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chemo back to week 5

StruTanToot
Posts: 102
Joined: Aug 2012

I pressed for a reason on giving me chemo week 6. I essentially was told it makes no difference, so I made the point that week 5 would be better since the side effects from radiation would be worse week 6.

The doc hadn't thought of that, thought it was a good observation, and put me back to week 5.

My understanding of treatment has been that chemo is given during weeks one and five. Yesterday my chemo nurse told me that I would get the second round of chemo in week six, which is during the last five days of radiation.

I asked her why and told her that chemo in week six is not protocol. She said it really doesn't make a difference whether it's week five or six. I'm being treated at Duke, and she said that giving chemo week six is the way Duke does it.

Duke is supposed to be an excellent cancer center, but I don't want to be part of a research study.

Does the week make a difference? Has anyone else received chemo in week six instead of five? Maybe I'm wrong, and the protocol is week six. Everything I remember reading though mentioned week five...if I'm remembering correctly.

Thank you for any info.

mp327's picture
mp327
Posts: 2666
Joined: Jan 2010

Is it possible that the chemo nurse misspoke? I would clarify this with your medical oncologist and have him/her explain why you will receive round 2 in week 6, if that is true. The NCCN Guidelines clearly state that round 1 is days 1-4 and round 2 is days 29-32, which would be during weeks 1 and 5. I would definitely want an explanation.

As for it making any difference, I don't know. Only your oncologist could answer that. I can only presume that the guidelines are set up as they are, based on research and evidence that this schedule provides the best and most effective treatment.

Please let us know what you find out. I'm very curious now as to any reasons your doc might give you for the deviation from standard protocol. Thanks.

StruTanToot
Posts: 102
Joined: Aug 2012

I'm getting 30 days of radiation. Is that not standard?

mp327's picture
mp327
Posts: 2666
Joined: Jan 2010

Yes, 30 days is standard for radiation. I understand why the info I gave you about the chemo might be confusing. Chemo days are counted including weekends. Radiation days are counted on days when you receive treatment, which is most likely Mon-Fri only.

eihtak
Posts: 784
Joined: Oct 2011

I for one did not receive chemo according to schedule. I never missed radiation, but due to some complications (I have a colostomy and my colon prolapsed out of my body!!!)...sounds worse now than it was; my chemo schedule was altered. My doc said it was all still ok ??? but to miss radiation would be worse. At my 1yr scan I was NED on the anal cancer. I was always worried that it didn't follow the protocal I had read, but did work for me. I would double check on why they are not following standard procedure, but also would not worry too much. Continued good luck to you, and please let us know what you find out.

StruTanToot
Posts: 102
Joined: Aug 2012

I talked to my radiation oncologist today. He said that chemo is used to boost the effects of radiation. He sees no issues, but I still don't know.

The second round of chemo will be Oct. 1-5; days 25-29 of radiation. Radiation ends Monday, Oct. 8 (no radiation on Labor Day).

mp327's picture
mp327
Posts: 2666
Joined: Jan 2010

I'm glad you talked to your rad onc. He is correct, chemo is used primarily to make the radiation more effective. I'm sure if he was concerned about you getting the chemo on week 6 instead of 5, he would confer with your med onc. Keep in mind that the radiation will continue working for awhile after your treatment ends.

Angela_K
Posts: 370
Joined: Jan 2011

I had my last round of chemo in week 6 at the direction of my rad and med onc. Just fyi.

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