Carbo/Gemzar or Topectin for Ovarian

[pattie1218]

My Mom's chemo treatments are being adjusted due to the nuerapathy issues it was causing. The doctor wants to consider changing it from the taxol to Gemzar.  The taxol was causing the nuerapathy, and he doesnt want her to have permanent damage as some of you ladies have mentioned. Is Gemzar a little bit easier to tolerate? What can we expect from the Gemzar? Will it still kill the cancer? She has Stage 3c ovarian. Her levels have dropped from (pre surgery) 790 to most recently last checked 5/31/09  levels are now 196 range. surgery debulking done in February. she has had 3 treatments and the 4th will be changed. Dr is consider Gemzar or Topectin. Any help is appreciated as always.

[bohan54]

Have seen two highly acclaimed gyn/oncs in the last 7 days.  Both say that once OVCA has recurred after gold standard carbo/taxol, all other combos are basically a crapshoot.  The likelihood of any having any major impact (ie. keeping the disease manageable) is less than 30% and each subsequent regimen has a lesser chance.  My doc is keeping me on Topotecan for the moment because the side effects do not compromise my quality of life greatly altho my OVCA symptoms are increasing.  They really don't know what to do with us at this time, I hope research will help future patients.  
Sorry, this may not be the answer you sought.
Sharon

[jane65]

Hi Pattie,
I started with carbo/taxol after my debulking surgery 2+ years ago. I was staged 4B and the cancer had  already metastasized to the lymph nodes.I had the full 6 rounds, then a remission of 4 months.

When my CA125 began to rise, I was started on Topotecan, which was a much easier chemo drug than my first regime.

Constipation, I used Miralax, Colace and prune juice and that combo worked fine.

Blood values dropped after each treatment, and occasionally I needed an Aranesp shot to get the bone marrow to produce red blood cells and raise the hemoglobin.

Fatigue was a factor, getting worse as the day went on.
Hair didn't fall out, it did thin though. Appetite and weight weren't affected.

Now my Ca125 has gone up a few points, and my oncologist said it shows the Topo. has stopped working. I'll have it repeated on Monday and we'll see if we'll be moving on to Avastin/Gemzar next.

I hope this info helped. Gemzar and Topo. work by scrambling the DNA in the cancer cells and they can't reproduce and die.

Best wishes to Mom for good health.
Jane

[jane65]

By the way, Topo. worked for 10 months and my CA went down almost every month. My last CT scan was clear, no sign of cancer, but my oncologist said it's still active somewhere.
Jane

[pattie1218]

Thank you for your suggestions. wow..sharon 30% isnt good at all. she is at her halfway point right now through this cycle and her numbers have dropped so thats why they think it will be ok to switch to gemzar or the topo. The numbness and nuerapathy was getting too much, and the doctor didnt want to permanently damamge her nerves so thats why they are taking this route. I hope we dont regret switching it. I guess we have to give and take the good and the bad with the symptoms/side effects verses the disease. uggh...
    jane, thank you for your suggestions too, my mom already has a problem with the constipation as her bowel is covered with tumors. the milk of magnesia and prune juice and the colace seem to help a little bit, i may have her try the mirilax ive heard thats pretty good too. Mom already lost all of her hair from the taxol, so that wont be a problem now. thank you so much for your suggestions...take care, pattie

[JC145]

I just had 3 rounds of topotecan and don't know how my CA125 has responded .. will know in a couple of weeks.  It is an easy drug overall.  I get it 5 days in a row .. then off 2 weeks.  Jane and Sharon get it 3 Mondays in a row .. off the 4th week.  Either regimen is acceptable.  So far, my red count has held .. take 2 iron pills a day.  The constipation is really bad .. I start Miralax the night BEFORE chemo and sometimes take it twice a day.  A lady I have chemo with (also on topo), mixes the Miralax in warm prune juice and says it works great.  You can also take stool softeners with the Miralax.  Hopefully, the chemo will take care of the tumors on/by your Mom's colon.  

IF your Mom goes on iron, there is a new pill "HEMAX" (an Rx) that is a combo of Vitamin C, Iron, and stool softener.  You need to take iron with Vitamin C for good absorption.

Good luck .. don't know anything about Gemzar .. but know it is rougher than topotecan.

Judy

[crecco]

pattie,
   I have been on Topotecan and Gemzar both. For me, Topotecan did not work. Gemzae did the first time but this time it hasn't. The Topo was a very easy chemo to tolerate but the Gemzar was pretty rough. I do not recall either being very bad as far as neurapthy goes. Neither will kill the cancer but hopefully they will keep it knocked back.
    Chris