Does this chemo cocktail work? What about radiation and/or surgery?

mdemetrius

Hi All!
Thanks to William66, I discovered that my dad's diagnosis of adenocarcinoma of the esophagus is not really stage IV, but more specifically, stage IVa. The past three weeks have been one test after another, with the first chemo treatment scheduled for this Monday, June 7th. I've researched several chemo combination therapies, and I'd like to know if any one of you have, or know someone, who has taken this combination. I know everyone's side effects are different, but I like to research as much as possible, and learn as much as I can from people who actually have EC, or are caregivers for someone with EC.

Findings from his CT showed an 8cm esophageal tumor involving the distal half of the esophagus to the gastric cardia. The oncologist said that the tumor was found at the lower third of the esophagus and cardia. In addition, there is malignant right pleural effusion at the base of the lung. And to top it off, there are 5 scattered lymph nodes. Luckily though, no organs have shown cancerous cells.

The chemo cocktail:
Oxaliplatin and Epirubicin (both given every 4th Monday) in combination with 5-FU. The 5-FU will also be taken daily via his port, and the med will be refilled every Monday.

The onco said that if there is nodular involvement or other organs involved (pleural effusion around the lungs), then the only option would be chemo. If the cancer was just located in the esophagus, then chemo, radiation, and surgery would be the option. I know that most of you are not doctors, much less oncologists, but I like to go to the doctor's appointments fully prepared. I'm not going to be one of those people that just goes along with everything the doctor says when I may know of other options!

Thanks again!
-Marissa

timp

My wife has been diagnosed
My wife has been diagnosed with EC Stage III. She is a surgical candidate. Her chemo regimen is cisplatin and 5-FU. She has had a serious reaction to the 5-FU, which developed into mucosidis, a very painful condition affecting the entire intestinal tract, especially the mouth. She is also receiving radiation treatments five days per week.

From what I have read and seen, cisplatin and 5-FU seem to be pretty standard chemo protocols for this disease. My wife appears to be unusually sensitive to the 5-FU, so you may not a problem with it.

Good Luck

Timp

paul61

Chemotherapy Experience
Marissa,

I have been completing a chemotherapy regimen similar to the one your husband will be receiving. I have been on this protocol for the last five months.

The protocol includes Cisplatin and Epirubicin administered via infusion every 21 days with 5 FU administered via infusion pump 24 x 7. My protocol includes six rounds or 18 weeks.

When I get the infusion with Cisplatin and Epirubicin they give me a pre-medication with anti-nausea medication and standard saline solution. The anti-nausea medication includes Emend, Decadron, and Anzemet. They also administer two additional liters of IV saline after they push the Cisplatin and Epirubicin to insure the chemotherapy medication is flushed from my system. The drugs can damage his kidneys if they are not flushed properly. Your husband should expect the process to take about six to seven hours. Don't be alarmed when his urine turns bright orange, it is the Epirubicin flushing from his system.

They also give me Emend, Decadron, and Anzement to take orally for two days after the IV infusion with Cisplatin and Epirubicin.

In terms of side effects.

First I should stress that everyone here will tell you not every one has the same side effects or reactions to the same chemotherapy medications; but for what is is worth, here is my experience.

I experienced minimal nausea post infusion. When I did have nausea it was the first week after I got the Cisplatin and Epirubicin. They gave me an additional medication called Phenergan that I take as needed and it manages it very well. Also during the last few days of the weeks I received the Cisplatin and Epirubicin my stomach would become very irritated (like acid indigestion)a standard OTC antacid would help but I basically just put up with it and it passes after a couple of days.

The 5 FU gave me mouth sores (mucositis) initially but my oncologist reduced the dosage slightly and that cleared up.

The 5 FU also give me periodic diarrhea (once or twice a week) I originally tried Imodium AD and that did not always work so my oncologist prescribed Lomotil and that works very well.

The other general side effect is fatigue. The longer I was on chemotherapy the less energy I had. But I find if I take it slow I can still walk about a mile a day and do things around the house. I just have to take more breaks then I used to take.

I should stress that I started my chemotherapy two months after a major surgery (I had an Ivor Lewis procedure to remove a tumor from my esophagus) so I am not sure if some of the "side effects" I am attributing to chemotherapy might be from surgery.

In general I would describe my experience as not fun but not as bad as I was afraid it might be. If you work closely with your oncologist they can normally mitigate many side effects with dosage modification or other medications. My oncology nurse keeps telling me "just because you are getting chemotherapy, it doesn't mean you have to feel bad. The more you communicate with us the more we can help make this experience as palatable as possible."

By the way; I find when my stomach is upset, water with lemon juice helps. When I have difficulty eating I find I can always eat vanilla yogurt. I have also found that taking a pro biotic (specifically Culturelle - lactobacillus GG) seems to reduce the incidence of diarrhea.

I will be praying that your husbands chemotherapy proceeds with maximum success and minimal side effects.

Best Regards,
Paul Adams
AKA "paul61"
McCormick, South Carolina

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mdemetrius

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Thanks!
Thanks you guys! I'm breathing a sigh of relief knowing that we're all in this together! It really is a relief knowing that there are others on this same regimen. We're only on day 2 and it's already a struggle.

-(My motto for cancer patients and their caregivers)
"The fight has begun and the opponent has no chance!"

-Marissa