compare frequency chemo

[SimplyStar]

I am interested in comparing the frequency of chemo, I hear daily times 5, I hear weekly, I hear once a month, also every 3 weeks.  Leslee does every 4 weeks,  wondering not what is best, but what seemed to work the best.  Leslee seems to recoop each time and her body seems to be ready for the next bout.  Is the frequency related to the chemo taken?   Is it a cancer center protocol?  Also interested in knowing if anyone here has had the chemo wash following the first surgery?  Is there a difference in the port versus vein for frequency?  Ain't I a pest for asking all these questions?  Marty

[PF_PVD]

One more thing about the port, my promised "little bump" is actually quite a large one obvious even through much of my clothing.  I have no fat left on my chest to cover it, so you can see and feel every part of it including the tube heading up to the neck.  As I continue to lose weight, it's all getting even more evident.  I just have to keep it covered.  With my friends I joke about my "third breast."

[PF_PVD]

Not having a port wasn't even a discussion amongst my doctors, and I was still in dx shock at the time so did what they told me. I love the freedom of movement is gives me during my treatments and in the hospital especially for transfusions and the endless blood draws.  In an unexpected trip to the emergency room, they found it very handy as well although they were a bit hesitant to use it at first.  In fact, when I went in for my surgery, they wouldn't use it until the IV infiltrated my vein the night after surgery and an RN asked, "Why the @#?% aren't we using your port?"  I do have to comment, though, that I felt the care and treatment of my port in the hospital was a bit more casual than I cared for or that I see at my treatment center.  
My carbo/taxol is given every 21 days, and I always get Neulasta injections and sometimes Procrit when needed.

[Jan214]

Thanks for the info on your side effects with Gemzar.  I will see what my levels are this Monday and hopefully the platelets won't be as low as last time.  It made me feel really weird.
Marie, I do have a port.  I got it before I started my first chemo last year.  My onc had another surgeon put it in.  My chemo nurses have said they have had to use a PICC line when insurance companies wouldn't pay for a port.  I have a great oncs office and I have my chemo there.  The techs and the chemo nurses are just wonderful and yes they can access the port and that's where I have it flushed when I am not taking chemo.  Hopefully that will be soon.
Thanks again and hope all is well with you all.
Jan

[Helmar]

Hi Marie..I've been doing chemo for almost 4 years...pretty much non-stop, and I've never had a port. They seem to find a vein without too much trouble, so while it's working I'm happy to leave it be. I guess there will come a time perhaps, that I will need to consider a port as an option, but at present, I'll stay 'as is'. I guess we are all different in all aspects of this disease.
I hope you had a lovely Thanksgiving and are feeling fine...hugs...Helen...

[SimplyStar]

It sure makes sense to me about the ports, cannot understand why Mayo is so against them,  they refused to do one for Leslee because as they put it, the infection rate is so high.  So far her veins have been fine except the one time a new Nurse punctured a vein and the drug infiltrated.  Leslee refuses to let anyone but the experienced Lab gals do it now. She has had a total of 15 iv infusions so far. Our family does have the fast healing gene, maybe that helps. Our surgeries heal in half the average time.  They put her on a new natural pain med last week,  it seems to work as well as the perscription ones. Plus she says she has more energy, less drowsiness. Her biggest problem is the foot neuraphy, she says she is going to buy stock in the comfortable shoe stores, foot gel forms and heel raisers.  We did have a great Thanksgiving, in my own mind now, I treasure every holiday with my family.

[rmarie]

You should ask about having another surgeon put in a port.  A port is different from a PICC.  A PICC, goes into an arm vein and is threaded up to the vena cava close to the heart so the drugs mix in a large vein.  PICC's are only supposed to be in 2 to 4 weeks, they have a higher infection rate than ports.  A port is inserted into the chest wall and goes in to a different vein and ends up into the vena cava.  My Gyn/oncologist put mine in, however other general surgeons put them in.  If you want one, call your insurance company, find out if it is covered, and make sure they have a good reason why it isn't, especially since this is your second round of chemo .  If you want it, get it, I never considered they won't put in a port, wouldn't have done chemo without it.  I have gotten quite use to the small bump on my chest, that no one but me notices.     Of course the Oncologist's office needs nurses who can access ports.  All my best to you.
Marie

[Helmar]

Hi Jan... I hope you had a lovely Thanksgiving too. We don't celebrate it 'down here'..unfortunately, so we have to wait until Christmas to have fun. :-)
Re the Gemzar treatment... I only have two cycles of it, as after the second one I needed transfusions for both red cells and platelets. My platelets were so low that my Oncol. called me in a panic, and ordered me into the clinic immediately in case I haemorraged, so he withdrew that and I was then on Doxil. That worked well, but I got 6 huge and very sore mouth ulcers with that, so I had 4 cycles of it, and came off that too. I don't get nausea with any chemos, but some of the other side affects are a drag. So far, out of the chemos that I've had over the past almost 4 years, the Taxotere/Carbo is the kindest for me to take, (apart from the loss of hair...but who cares when I have a nice wig :-).....and it works really well at getting those numbers down. I've never had Taxol or Cisplatin, as my Oncol. tells me that the other combo that I take does a good job, and is not as toxic.
I hope you are doing well Jan.... thinking of you...hugs...Helen...

[crecco]

I am not real sure but I was under the impression that the frequency of the chemo depended on the dug given. When I was on carbo/taxol, it was once every 3 weeks, the same with taxotere. When I was put on Doxil, it was once every 4 weeks.When I was put on Gemzar, I was told there were a couple of different ways it could be give, but since I had a 45 minute drive to treatment, we would go with once a week for 3 weeks then 1 week off. The same thing with Topotecan which I just started. He has always kept a close eye on how hard each one hit me and if he felt it was needed, he would reduce the dosage slightly. I do not have a port but last week my onc suggested that maybe I should think about it. So long as my veins continue to hold out, I would like to hold off. I think the Gemzar was the hardest I have been on yet, as far as how I felt afterwards. But thankfully it did start easing up to the point where I only had a little fatigue that same evening. Naturally by that time my counts started rising again, so last week I was started on Topotecan, which I fould to have very mild side effects. The Gemzar played havov with my white counts and I had to miss treatment a few times. So they started sending me home with Neupogen to give my self for a few days. I undarstand that Topotecan can be just as hard on blood counts so they again sent me home with Neupogen last week . I agree with everyone above when they say that some regimes are also given according to the individual.  Hope you had aq nice Thanksgiving. Chris

[Jan214]

I asked my Dr why I was taking Gemzar on day 1 and day 8 (considered 1 treatement)  with a week off, versus carbo/taxol which I had every 21 days and he said it had a lot to do with how long the drug stays in your system.  They can't give me a big enough dose on day 1, but they want to get another dose in just as day one dose is wearing off.  Also on the week I am off, my platelets plummet from 450,000 to about 100,000 so I guess it is doing its job.  My last CA 125 was 31 down from 61.
My onc does not do PIC lines if he can help it.  Some insurance companies don't pay for it, but that is a crime because having chemo drugs put straight into your veins collapses them quickly.  
I think a lot of times the side effects can be really different depending not just on the drug but what has happened prior.  Carbo/taxol seemed to make most people in my onc's office really sick, but they had all just gone through surgery and were still weak.  I have a friend who is starting it without surgery and she is just flying through it.  
HELEN:  How far into your Gemzar treatment did you have to have transfusions.  It is very hard on the blood counts and the mind.  Carbo/taxol was really rough physically especially with the neulasta shot and I felt horribly sick and just when I felt better it was time to go again.
Hope you all had a great Thanksgiving
Jan

[Helmar]

My thoughts are that each chemo, and the dosage taken, could have a different reaction to different women. We seem to be all individual in how we cope,regarding these treatments. I've had Topotecan each day for 5 days straight... I was very fatigued, and it didn't work for me, yet I take Taxotere/Carbo every 3 weeks and it works really well, with nothing much in the way of side affects. Gemzar was very harsh on my blood counts, and is the only one I've had, where I've needed transfusions for red cells and platelets... yet that didn't work well for me either. As I've mentioned here on a few occasions... it seems to be 'trial and error' for each of us, on what works for us, and what dosage is best for us, so I don't think we can really compare with each other, how each of the chemos will/won't work... and what is the best way to administer them. What works for me, may not work for some others. I think this is one of the most frustrating things about this disease... there doesn't seem to be any 'set pattern' on how to tackle it. Wishing each and everyone here good success with whatever they decide to take. We are all hoping for the same outcome...eventually....Hugs all....Helen...

[Brownie3321]

Hi Marty. I hope you and Leslee enjoyed Thanksgiving. I have chemo every 21 days. I started with Carbo/Taxol in my chest port and now have a combo of day 1: carbo/tax in chest port, day 2: cisplat. in IP port, day 8: taxol in IP port - start all over 21 days from day 1. My onc told me cancer cells can reproduce every 3 weeks, but he also told me the amount they give and when depends on your blood count. Thank God my blood count is always fine to have the chemo when scheduled. I do take Nulasta shot after every chemo. I don't think I ever had a chemo wash, as I don't know what that is?? My last CT/Pet scan showed no signs of cancer and my last CA-125 was a glorious 19. I started at 6,000, went to 195 after surgery, 220 after 2nd chemo, 50 after 3rd, 19 after 4th plus IP. I very much enjoy the port and find I would not like to be poked every chemo. I also have blood taken through chest port. Marie is correct about the veins and infusions. :) I hope this helps. With love, Deandra

[rmarie]

I always believed that that the only stupid question was the one never asked.
I believe that the dosing of chemotherapy is based partly on the recovery time of our bone marrow.  As you know chemotherapy destroys healthy cells that are replaced more frequently than other cells in our body.  Especially senstive is the bone marrow, where the red and white blood cells and platelets are made. I believe they factor the affect on the bone marrow into the drug dosages and delivery cycles.  Red blood cells last the longest at 120 days, platelets 7 to `4 and white blood cells about 13 to 21.  So many of the  drug combinations are 21 or 28 days probably depending upon how they affect the bone marrow.  This rest gives us time to recoup and get ready for the next round, however it is also the reason why we may need neublasta for white cells or procrit to help produce more.  Other drugs are given at lower doses over a number of days, like Yvonne's topotecan.  Gemzar is given differently depending upon the type of cancer.  Each cancer type gets a protocol, and they are usually standard evidence based protocols, unless one is in a study where they would be establishing it.  

I believe the problem in giving these drugs without a port, is you can run out of veins.  The drugs are very irritating at the doses they are given at, and the longer one is receiving chemo and getting infusions, the more difficult it will be to find a vein.

Hope this answers your questions.  Did you all have a good Thanksgiving?
Marie

[SimplyStar]

Well I for one am very stupid  and I admit it, since I don't walk in your shoes , all I learn is from you ladies and my research on the net.  I was always told  '''there is no such thing as a stupid question"  Its too bad this disease isn't "one shoe fits all"  then the comparisons would be simpler.  glad you are feeling better.

[YvonneS]

Go for it Marty.  We all have questions like this, but think other people will think we are stupid.  My Ono told me last week that we are treated as indivuals, so it doesn't' so much matter what other people are getting.  I have been on topotecan once a week since August.  The usual way is to give it 3 days in a row, skip a week and do it over.  But, this seems to be doing some maintenance for me.  Last CT showed some tumor reduced, yet new ones.  Not what we want, but something is happening.  I feel the same way about the CA125.  I told Ono I thought it was a bunch of bunk.  He said, "well, I always said, the CA125 doesn't lie".  I am down to about 150 after going up into the 200's.  Have all kind of questions like you, but feel like such a dummy asking them.  Feeling so much better since I had the ascittes (fluid) taken off my stomach last Tues.  Hugs, Yvonne