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Chemo choices... opinions?

julia12756
Posts: 22
Joined: Jan 2012

My gyn/onc told me there are 2 choices for my chemotherapy and he gave me his opinions for each therapy were. I wonder if there are similar opinions from your experiences?

Either therapy requires a port which I am having put in tomorrow. (I'm a little freaked out about this but am reassured that it will not be too bad.)

Ifosfamide + Taxol
My doc prefers to administer this on an inpatient basis over 3 days. His reasons are that there are risk factors he can keep an eye on better if I were in the hospital. He says this therapy has been around longer and has been tested more.

Carboplatin + Taxol
My doc says there are studies that say this is possibly just as effective as the Ifosfamide/Taxol therapy but has not been around as long. He also said this therapy has less side effects and can be given on an outpatient basis.

Anyone care to share your experience or info that you have gathered about this? Thanks in advance!!

Julia

JoAnnDK
Posts: 276
Joined: Jun 2011

I had the second combo that your doctor offered you, Julia. It was what was indicated by my tissue assay (did you have one of these done?)

I cannot imagine anything having worse side effects than the ones that I had. But everyone is different and I know people who have had NO side effects from these two drugs.

Taxol is known to cause neuropathy, so you might want to talk to your doctor about what you can do to minimize this.

The port is a blessing. I had never heard of having one until a week before mine was put in.

Best wishes.

JOANN

julia12756
Posts: 22
Joined: Jan 2012

Hi JoAnn:

I didn't have a tissue assay done but I asked about it. With the people that he consulted about my case, I guess they did not think that one would be worth it. I don't know if it was a timing issue since we were moving quickly for my treatment.

I did read about the neuropathy with Taxol and his treatment coordinator told me that I should let them know because there was another drug that they could use instead of Taxol if that happened. (I don't remember the name of the drug but it was similar in name to Taxol but a little longer.)

I have heard the port is the way to go but I am still a little apprehensive for my appointment. Thanks for your comments!

Julia

Ro10's picture
Ro10
Posts: 1395
Joined: Jan 2009

Most people have had your second option for their chemo. I was given the option of going into the hospital for my taxol/ cisplatin infusion.....if insurance would approve the hospital stay. I opted to go the infusion center for two days instead. each of my drugs need to be given slowly due to previous reactions.

The port is a very good idea. I did not have one for my first three treatments, and my veins have Never recovered. It is nice for lab work and CAT scans, too. Hope you get a power port or smart port. Other ports cannot be used for scans.

Good luck with making your decision. Feel free toask anyotherquestions you mayhave. I remember my anxiety before i started chemo duetotheunknown. In peace and caring.

txtrisha55's picture
txtrisha55
Posts: 424
Joined: Apr 2011

Julia,
I was given this choice also but it was to go into a clinical trial study that studied the results and the side effects of the two different chemo treatments. They gave me the paperwork that described the two chemo treatments to let me decide if I wanted to go into the trial. You could not chose which therapy you would get if you went into the trial but after you decided to go in they would let you know which drug you would get. I had MMMT stage 3C1. I went to UTSW Cancer Center here in Dallas, TX. It is a training research hospital. My family asked my GynOnc Dr (Dr. Lea-female) what she would recommend. She said she would recommend just the Carbo/Taxol instead of the trial but it was my choice. After reading all the paperwork on the side of effects of both chemos, I went with her recommendation and had the Carbo/Taxol.
One of the side effects mentioned in all the trial study on Ifosfamide chemo under the title heading of Serious was Death. When I saw that I freaked a little because I throught chemo was suppose to save your life not kill you.
My journey started in April 2011. DX in March, Surgery 8 April, Port 28 April, 1st Chemo 6 May, Last Chemo 22 Aug. Now in the montoring stage every 3 months blood work and every 6 months CT scan. The port was a blessing because I personally hate needles and this does save the veins and being poked all the time. Wishing you all the best in your journey. trish

CindyGSD's picture
CindyGSD
Posts: 191
Joined: Aug 2011

I asked a very similar question of this list last July.

My doctor wanted me to have Ifosfamide/Taxol, but never suggested it would be given as an inpatient. She also offered me the Carbo/Taxol combo if I couldn't handle the other, because I also work full time.

I choose the Ifosfamide/Taxol, six rounds, three weeks apart. The infusion lasts over a period of 3 days as an outpatient. The first day I get Ifosfamide/Taxol (six hours total) and the other two days just Ifosfamide (four hours). They also give me something called Mesna which protects the bladder from damage caused by the Ifosfamide. I think that is the biggest side effect of Ifosfamide and why they want you in the hospital. It allows them to keep you hydrated through an IV drip. I have had literally no side effects from the Ifosfamide that I'm aware of. They take a urine sample each day of the chemo treatment to make sure there is no blood in it and I'm told to drink a ton of water. I drink approximately a gallon a day - four 1 liter bottles. Most of the side effects I have suffered from seem to be related to the Taxol. If going into the hospital doesn't appeal to you, you might ask the doctor why he feels its necessary...if its an hydration issue...promise, promise promise you will drink tons of water and he may relent. It seems like more and more women are getting this chemo cocktail as an outpatient. Just make sure they give you Mesna.

Having said all that, I think you will find that most women here get carbo/taxol, though that could also be related to the type of cancer they have. I think Ifosfamide is used to treat MMMT vs other types.

As far as the port, I went through my first treatment (remember 3 days) without one and it took that experience to convince me to get one. In fact, I had a minor freak out last week when my port became clogged and I thought I would have to start the second half of my chemo by IV's but fortunately they got it taken care of and treatment last week was a breeze.

I'm sure whatever you decide about your chemo will be the best option for you.

Take care,
Cindy

julia12756
Posts: 22
Joined: Jan 2012

I just finished my first round of chemo (Ifosfamide/Taxol) and feel fairly lucky that I did not have any problems so far. I am now home with my Rx of anti-nausea in case I need it.

My doc definitely wanted to monitor me for hydration and says he only offers it inpatient so I am stuck with the hospital but it's ok because other than boredom, it's fine. They did give me Mesna with the Ifosfamide and some pre-meds with the Taxol which kind of knocked me out. (One was Benadryl which put me to sleep.)

Julia

JoAnnDK
Posts: 276
Joined: Jun 2011

Julia, do not let the nausea get ahead of you. I started taking Zofran 24 hours after my chemo treatment and took it religiously for 3 days. Never missed a dose.

You know that chemo is cumulative, so you may have symptoms the next time.

Take drugs. They are your friends during this time!

JOANN

Ro10's picture
Ro10
Posts: 1395
Joined: Jan 2009

Glad you tolerated everything well. May your next treatments go well for you, too. Enjoy each day. Remember to take those antinausea meds as needed. In peace and caring.

longtermsurvivor's picture
longtermsurvivor
Posts: 1780
Joined: Mar 2010

has been around since the late 70's, and is still the gold standard for first line treatment for epithelial ovarian ca. Carboplatin was patented in 1989. Maybe there was a communication lapse, but you are not wrong to take carboplatin as a first line drug. This drug is very well studied, extensively used, and has a known and acceptable side-effect profile. It generally is the one employed.

best

julia12756
Posts: 22
Joined: Jan 2012

Thanks for your message - I wonder why I was given the other therapy. My doc was pretty certain he wanted me to have the Ifosfamide/Taxol regimen.

In any case, I tolerated it fairly well and also had the Neulasta shot and that went fine also. So far I count myself lucky since I have not had leg pains, extreme nausea or bone pain.

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

So happy the first round went well. Worst thing is when it starts off bad with lots of side affects and you have bad taste in your mouth about the journey going forward.

Might I as well reiterate what someone else mentioned, in most instances (as was with me too) drugs are cumulative, therefore, side affects can get worse. I took the nausea meds like clockwork for first 2 and then decided to not take them and see how I felt. Had no need for them, therefore, they were left in the drawer. I learned to drink lots and lots of fluids and eat very small, simple meals. Important to keep food in us, which builds up our strength.

Also suggested I take whey protein, which builds us up, as drugs break us down. Very helpful as the powder whey I'd put in milk or OJ and drink twice per day.

FYI I had very few leg or bone pains until hit with Neulasta shot for last 3 chemo rounds. FLu-like symptoms are main side affects, but only lasted for 3 days.

Best to you and happy all is going smoothly!!
Jan

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