.6 I think…
Hi Derin,
Sorry to hear about your daughter. Seems like a lot of stuff going around right now. I’m just getting over a bronchial infection, so I haven’t slept in my bed for a month. John has never really taken any extra precautions since he was diagnosed with ICC, but he had always been very healthy before. Luckily, the kids don’t get sick that often, although they’re both stopped up right now. I think our beautiful weather has something to do with it. I’m glad that your counts went up and I hope your chemo on Friday goes well. Sending well wishes to Sydney and positive thoughts to you, PeggyP
OK, had a quick trip to Jacksonville, FL Mon-Tue this week. Of course, when I’m gone, daughter blows a 103.8 fever… I get home last night, stay at the inlaws and went to get bloodwork this morning to see how I looked.
WBC 4.8 (1.9 on Friday)
Hgb 14.1 (13.5)
HCT 41.3 (38.7)
Plat 104 (76)
ANC 2.4 (.
Apparently my bone marrow is working just fine to bring the numbers back up… Dr. said I could be at home which is where I am tonite. Sydney still has an upper respiratory infection, on Zpac, treating fever to bring it down until the Zpac kicks in… She’s quarantined in her room (not that that’s bad, TV and computer in there, plenty to do, and room service to boot!!). Gem/Cis Friday, hopefully she’ll be better by Friday morning as her and her mom are supposed to go on a bus trip with the Venice Y to UF to watch a gymnastics competition…. My mom and brother are coming up for a visit from Ft. Lauderdale this weekend also. We shall see….
Hi Derin,
Re: the number of cycles
Several considerations:
1. ABC-02 trial used 8 cycles to treat nonresectable/metastatic cases. I think it’s logical to conclude that adjuvant chemo should do less than 8 cycles.
ABC-02 is British Phase III randomized trial that proved Gem/Cis to be superior than Gem alone
http://www.nejm.org/doi/full/10.1056/NEJMoa09087212. Biliary Tract Cancer Treatment Protocols recommend the same protocol as in ABC-02 trial:
Quote:Systemic therapy for nonresectable or metastatic diseaseSelected stage III-IV (T3-4, Any N, M0-1):
Standard-of-care front-line chemotherapy for patients with good performance status (ECOG score ≤ 2):
Cisplatin 25 mg/m2 on days 1 and 8 plus gemcitabine 1000 mg/m2 on days 1 and 8; then every 21d for up to 24wk or until disease progression
Up to 24wk = Up to 8 cycles. Again, this is for nonresectable or metastatic cases. Adjuvant chemo should probably do less.
3. Before my wife started Gem/Cis chemo, our oncologist said he wanted to do 4-6 cycles. I asked him why not 8? (based on the info above). He explained that they usually do adjuvant chemo for up to 6 months, including 5FU/Xeloda chemo done concurrently with radiation. Marina did 5FU chemo-radiation for 2 months. That left her with 4 months to do Gem/Cis chemo. Enough for up to 6 cycles.
4. As I mentioned in another thread, we were on the fence about continuing adjuvant chemo past the 4th cycle. We met our oncologist last week. We asked him if more cycles is better. He said they don’t have any data to support any particular number of adjuvant cycles. For what it’s worth, we decided to do the 5th cycle. We are scheduled to do CT scan after the 5th cycle. No decision on the 6th cycle at this point. One cycle at a time…
Hope this helps,
EliHi,
I do not know the answer;normally CT scan every 3 months will tell the progress of the treatment;that means around the time of the cycle 6.
If they will do the radiation+Xeloda, please ask whether you need a chemo free period before the new treatment starts.
God bless.OK, numbers were down on Friday’s bloodwork… Off week last week, so should see numbers increase by this Friday and hit the Gem/Cis for cycle number 4. Gotta ask the ONC this Friday exactly how many cycles he thinks I should be doing. I have no clue, any suggestions for number of cycles for adjuvant chemo?? I’m pretty sure they are going to do adjuvant radiation with Xeloda as well, I’m going to ask about that as well.
Marion,
That’s what I thought. But I got chemo 5 days ago and the bloodwork yesterday showed an increase in all of my numbers except platelets, hence the confusion on my part… But I’ll take it, that’s for sure!Derin…generally the break from chemo will help bring those numbers back up.
Enjoy your time off.
Hugs
MarionWell, they were concerned Friday about my bloodwork, so had me come in today. Here are the results…
wbc 3.4 (2.6)
Hgb 12.9 (13.9)
hct 40.4 (42.3)
Plat 112 (230)
ANC 1.9 (1.0)I’m still confused. I thought chemo was supposed to pound the numbers down, yet the only thing that went down was the Platelets… Oh well, off week this Friday, next week we’ll hit it again!!
Derin-Glad chemo isn’t wiping your butt!!! I can’t even do a blood draw with out a minium of 2 sticks. I am amazed at you having portless chemo. I got a blood infection during my second transplant stay and all foriegn objects were removed from my body, so there went my port! I was more upset by that then being back in ICU! I have no veins, so my port was a gift from God. I could have all blood draws thru my port, it was toooo easy!
Can’t let my husband Jeff see your fishing reports, he sleeps with the Brass Pro Store add under his pillow!! LOL! We have 2 weeks till our camper opens at Kentucky Lake and he is bass fishing!
Lots of prayers-CathyMy veins did NOT like the Gemzar. They had to move the IV 2x until they found a vein big enough to handle it. And I had track marks for over a week. You could actually see the bruised vein all the way from my elbow area to my shoulder. The Gemzar was nasty painful, and I immediately scheduled to get a port! Much easier on me.
Kudos to anyone who can handle the chemo without getting a port. I wish I could have. But I’m not surprised I couldn’t do it: I had 10 IVs in the 10 days I was in the hospital last year. And the first IV lasted 3 days. One of them only lasted about 1.5 hours before it blew. I figured with that kind of track record, I wouldn’t last long with chemo. And since the “pre-port” days started, I’ve actually lost 2 veins in my arms.I hope you don’t have too long of a drive so your bladder holds up!
Kris
I’ve never heard much discussion about port or using IV, I figured I’d try the IV and see how I handled it. I only had one very small issue with the Gemzar about 3 weeks ago for only 4-5 minutes of the 30 minute treatment but it was in no way ‘unbearable’, just slight irritation and that’s it. Nothing today either and the cisplatin is flowing in! Then 500ml of Magnesium and 500ml of Potassium and I can go home (after I pee 5 more times…
)Derin:
How I wish I had your veins!! I went with a port after 1 treatment with Gemzar. 3 veins in 90 minutes.
Glad to hear your numbers are still good and you are feeling well. Good luck with the fishing expedition. I hope you get that trout.Kris
Well, I’m sitting in chemo, labs from this morning:
wbc 2.6 (5.0 last week)
Hgb 13.9 (14.1)
hct 42.3 (44.2)
Plat 230 (191) (went up again after chemo…???)
ANC 1.0 (2.6)Even though these numbers are similar or better than a previous 2nd day of cycle report, they want me back on Tuesday to check blood levels again. I took off this week from the gym to start builidng our cabinet for the murphy bed in the guest room, that’s the only change I’ve done this week. I’ve felt a little more tired than usual, but just yawns and not even remotely “I can’t move I’m so tired” at all.
Gemzar done, vein from last weeks treatment got a little hardened so we used the right arm for the first time this week (that’s 5 treatments in the left arm, 1 in the right so far!). That’s the first time any vein had a bad reaction, but the first time Gemzar was 1700 versus the previous 4 at 1600. Hope everyone has a great weekend, since I can’t sleep until late, I’m planning on a late night fishing expedition like last week. Got 3 crappy ladyfish and one nice 24″ snook last week, hoping for a spotted sea trout tonite so we can have some dinner this weekend!!!
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