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Nausea from Taxol and CARBO

pamjay's picture
pamjay
Posts: 7
Joined: May 2009

Hi I'm new here. I am just 2 weeks post op with a dx of ovarian cancer. It was caught early so my outlook is very good but I will soon be starting a round of chemo with Taxol followed by an injection of CARBO the following day. I was wondering if anyone has had this combination and what the possibility of nausea and vomiting is going to be. I know everyone reacts differently but just curious how others may have beed affected.

I am to to have six treatments at 21 day intervals. They have already given me rx for Ativan and Penergan suppositories but said if they didn't work we'd try other things.

I'd just like to know what I might be in for.

lnyeholt's picture
lnyeholt
Posts: 65
Joined: Apr 2009

Welcome Pamjay:

This is all very new to me, too. My ovarian cancer (staged at 1C) was caught accidentally in March when I decided to have a hysterectomy primarily to relieve my long-standing problem with fibroids. The port was installed this morning and then I started my carboplatin/taxol treatments in the afternoon. So far, so good but it is my understanding that Day 3 & 4 is when symptoms such as nausea begin. My oncologist told me with the anti-nausea plan I'm on it's unlikely that I would get to the point of needing to vomit.

This is the regimen I've been given for nausea relief:

* 5 Decadron (steroid) 4mg tablets the night before chemo
* 5 Decadron in the morning treatment is scheduled. Decadron is also given intravenously prior to the carboplatin/taxol.
* Emend Tri-pack: one pill 1 hour before chemo, pill #2 morning after, pill #3 following morning. The N.P. at the oncologist's office says these are miracle pills but not covered by all insurance. Fortunately, my insurance paid for them.
* Zofran 8 mg. every 8 hours, starting day 2. Zofran is also administered IV prior to chemo. Some on this site receive this drug as a "melt" but mine are pills I swallow. I asked the N.P. about this and she said the former is good for people who are severely nauseated and might vomit a pill they swallowed but since they taste bad pill are usually a patient's preference.
*Compazine 10 mg.: optional, as needed
*Ativan 1 mg.: also optional and administered in IV form prior to chemo.

The ladies on this site have offered a wealth of information about making chemo more bearable. You might want to check back on older posts or type in a key word search at the top of the page to see where this topic has been discussed previously.

Be sure to check out the subject "BM" on this page. The ladies who have had years of chemo strongly suggest that prior to treatment use a stool softener and also one of the daily use products designed to relieve constipation. Drinking LOTS of water is also strongly encouraged.

Another good stream that has information that might be of use in general is titled "Apricot seeds". Especially towards the bottom there is a lot of good information about nutritional support during chemo.

Good luck with your treatments. When do you start?

Lyn

pamjay's picture
pamjay
Posts: 7
Joined: May 2009

Hi Lyn,

Sounds like we both found out about the same time, glad to have contact with someone who is also new to this stuff. I am not sure what stage mine is considered. It was basically confined to the right ovary with perhaps some cancer on the left one. I had already had a partial hysterectomy about 35 years ago when I was 30 due to recurring fibroids and the fact that I didn't want any more children. Had two, one boy, one girl, I was done! The lymph nodes were clean but there were microscopic cells on the omentum.

This is all new to me and I don't really know what I'm talking about. I had a melanoma diagnosis and removal on my right clavicle five years ago and thank God my dermatologist made me follow-up with an oncologist who has been doing the PET scans. If not for her and the scans the GYN said this would be so far advanced before I even had a symptom that I'd be up a creek without a paddle. The PET scan gave me a very early diagnosis so all should be well once I make it through the chemo.

I don't have a definite chemo start date yet. I go back for my one month post op visit on May 18, they went in and took out both ovaries, tubes, the omentum and lymph nodes. They will put in my port at my appt. on the 18th too. We had a Memorial Day weekend trip planned so the doctor said we could start treatment the week after that so I'm assuming it will begin sometime between May 25-29.

They have given me prescriptions for Ativan and Phenegran suppositories to begin with but said if that doesn't work (if I need them) that they will find other meds to help with any nausea. Hoping I don't have any. I'd rather be hit in the head with a baseball bat than be nauseated and vomiting! I saw a posting where someone else mentioned Emend Zofan and said it was expensive. I don't know if our insurance would cover them or not, will have to look just in case I want to ask the doctor for those. I have a lot of faith in my doctor so feel confident that she will do everything she can to keep me feeling as well as possible through this

I have started taking 150 mg of Iron daily along with a stool softener as directed by the surgical nurse and already drink water like a camel getting ready for a trek across the Sahara on a regular basis.

Nutrition is not a strong point with me. I have good intentions but never seem to carry through very well. Over all, I don't have a bad diet but I'm not good with fruits. Most disagree with my stomach. Seems the older I get the less I like and the more limited my diet gets.

Pam

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

I had 6 rounds of carbo/taxol in a similar 21-day interval schedule as you are getting. I was all set up with anti-nausea medicine,.... and never needed it! You may surprise yourself at how well you tolerate your chemo. It's no walk in the park, but is SOOOOOOO much more 'do-able' than I would have believed when I was at your current juncture in the journey. I had some blood count challenges during my chemo, but I never once threw up, ever. And I only ever took 3 anti-nausea pills because I felt a little squeemish a couple of days, but I don't think I ever really needed the pills even then. (I was just trying to get ahead of any nausea, since I hate it too.)

My last chemo round was March 26th and the only after-affect I have (other than the temporarily hairless body!) is a tiny bit of off-and-on nueropathy in 2 toes on each foot, and that is hardly noticeable. So, DEEP BREATH! You can do this. and BIG HUGS! because I know it's scary. Love & prayers!!

BonnieR's picture
BonnieR
Posts: 1549
Joined: Jan 2004

Dear Pam,

Linda explained it pretty good for you. Each person is different and some sail right through without many side affects. Expect nausea about the 2nd or 3rd day, I could not even stand the smell of the food and hubby had to cook outside on the grill as much as possible. And then I got the bone pain, but again everyone doesn't get this. Sending lots of hugs n prayers your way. Bonnie

pamjay's picture
pamjay
Posts: 7
Joined: May 2009

Good Morning Ladies,

Thank you for the advice and encouragement. I hope I'm in the group that has little or no trouble with nausea but if that's my biggest problem then I should just shut up and be grateful!

It seems that everyone on these message boards is so up beat and everything you guys have to say is so helpful. It really is a great place for information and inspiration.

Do any of you have any advice on which side is better to have the port put in? I am set to have that done on the 18th and got the idea that it would be up to me which side they put it. If you turn on your side in sleep does it bother you? Guess that's another individual thing like so much of this is.

Pam

christianchickcher's picture
christianchickcher
Posts: 26
Joined: Feb 2009

I cannot believe I had enough in my belly to vomit as much as I did today as I've been unable to eat or drink much. I know i have to force myself to at least drink, right?

rasunshine
Posts: 28
Joined: Feb 2009

Hey there, those are the words I live by. You will make it though all this, because you have courage, and you are not alone. I happened to make it through with none of the pages of side effects they gave me. My taster was off a little bit for about a week, but I just slathered everything in mustard and pickles and was on my way. After around 2 weeks or so, hair will be on the pillow, but don't worry, you will never have a bad hair day, you save money aka no hair products and you will have the smoothest skin around. no hair to shave, no bikini line it's great...oh.. and you have will have the 'LOOK....the 'LOOK OF LOVE'. Put on your make-up, tie a fancy scarf around your head..www.headcovers.com..put your shoulders back, head held high and go show the world you are YOU... you are not sick, you are where God wants you right now..
My port is on the left,slightly above my breast..my request..I am slightly bony in the chest area and my first one I had in 2005-2006 showed with my summer tops and swim wear. You will get used to it, it is just a little square deelly with nubs..real cute sitting under the skin. No one will notice..unless you mention it.
As for nutrition. it is very important in my book. Start researching Natural cures. There are tons of book at the libraries and the Health Food store. A good site to check out is www.gerson.org and www.elisa/act.com. Also www.rain-tree.com. It is very important to keep the liver healthy and to eat organic foods. A Chiropractor or a Naturopathic Physician will help you..
My belief is ..the body will heal itself, but you need to give it the tools to do so.Not to scare you, but These chemicals you going to get are VERY harsh on every inch of your body, they will do the trick, but you will need to rebuid what they tear down..So proper nutrition is very important along with physical activity, yoga, meditation and Faith in God, He is the Ultimate Healer..Just Believe that his white healing light flows through your body. He will show you the way.
And you are right... start a question thread and you will get takes from all of us.

I wish you well and always remember...Let the sun shine in.

Lifting you up in Prayer,
RASUNSHINE

lnyeholt's picture
lnyeholt
Posts: 65
Joined: Apr 2009

It does sound like we're on a similar path, Pam. It will be interesting to compare notes as we progress along our medical treatment in the upcoming months.

Yesterday I had my first round of chemo. I arrived at the hospital at 6:30 a.m. to have my port surgically installed and then over to the clinic at 11:30 am, to begin chemo. I was worried about doing both at on the same day but it actually worked out well because a line was left open and the nurse at the clinic was able to hook the I.V. right in without messing around with accessing the port. All went well but was a very LONG day! I was able to sleep through most of the 6 hours of chemo yesterday but that was probably because of all the anesthetics and pain relievers I had been given earlier. My husband, Bob, spent most of the day with me, popping in between his appointments. Collin, my son, stopped by with yogurt, Odwalla C-Monster juice and a blueberry scone about 1 p.m. I had a small pulled beef sandwich, soymilk & juice (with Metamucil) last night in addition to drinking lots of water, as strongly encouraged by all the informative ladies on this site.

One thing I would definitely stress is don't be afraid to speak up and ask questions! Due to the steroids I had to take prior to surgery and the necessity of arriving on an empty stomach I was feeling slightly nauseated and headachy prior to surgery yesterday. The anesthesiologist immediately ordered I.V. drugs to relieve the symptoms. There is absolutely no reason to be stoic or to suffer in silence.

Last night I went to bed early and slept from 9 p.m. until noon. It's almost 3 p.m. now and I am about ready to take a nap. I had read that chemo is tiring but there is really no way to prepare. My appetite is gone again but I have an appointment with a nutritionist next week to get some guidance on what I should be eating so I don’t have deficiencies. My main concern is all the food allergies I have. I take a lot of supplements but with all the drugs that are being introduced into my body I just want to make sure I’m not being depleted of essential nutrients. Thank you to all the other ladies who have responded to this post - I plan to check out the recommended web sites!

I felt pretty good when I arrived home last night. The port was pretty painful but they gave me I.V. painkillers in recovery and told me to use my Darvoset. That seems to be doing the trick. Today the site feels fine, just a little achy, so I switched to Motrin. Despite all the painkillers, I have a slight headache. The oddest thing about the surgery yesterday is that when I came out of anesthesia I was coughing and wheezing very badly and needed to have advair administered. Coughed most of last night but am fine now that I'm up today. I'm asthmatic so maybe something with the general anesthetic was atrigger.

My oncologist put the port on the right side. I am left-handed but his reasoning is that if you are driving it's better to have the port on the opposite side so it's more comfortable to wear a seatbelt. I also mentioned the potential bra-strap issue so although it's over far enough it will probably be visible under low cut clothing it won't interfere with my much-needed support system :)!

Down side is that all the fluids that went through me yesterday added 5#. Can’t wait to get to the nutritionist next week.

I hope some of this will help when it's time for your chemo to begin. be sure to let us know how you're doing!

Lyn

pamjay's picture
pamjay
Posts: 7
Joined: May 2009

Linda, Bonnie, Rasunshine, Lyn,

Thank you all for all the information. I've been reading your posts to my husband too since he's my main support system.

Lyn, you had quite a day! I'm tired just reading about it. Having to cope with food allergies and asthma too on top of all this can't be easy. I'm glad to have found someone that I can sort of go through this with and compare notes. Hopefully we will both breeze through this without much trouble.

Luckily I am basically in good health. I am 65 years old and I know age is always a factor too but the only health issues I have are blood pressure, cholesterol and minor digestive problems all under control with medications.

I had not given what I eat or don't eat much thought, just figured I'd eat like normal. I don't eat a bad diet but it is not super nutritional either. I probably need to give that more attention.

I didn't know if anyone had found a preferred side for the port. I'm right handed but don't go out much so the seatbelt issue wouldn't be a big deal. I don't go out in the sun so don't wear bathing suits and at 65 almost 66 I don't wear anything too low cut anymore. My main concern is comfort in sleeping at night. I have back and joint pain issues and flop around like a fish all night from back to side and side to side but do tend to favor laying on my left side, that hip hurts the least quickly.

I have until the 18th of May to decide which side I want the port and then they may have a preferred side too for some reason but I'm open to all opinions on port placement.

Thanks to you all,
Pam

LPack's picture
LPack
Posts: 658
Joined: Oct 2008

Pam,

My port is on my right side and I am right handed. Have had no problems whatsover with my port. I am short so could have a seat belt issue anyways, but never have. Maybe just got use to it over the many, many years.

When my port is accessed, which it still is to flush once a month or blood work when needed, all the nurses really like the placement of my port.

I too have had joint pain even before chemo, probably because of menopause and arthritis, but now even more so. Water again helps with lubrication, kidneys, bowels and again with the chemo treatments to get it through your system faster.

Praying for you,
Libby

LPack's picture
LPack
Posts: 658
Joined: Oct 2008

I too did pretty good with carbo/taxol some nausea.........just remember drink plenty of water. Helps out with everything.

Libby

rasunshine
Posts: 28
Joined: Feb 2009

The amount of water that you should drink would be your weight divided in half, which gives you the number of ounces..120 lbs would be 60 oz. Sounds like a lot, but if you fill a container and leave it out, room temperature is better for the digestive system, you will be more apt to consume it. The water you drink should be filtered and not from a plastic bottle.You will also get water from eating celery and lettuce. Watermelon is a good substitute, plus it is high in alkalinity, which is where you want your cells to be to stay healthy. One thing to remember is that dairy (cow's milk) will cause the making of Salmonella typhimurium bacteria which in turn can cause tumourous growths that cause your cancer antigens CA-125 marker to rise. It is best to eliminate all cow dairy from the diet, which includes multitudes of foods. But there is goat and sheep cheeses which are very tasty and goat milk. This is food for thought or however you want to use it. I have found that with cancer you have two problems, the cancer in itself and the contributory problems, which will be different for each of us, we have our own cellular blueprints. I have taken up the challenge to help myself through other avenues, so when I put something out there on this site, I guess you can take it or leave it. I wish you well and my prayers for a healthy journey..

Let the sun shine in.
RASUNSHINE

lnyeholt's picture
lnyeholt
Posts: 65
Joined: Apr 2009

Today is day 3 after chemo. Most of the soreness has worn off from the port installation already, although I'm still medicating with Darvoset at night and Motrin 600 mg during the day. The first night my right arm was very sore and I wouldn't have though of sleeping on that side of my body. Today, it's fine and I'm having less discomfort when I move the arm or raise it to reach for something.

One of my close friends recommended an herbal based product called "Estroven" to help with the night sweat problem. I asked my doctor if I could use it and he told me that as long as it's not an estrogen replacement product, it should be o.k. I've been taking Estroven-Night the past two nights and sleeping better than I have since my surgery 6 weeks ago. Some of the anti-nausea drugs I'm taking cause drowsiness also, which is helping. I'm sure all the other meds I'm taking help, too - but it sure feels good to get a sound night's sleep!

I made a big pitcher of lemon water and that seems to be helping me get as much fluid in my body as possible between naps. I have been exhausted and sleeping most of the day but no problem with nausea so all is well.

I'm not sure exactly what I was expecting, but so far not too bad. I'm praying your first treatment goes well also, Pam!

Lyn

pamjay's picture
pamjay
Posts: 7
Joined: May 2009

Hi Lyn,

The sleep issue was my biggest concern as far as the port is concerned. I don't sleep well anyway unless I take something. Maybe once the initial soreness of the port installation wears off I won't have any more problems with sleep than normal.

I talked to the nurse yesterday and I go for labs this coming Thurs. then see the doctor on Mon. and get the port and presume they will give me the starting date for chemo. I am dreading and anxious at the same time to get started on this.

The suggestion of putting a jug of water on the counter is a good idea. I prefer room temp water anyway and if it's setting out I'm more likely to pour another glass and drink it.

I hope I do as well as you are doing.

Pam

Bstrange's picture
Bstrange
Posts: 87
Joined: Feb 2009

I had no nausea or vomiting. I really never had much reaction. On Thanksgiving I lost my taste- so I ate the next day. This is my second round on it and I finished the last one Wed. Thank God.

I did have problem with my taste and tingling the chemo time before this last one. It lasted 4-6 days the taste, but got much better immediately when my sister prayed with me. The tingling was bad for about 2 days. Of course, when you start feeling great it's time for another.

My Oncologist gave me Emen ( take one the day of chemo, day after, and the day after that). She gave me Prochlorper (generic) for nausea, only if I needed it ,and Dexamethasone (4 day before, (4 day of) and ( 4 the day after). She did not wait for me to see if I'd have a reaction she was proactive.

Have a positive attitude, remember God is the physician, and don't expect to get sick. My hair has even grown back while under chemo!

God Bless You,
Barbara

green50
Posts: 318
Joined: Feb 2008

I never got nausea with the any chemo weakness and tiredness little foggy headed. But after perhaps a few days some side effects go away. As the ladies said everyone is different. I have taken taxitere probably 3 times and carbo 2 times. Yes it "may make you loose your hair." It grows back. I have taken several chemos over 7 years and it worked the best on me. Hopefully this will be your first and last treatments and then you go on as I have seen MANY do. mine was stage 3 but even that doesnt mean everything. Some are cured after stage 4. I pray everything goes well. Be positive and try not to be worried. They have stomach meds which they gave me in IV plus steroids. Lemon drop candies help the flavor in your mouth not to taste like metal and even using plastic wear to eat with instead of metal helps. The Zofran that melts on your tongue instantly helps nausea quickly. But again as some of us you may not have nausea. I took one of my husbands when I thought I had the flu and it was food poisening but it took my nausea away immediately. But again you may not have it. I pray everything goes well for you and this is the only time you have go thru this.
Prayers and Hugs
Sandy

pamjay's picture
pamjay
Posts: 7
Joined: May 2009

Sandy,

Thanks for the input. It seems a lot of the posters have not have nausea problems with Taxol and Carbo so I'm more hopeful now. I don't know what stage my cancer is/was but I know it was caught very early. I have just come to terms with the phrase "I have cancer". I just never thought to ask the doctor yet what stage she would classify mine. Heart disease is the big killer in my family so cancer wasn't really on my list of things to be concerned about, SURPRISE!

I thought I read somewhere that the Zofran was very expensive and that some insurance didn't cover it but glad you had such good luck with it stopping the nausea.

The doctor said they'd be giving me all sorts of meds during the chemo treatment to prevent nausea and whatever but that it would be day 2 or 3 after that it might hit me. I'll try to think positive as you all on the list have said.

Thanks to everyone on the list, you are all in my prayers.

Pam

lnyeholt's picture
lnyeholt
Posts: 65
Joined: Apr 2009

Pam, I know that one of your concerns is sleeping. Most of the anti-nausea meds cause drowsiness. I've found that sleep is no problem - I sleep from about 8 p.m. - 7 a.m. and then two or three long naps during the day. My port is a little itchy but other than that, it has been fine since the second day, not much soreness at all and no difficulty sleeping on that side. I will tell you my biggest problem yesterday and today is feeling very achy in my joints and bones. This isn't much fun, but it sure beats the alternative.

Lyn

saundra's picture
saundra
Posts: 1390
Joined: Mar 2007

Sounds like what happened to me. The deep bone pain was the most bothersome. I tend to sleep off discomfort and did a lot of it. Daily got better.... I did have nausea some on dose 6 to 8 but the pills worked if taken as directed. Saundra

worriedaboutmom
Posts: 31
Joined: Apr 2009

hi! nice to meet you! my name is becky and my mom is currently being treated for ovca stage 4. she just finished her first round of carbo/taxol and she is doing beautifully. only had to take nausea meds one time. hope everything goes well for you! i will keep you in my prayers!
love becky

ambientbeats's picture
ambientbeats
Posts: 15
Joined: Jun 2009

I too was quite concerned about the nausea side-effects of carbo/taxol (since I hate vomiting and being dizzy). But, knock on wood, after 5 chemo sessions, I have not had a real problem with it. What I've done is to get ahead of the nausea. I was told by my ONC and nurses that if I felt even a tinge of it, to take the meds. The 2nd or 3rd day after chemo, I depended on Zofran (and you're right, they're expensive so I was only given 9 - for 3 days, which is about what insurance would pay). After that, Ativan does the job, if EVER you feel that tinge. Ativan also helps at night, if you can't sleep. I find it's a miracle drug of sorts.

Like the other ladies said, hydrate. It's good for you -- particularly those electrolyte infused waters like Smart Water. Also, ginger is the best thing if you're feeling nauseated at all, wether in tea form or candy. I always keep these in my bag as they're effective nausea settlers. :-) The most effective ones are "Go Naturally Organic Ginger Candy" They're hand made/gluten free/natural -- and EFFECTIVE. Here's the website: www.hilsidecandy.com.

Everyone reacts differently. It's my hope that carbo/taxol doesn't nauseate you. It's a pretty good combo for getting rid of those pesky cancer tumors though.

best,
c

flynpool
Posts: 1
Joined: Jul 2009

Hi........I had 8 rounds of taxol/carbo and was never nauseated. Treatments were just horribly dibilitating, and got more tiring with every treatment. Hang in there!

eve140
Posts: 3
Joined: Oct 2009

i finished this teatment july15/2009..i never threw up once..i did have sore muscles and bones .

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