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weekly vs. 3 cycles of cysplatin.

dclear14's picture
dclear14
Posts: 35
Joined: Jan 2012

Hello,

My husband Robert is scheduled for weekly cysplatin chemo infusions for the 7 week period along with the radiation treatments. The standard is 3 cycles of cysplatin but there are issues with hearing loss and people getting so sick that they don't even get to the third round. Sloan kettering says that it is an option, but they do the 3 cycles because that is what is documented to work. His doctors in Lehigh Valley offered both and we picked the weekly smaller doses thinking it would be better tolerated. He starts Tuesday. Please let me know if anyone has done the weekly cysplatin and how it went? Thank you in advance, you are all such a wonderful inspiration and a wealth of information.

Denise

jtl's picture
jtl
Posts: 420
Joined: Sep 2011

I opted not to take cisplatin for those very reasons and more. The explanation I got for why 3 high doese if most people cannot complete the third dose was "that is just how we do it". I took 8 rounds of Eurbitux which has only recently been approved as a first line drug for scchn. I read every thing I could find and my medical onc agreed that for me Eurbitux was a better choice. I liked the fact that it only targets cells that express EGFR which is the cells that cause our cancers and therefore has less side effects for most people when compared to the platinum drugs. The downside it is newer, alot newer, and not yet embraced by the majority of the oncology community except when the platinum drugs fail. My doc thinks that will change but not for a while. So for now it is a game of pick your poison.

Skiffin16's picture
Skiffin16
Posts: 8062
Joined: Sep 2009

I had both of the above....no significant problems.

I had nine weeks (three week cycles) of Cisplatin, Taxotere and 5FU. Then similar to you and additonal seven weeks of weekly but that was actually Carboplatin for me with the 35 daily rads sessions.

The Carboplatin didn't give me any complications and was very tolerable actually concerning any nausea, etc....

It's supposed to aid the effectiveness of the radiation (or vice versa)....

I haven't heard of anyone having smaller weekly doses of Cisplatin though. The radiation will more than likely put a hurting on you for awhile more so than the Cisplatin.

But Cisplatin does have potential for some serious side effects so stay alert for them..flushing and hydrating a lot, watch for signs of neuropathy, tennitus, etc..

I never had any sever problems with any of the chemo fortunately...

Best,
John

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

Bad joke,I know. It is done both ways. Choose whichever is more convenient for you. It is true that the higher dose cisplatinum more likely causes nausea. It is also true that this is self-limiting and that MOST patients do not discontinue as a result of this. Modern anti-nausea drugs are far better than they were in the early days of cisplatinum, a drug that has been around for about 35 years now. Both protocals work, so make an easy decision.

Pat

Skiffin16's picture
Skiffin16
Posts: 8062
Joined: Sep 2009

If the cancer doesn't kill ya, the chemo is going to put a hurtin on you....

One of those anti-nausea drugs, especially for the high dose Cisplatin, Taxotere and 5FU that I took was EMEND....best stuff ever (though expensive, but what in this treatment isn't)....

EMEND taken for three days starting the day of chemo, I never even came close to being sick.

For the Carboplatin, I only had Zofran and Phenegrin...took the edge off of nausea (if I could keep my mind off of the next round).

I'd start thinking about it on the weekend before, and get queasy...kind of like when you eat something that makes you sick, just the thought tends to make you feel sick.

JG

Marty36
Posts: 84
Joined: Aug 2011

I was talking to my onc on Friday about this very subject. I'm about to do another short round of rads/chemo and I'll be doing Carboplatin instead of Cisplatin, which I did the first time. He said Cisplatin was "the worst chemo he gave" (he focuses on head/neck cancer) and said at the recent meeting of Head and Neck docs, the buzz in the research was that 2 rounds of Cisplatin instead of 3 was becoming the new norm because there doesn't seem to be a difference in outcomes with 2 versus 3. He actually planned that I would only do 2, which actually was a relief since I can't imagine facing another chemo round at the end of 9 weeks of radiation. Knowing that was behind me really helped mentally.

All that said, I did OK on Cisplatin. Some ear ringing for about 10 days. Nausea, but nothing awful. Just felt queasy for about a week after. Had a terrible case of hiccups from the anti-nausea and pain during infusion of one of the other anti-nauseas. But I went back to work a day or two after each round of chemo.

Kent Cass's picture
Kent Cass
Posts: 1746
Joined: Nov 2009

Please keep in mind the C Survivor mindset that the ultimate wisest route to take is to Error On The Side of The Aggressive. This is C, and that is as serious as it gets. Yes, it has taken many of us to the brink of tolerance, for which the Drs help with the meds, but we emerge from the C experience with success. I would hope that the total C doseage is typical- that's probably what matters the most.

kcass

MGC
Posts: 8
Joined: May 2010

I was supposed to get 3 along with the 33 rads but they refused to give me the 3rd because of my hearing damage.
I am 21 months out and the ringing is the same and constant and the hearling damage is forever they told me. That is the only issue I had with it though. Zero nausea. I am not complaining and thankful to be healthy. Also still have plenty of radiation side effects but still getting better all the time. I was SCC right tonsil and BOT.
Hope this helps

Mark

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