DOXIL question

[annie]

I am starting Doxil tomorrow and am wondering how careful I have to be.  I stuck my hand in the shower this morning and I knew I was not going to like climbiing into that cool water.  After the 5 or 6 days can I go back to taking a warmer shower or does it continue all the way through to the next treatment?  What else do I have to be careful with?  Temperature of food or just avoiding spicy food?  Any tips anyone could give would be much appreciated.  

Does Doxil get combined with another drug sometimes?

[rmarie]

I think that they really don't know, they go on what the drug companies tell them, and that literature is scary.  I think we each need to experiment and share.  It is also very individual.  When I read the reactions people have to taxol and carboplatin I cannot relate.  I got tired 3 days after, however no bone pain, and my husband get me off the couch for a couple of hours at a time.  I also worked out 5 days a week and maintained my counts, granted the time and the intensity, I was working out decreased over the six treatments.  I don't know if it made a difference or not.  I will let you know how it goes.  Good luck to you.

[annie]

Thanks for the abstract!  Sometimes  I wonder if these Drs want us to come up with our own treatment plan.

So far, so good with the Doxil.  I was really careful the 1st day but the shower water has been getting a little warmer the past 2 days.  Good luck on Monday!

[rmarie]

I am stage 3 C Ovarian diagnosed in Sept. 05 with surgery in early Oct.  I had a normal CA -125 before surgery, went to 99 after and then immediately dropped.  I did 6 treatments of carbo and taxol, finishing in March 06.  I did well recurrence found on a scan because I had nausea.  CA 125 still normal, it is useless for me.  I had surgery a month ago, they were able to get it all, I had a lesion on the liver and the diaphram, a second on the diaphram 3 others on the colon,and now I start with the Doxil and Carbo.  I am getting treated in upstate New York.  I have not been told that it is based on this study, but it is the same combination.  I had a friend get me a copy of the article.  

The article that reported on the combination is in the February issue of the Annals of Oncology, below is the abstract.  

Background: Platinum-based chemotherapy is standard second-line treatment of patients with advanced ovarian cancer (AOC) in late relapse. Pegylated liposomal doxorubicin (PLD) has significant single-agent activity in this setting. Therefore, we evaluated the use of PLD plus carboplatin in this patient population.
Patients and methods: PLD 30 mg/m2 followed by carboplatin at area under the curve (AUC) 5 mg

[annie]

What is your situation? I had surgery may 31, 2006 and was dx with Primary peritineal cancer.  Finished carbo/taxol end of Oct and did fine throughout.  At check  up in Jan Ca125 started going up.  Pet/Ct on Jan 30 did not show anything.but Ca125 was about 334.  Dr said they wpuldonly be treating a number so she would wait.  Had another CA125 about 2 week later and it was in the 700s.  They put me on topotecan/thalidomide had 2  (M-F) treatment -3weeks apart and was half way into my 3 session when they called and said it did not seem for be working.  Had another CT scan which now showed multiple implants in my abdomen and some fluid in there somewhere.

Do you remember what the article in the Annals of Oncology said about the combination Doxil/Carboplatin?  I have not been able to take a look at it.  Is it available online?

Where are you getting your treatment?.

Annie

[rmarie]

From what I read, it is ok to to go out with sunscreen and a hat.  Glad the infusion went well.  I plan on following the 1 day before and the 2 to 3 days after.  Keep me posted on how you do, I keep telling myself, I got through carbo and taxol and stayed in the gym, this can be done, with caution.  Good luck

[rmarie]

My doxil is next Monday the 7th, I will let you know. Thank you for asking

[annie]

How did you do with your Doxil on Monday?

[laura195]

I've been on Doxil for three months.  I follow most of the precautions the day of and three days after treatment.  I refuse to take a tepid shower, and so far my hot showers have not caused any problems.  I stay away from hot foods and drinks with the exception of my morning coffee, which I won't give up.  I take a drink of coffee and follow that with ice chips, and so far that's working fine.  I haven't gone to any great pains to ice my hands or feet so far, since I live in an area that's cold in the winter and I'm always freezing.  I'll pay more attention to that as the weather warms.  I haven't had any skin problems at all so far.

[annie]

Well I got through my infusion withour any problems.  I guess I will follow the rules this month and if I don't have any problems I might get a little more adventeerous next month.  Is it OK to go outside and do some yard work al long as I have sunscreen on and it is not too hot and sunny?

[pjet]

Everyone's response to doxil is different but till you know whether you will have the side effects it may be better to be cautious.  I started doxil in the hot summer months.  I didn't use the ice packs during infusion, and when I got inflamed feet and hands I burned my feet further on the hot sidewalk.  My meals were too hot.  I soon learned my lesson.  Now I use ice packs and drink iced water, keep myself well hydrated all month, especially the days before and after infusion, dress very light and stay cool, eat lukewarm meals, cool (yuk) coffee.  I get a red rash and flushed so it is important to stay out of the sun and away from sunshiney windows.  Warm water baths, soap and shampoo, and lotions with alcohol make things worse for me, so I use vegetable oil.  For me this is a monthly process but not so bad if I follow my body's rules.  Only 30% of users get this to some degree, but 80% don't, so I hope you are one of the lucky ones.  Important thing, it is working and fairly easy to tolerate.  Good luck.

[plady]

Dear Annie:

I have to follow the precautions the whole time I am doing Doxil.  That's how I got into trouble before was not be cautious.

prayers and best wishes,

plady

[annie]

Thanks for the info!  I am set to have it every 4 weeks.  Did you have to follow all of these precaution throughout the whole 4 weeks or just for the day before and about 7 days after.  I have already found a problem when I go to wash my hands - I automatically turn on the hot water.  I think I will need a bit of reprogramming.

[plady]

Sorry, I didn't finish.  

1.  wrap hands and feet during chemo
2.  warm showers
3.  Triple mouth rinse prescribed by Doctor for mouth sores
4.  Loose bras
5.  I ate no spicy foods, as they burned my mouth
6.  Avoid friction on your feet
7.  Biafine cream (Radiation Cream) twice a day on feet

The worse problem I had  was with my feet.  I made the mistake of ignoring warnings and I overdid walking in my outside work.  I have finally gone to avoiding a lot of walking and I wear Crocks all the time with socks to avoid the rubbing and friction.

Other than these side effects I have felt pretty good on the regular dose and I am now on low dose Doxil and I feel real good.  

Best of luck

plady

[Helmar]

Hello.. and re Doxil. I had tepid showers during my Doxil treatments. Providing the water isn't hot, just taking the chill off won't hurt....well, it didn't for me. Don't wear tight clothing, and although I didn't do it during treatment, I've since heard that if you suck ice, and use cold packs on hands and feet, that does help a lot too. Sore hands/feet are side affects, although the only side affect I had was very large and sore mouth ulcers, so next time I will suck on ice.
I hope the Doxil works for you both, as it worked well for me. Check with your Oncol. re a MUGA scan to check your heart before starting this treatment, as it's said to be quite harsh on the heart.
Wishing you all the best.... Helmar..

[plady]

Dear Annie:

I have been on Doxil since September, 2006.  I had a lot of problems with side effects and the following is what I finally did to help.

[alanpvegas]

Managing the side effects of Doxil:
http://www.alanpeto.com/ovarian_cancer/infobase/questions/14/Managing+Side+Effects+of+Doxil

Also they have a e-mail based support group:
http://www.alanpeto.com/ovarian_cancer/infobase/questions/15/Is+there+a+support+program+for+doxil%3F

Sources:  www.doxil.com

------------
Ovarian Cancer Research Website (In BETA Testing)
http://cancer.alanpeto.com/

[rmarie]

I start Doxil on Monday, and I have the same concerns.  I am getting it along with carboplatin, it was reported on in Feb. Annals of Oncology as getting good results.  Good luck to you, let me know how it goes.  I exercise alot, and your not supposed to sweat.