whats next after failed gemcitabine

reenie

Wed we saw the dr to go over ct results. Sadly the gemcitabine /Tarceva did nothing for Sam. Along with the original 2 masses in the mesentery growing and matting together, the one in the liver increasing about 60%,
he now has two lesions on the lung. Oddly nothing showing in the pancreas. The Eus/FNA in april confirmed the pancreas as the primary but the cells there were necrotic - I guess once they've done their dirty work they sometimes die off.

I guess with all the info out there I realized there was not a great chance of hearing good results on Wed. My idea of good results would have been something as simple as no change. While Dr can't say how long, he has indicated that while Sam's time is limited, he appears to have "months". He said he can never tell for sure and things could change quickly. Right now Sam is enjoying the time he has. He is able to be up and alert for long stretches during the day and is sleeping well at night. Yesterday he was able to putter about the house fixing little things here and there.

Monday we'll here about xoloda and oxyplatin. Almost hate to put him through anymore but he is willing to try anything. That balance between quality and quantity is his choice to make.

Big fmaily doings this weekend. Everyone is coming for Sam's Confirmation and a big brunch on the lake afterwards. that will be so difficult for us all and nice at the same time.

rechargeable

reenie,

My dad was on gemcitabine for a while following his pancreatectomy. Two or three months after coming off it, he had a lightning-fast recurrence. They think that the gemcitabine was probably suppressing the cancer and that once he came off it, the cancer flourished.

So, having failed with the gemcitabine, dad is just beginning with oxaliplatin and Xeloda. Tomorrow is his second infusion of oxaliplatin, and he is on a one-week-on/one-week-off regimen with the Xeloda. So far he has experienced heavy fatigue and a greatly diminished appetite (though he was already experiencing those symptoms to an extent.) They warned us about cold-sensitive neuropathy, but he hasn't experienced any of that yet.

Depending on their judgement of how well he's tolerating the oxaliplatin, they may begin including Avastin in the infusions. Avastin is something that intereferes with the tumors' blood supply.

Hope your next appointment goes ok.

reenie

We are still waiting to hear from the Dr. re: Xeloda and Oxaliplatin. Thanks for the heads up on the side effects.

I've contacted NCI at the Dr's request and they are searching for clinical trials. We can't consider anything below a phase III.

I am curious about why your dad came off the gemcitabine. Did they do a CT and determine it hadn't worked, or was he not able to tolerate any more of it?

Oh, did you get the pain med issues resolved? Reenie

rechargeable

Well, dad never really "came off" the gemcitabine. He finished that treatment, and then a couple months later, his current enormous recurrence happened. They think the gemcitabine was suppressing the cancer, but although it was at least doing something, there's some reason that they've now opted for the oxaliplatin. I'm not sure what that reason is. He tolerated the gemcitabine fairly well but it might not be as effective against advanced cancer, like he has now, as it was against the invisible cells left over after his operation. I have to ask the oncologist when I see him next.

I'm still working on finding a pain specialist or pain management center. Right now the oxycodone he has is working for him, thankfully.

Regarding side effects, my father's last infusion happened on tuesday (not monday like it was supposed to), and this time they gave him Avastin along with the oxaliplatin. It's hard to tell which drug this might be related to, but last night my father woke up shivering quite violently and had a "just ran five miles" feeling in his leg muscles. I immediately checked his sugar, which was low, and gave him some cranberry juice. Shortly thereafter he threw up and stopped shaking, but developed a significant (but brief) fever, up to 102.1. I was on the verge of calling an ambulance but he really didn't want to go (understandably.) So we watched his temp and sugar for a while longer and both stabilized, thank god.

I realized during all this that I forgot to give him one of the anti-nausea pills he was supposed to get. Last infusion, they gave us samples of Kitril, which were twice a day for three days following the chemo. This time, they were out of Kitril samples, so they gave us Zofran, which is three times a day, also for three days following the chemo.

My lesson from this is never, ever forget the anti-nausea meds. I don't know for sure that that's what caused this episode, or whether it might have happened anyway, but who knows.

westlake · New User Joined: 20 Jul 2006 Posts: 5

Instead of choice the second chemo regimen, a botanical alternative therapy may be with much positive prognosis in his case. However the therapy is applied outside of USA... Hope for the best. /westlake

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