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Abdominal Ascites / Gemzar (gemcitabine)

RachAndMom
Posts: 8
Joined: Mar 2010

Hi,
My mother has stage 4b UPSC ENDOMETRIAL cancer but is experiencing major ascites which we have been told is more common in Ovarian cancer so we are hoping to find some information on this board. Her doctors are switching her to Gemzar (gemcitabine) which is apparently more common for Ovarian cancer as well. If anyone has any experience with this symptom (ascites), and/or Gemzar (Any special side effects we should be aware of?) we would be most grateful for any information!

She has completed 3/6 scheduled rounds of weekly carboplatin/taxol. Despite having a couple early setbacks (kidney failure treated with ureteral stents, and a deep vein thrombosis in her leg) she was doing was doing remarkably well with no major symptoms for the past couple of months up until a couple of weeks ago when the ascites started accumulating in her abdomen. Her CA125 numbers had gone down to normal and her CAT Scan one month ago showed marked improvement but in the past couple of weeks this ascites started and a follow up CAT Scan indicates increased cancer growth and omental caking

She had 2.3 liters drained (by paracentesis) from her abdomen less than a week ago and another 1 liter drained today. The paracentesis has relieved some of the nausea but she still has a distended abdomen and is horribly uncomfortable

Her doctors have concluded that the carboplatin/taxoll isn’t working and want to start her on Gemzar (gemcitabine) this week until functional profiling results come back.

We are having trouble finding information on abdominal ascites during treatment for endometrial cancer or treatment of resistant endometrial cancer abdominal ascites using Gemzar.

We are all very worried about these new symptoms and nervous about the switch in chemo. If anyone has any experience with ascites or being treated with Gemzar we would be very grateful for any information.

Thanks!
Rachel and Mom

sanam's picture
sanam
Posts: 112
Joined: May 2010

Dear Rachel
I am sharing my Mom's case with you and I hope it helps though it is not similar.
My Mom cancer was diagnosed from ascites.She looked bloated and 9 months pragnant for 2-3 days and then she took a sonogram which showed ascites but anything else reported normal.then she had a scan which again showed ascites and a lesion between liver and colon.She stayed in hospital for 10 days and her CA125 was 1199.so they concluded that she has PPC or OVAC.During her stay in hospital they drained 4 lit of acsited and the cytology report showed adenocarcinoma cells in the fluid.they started carbo/taxol right away.after the fourth session the ascites was gone and her CA125 was on 114.they continued 2 more sessions the same chemo and then she had a 1 month off chemo and then the scan showed a mass on her right ovary and some acsites in her pelvic area.She had her debulking surgery with optimal results and they removed ovaries,uterus and omentum. The pathology report came back with undiffrenciated carcinoma all over omentum and the source was the right ovary.and 1 lymph node was affected.
Afterward they started Gemzar/Campto regimen for her every 2 weeks and each 2 sessions is 1 round.She is doning well on gemzar.No fluid built up.her hair is growing back.she experienced constipation for 5 days after the chemo and some flashes on her face and feet 1 day after chemo which is not a major issue.other than that she is fine.
I hope it helps and gemzar works for her.
Hug
Sanam

nancy591's picture
nancy591
Posts: 1059
Joined: Sep 2009

Sorry to hear the carbo/taxol isn't working as well as everyone would have liked! Did Mom have her surgery yet? If not, is surgery in her future?

I have been on Gemzar since May of this year. Gemzar is way easier on the system then carbo/taxol is!!!!! It can be hard on the blood counts though. I've been having to take Neulasta or Neupogen after each infusion. Those are injections you have to take 24hrs after chemo to bring up your WBC (white blood cell count). The only premedication you have to take is a steriod pill the day of chemo. I've needed no anti nausea mediction in addition to that pill the day of chemo. I do get fatigued and 'icky' feeling a day or two after chemo. For me it is a piece of cake...almost like I'm not on chemo. Mom will also get her hair back that she lost from the taxol.

I've had no acities so I can't help with that. I am not sure if the Gemzar is working for me though. I go for a scan this Friday and hoping for the best. There are other women on here though that have had success with Gemzar. There are also lots of other good options if the Gemzar does not work so don't despair.

I can see what a loving and caring daughter you are. Good luck to your Mom and your family. Let us know how things work out!

Nancy

Tasgirl's picture
Tasgirl
Posts: 85
Joined: Jun 2010

Hi Rachel and Mom
I had ascites when diagnosed with Primary Peritoneal - I had 7 litres drained when I had my debulking surgery October 2008. I had carbo/taxol with no problems so have no idea about Gemzar. I know a few ladies who have had ascites and only have chemo and the ascites dries up. Hope the rest of the treatment is successful. Jenny

Hissy_Fitz's picture
Hissy_Fitz
Posts: 1869
Joined: Sep 2009

Usually the chemo keeps the ascites in check. I had 3 liters of fluid drained prior to my de-bulking surgery and no ascites since (11 months).

Has she had scans of her other organs - lungs, liver and kidneys, for instance? If the cancer has spread, that would account for the ascites. Liver disease is particularly known for producing ascites.

Tina Brown's picture
Tina Brown
Posts: 1054
Joined: Nov 2009

My cancer - PPC was diagnosed by ascites and it had spread into the cavity around my lungs. Cancer cells "weep" fluid and they also "block" the natural drainage system. That is why it gets stuck or blocked in cavities such as stomach area & lung area. There are 2 ways to get rid of it:
1. Having it drained. But this is not a long term solution because it will come back. I had 4 chest drains before I started chemo.
2. Chemo. As chemo kills off the cancer cells or tumour the fluid will go. Sometimes it is re-absorbed by the body. Also (I think) the chemo allows the drainage system to work again properly so the fluid DOESN'T build up again.

I was diagnosed Nov 09 with fluid around my lungs. My last chest drain was Jan 10 as the chemo kicked in and all the fluid just drained away. Fluid in my abdomen just drained away as chemo started working. My treatment finished March 26th and I am still fluid free - yipee :)

I hope things go well for you both. Love Tina

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

I'm on gemzar and cistoplatin, two weeks in a row and skip one week. I have found it very easy to take. I sleep a lot, no nausea or other side effects other than low red blood cells. Had to have 2 units of blood week before last. I have not had any ascites in 3.5 years. Saundra

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

Saundra,

That is good. Gemzar/Cis did a number on me. So far out of all my treatments, that combo has been the worse!!

I just had my first diagnosis of slight ascites with this last CT scan. Scheduled for another already! In clincial trials I guess you get all kinds of tests and attention!!

I did end up allergic to the cisplatin.

Take care!!
Love,
Libby

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