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how many chemos are enough

Kirama
Posts: 1
Joined: Apr 2007

I have stage 3C endometrial cancer - 2 lymph nodes positive out of 19 after february 07 surgery. I have had three chemo tx's of cisplatin, doxorubicin and taxol (each tx over two days), followed by 25 radiation txs. Just started second round of chemo in early july - which wiped all systems out and landed me in the hospital for transfusion, hydration, electrolytes, antibiotics and counts that were in the basement. Neuropathy now in feet too after this last treatment. One onc doc told me - at the hospital -if I were his patient he'd have me stop the chemo now. He said three chemos were needed (I have now had 4) and beyond that he called them "safety" chemos ie there is no literature backing up that one needs more than the three. Perhaps the ca-125 marker might be useful though, he said, in assessing whether it is definitely time to stop. My own onc is still pushing for me to finish out the 6 treatments but perhaps without taxol. I am thinking it is time to stop. My body feels like it has reached its limit... but I have doubts about which way to go. What are your experiences with making this kind of difficult decision and on what did you base your decision?

kmygil's picture
kmygil
Posts: 829
Joined: Feb 2007

Hi Kirana,

I'm sorry that you have had such a rough time of it. I hope that after research you will be able to make a much more informed decision.

A little history: Aug '06 dx's w/Stage IIA colon cancer; surgery Aug 30 followed by chemo (5FU, leucovorin, oxaliplatin). I was scheduled for 12 rounds, but like you, I ended up w/crashed blood pressure, neuropathy, low counts etc. Initially it wasn't too bad, but after round 6 the dose was lowered due to cumulating side fx & sickness. After round 9 I ended up so weak I was falling down, with a BP of 67 over 40, and totally dehydrated. I made the decision to stop and my onc agreed that I should stop, as the purpose of chemo is to help, not to kill. I have rather severe neuropathy in my hands/feet, but it has gotten tolerable with 300mg of Neurontin 3 x daily and Vitamin B6 4 x daily. I also had severe bone pain which was only tolerable with Dilaudid, but which has eased to intermittent status and not so severe.

In 3 days I have surgery for EC, diagnosed last month. Needless to say I was not a happy camper, but it seems to be early stage. I think you should go to the Anderson MD cancer site & check out what the protocol is for your grade & stage of cancer. Whether you decide to continue or not, you should have a good game plan for follow-up checks once this is over. I hope you get better quickly and that you remain NED forever!!!

Hugs,
Kirsten

tlva
Posts: 56
Joined: Nov 2005

Hi Kirana,

So sorry for all you are going through. I did not have to have chemo so I'm not sure what the protocol is, but I wonder why doctors have to disagree in front of their patients instead of between themselves. What does that really accomplish for the patient's emotional well being when we are trying to do the right thing and they are supposed to be the ones who know what's best?

My sister is a breast cancer survivor and was in a study for the effects of Taxotir (spelling?), which is similar to Taxol, and I know it wiped her out and she wound up in the hospital for a few days after passing out during a treatment. But she did complete the therapy and is now an eight year survivor.

I don't know if that helps much, but I would say to go with your gut feeling about what you want to do so that you won't have any regret or guilty feelings down the road about doing enough. Ultimately, we should be the ones in control based on the advice of professionals armed with courage from the grace of God.

I wish you well and hope that you recover soon and enjoy a beautiful life ahead of all this!

Prayers to you,
Tammy

amelle
Posts: 2
Joined: Jul 2007

Hi, i am also a stage IIIC endometrial cancer patient with both pelvic and PA nodes positive. When you stop chemo is an extremely personal decision. You need to know that if you had a recurrence, you could live with the decision you made. If you need ammunition on the side of stopping now, however, I can share some of the things I read and heard in my journey through this process.
I was told by an oncologist that there's no data on how many chemo session are required, that the no. 6 is basically a "tradition". Apparently, in ovarian cancer(don't know if this applies to all stages and grades or just some), it was only recently determined that 4 chemo sessions are as good as 8. 8 were being given for years without an actual study showing that that was the optimal no.
The 2007 annual meeting of ASCO (Am. Scty for Clinical Oncology) had a closed door session (I found this online), in which it was revealed that the 3 drug combinations for endometrial cancer are much more toxic and dangerous than the 2 drug combinations, and add one month of life. So, if you decide to continue, I'd definately switch protocols. Hope this helps. I would recommend that you look all this up yourself. I did a lot of research for my own case, but am hardly an expert. Hope you find a decision you're comfortable with.

Felixthecat
Posts: 37
Joined: Dec 2007

If you still have progression after the treatment you could consider this trial. The Phase I trial went well so they are doing a phase II trial now:

Endometrial Cancer Trial Drug Now Free
http://www.cancerwise.org/may_2005/display.cfm?id=1A29F5A7-F64B-4656-9FF3A93B491655CF&method=displayFull&color=green
Women with endometrial cancer will no longer have to pay for a drug being studied in a hormonal therapy clinical trial. Thanks to funding from a $10.4 million Specialized Program of Research Excellence (SPORE) grant, M. D. Anderson study investigators hope to recruit more women in a Phase II clinical trial for Mifepristone as a treatment for specific types of endometrial cancer. Before the SPORE funding became available from the National Cancer Institute, study participants had to pay $500 a month to cover the costs of the drug.The goal of the study is to determine the potential benefit of Mifepristone for recurrent or advanced endometrial cancer patients with tumors that are sensitive to estrogen (progesterone-receptor positive) or patients with low-grade endometrial stromal sarcoma (LGESS), a less common cancer that develops in the supporting connective tissue of the endometrium....(more info via link above).

Details of the Clinical Trial:
Mifepristone for Patients With Endometrial Cancer and LGESS
This study is currently recruiting participants. Verified by M.D. Anderson Cancer Center, July 2007
http://clinicaltrials.gov/ct2/show/NCT00505739?cond=%22Carcinoma%2C+Endometrioid%22&rank=3
Phase II Study of Mifepristone (RU-486) in the Treatment of PR Positive Advanced/Recurrent Endometrioid Adenocarcinoma and Low Grade Endometrial Stromal Sarcoma (LGESS)

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