Neutropenia and lower dosage of chemo, your opinion please!

pepebcn

Hi mates , would appreciate your comments .Since I had an episode of neutropenia ( infection included hahaha)in my last infusion, my doc wants to low a little,just a little he said, my dosage, he says it will not affect the results of chemo since normal dosage use to be the maximum your body can deal with, not what the cancer needs ,but as usually I don't feel very tranquil ! hahahaha.( patient syndrome ). Any of you have been lowered a little the dosage?.
Hugs my friends!And thank you in advance!.

abrub

Yes. My dosage was lowered
Side effects were extreme, so my dosage was lowered. This is a common tactic. They start with the maximum, but back off in many cases. If your body can't tolerate the chemo, then they need to make it to a level you can deal with, so that you can get the maximum advantage with the fewest problems.

pepebcn

abrub said:

Yes. My dosage was lowered
Side effects were extreme, so my dosage was lowered. This is a common tactic. They start with the maximum, but back off in many cases. If your body can't tolerate the chemo, then they need to make it to a level you can deal with, so that you can get the maximum advantage with the fewest problems.

Thank you Alice!
More tranquil now, did you felt the difference?

pete43lost_at_sea

tcm, diet, juicing, supplements, exercise and rest
dear pepe,

while i was doing my 12 folfoxes i tried my usual chemo supports.

i would say tcm helped me the most but cannot be sure, my lympocytes have always been low.

goodluck with whatever you try.

hugs,
pete

Kathryn_in_MN

yes
I had the bolus pulled out after the first round of FOLFOX due to severe neutropenia. And added Neupogen shots for 3 days each cycle (which later was reduced to just 2 days). Later towards the end of tx's I had the dosage lowered a few different times to help alleviate severe side effects and neutropenia.

We tried the bolus again with FOLFIRI and my first cycle my neutrpenia was even more severe. I had to wait an extra 2 weeks before I could get treament again. We pulled the bolus and added Neulasta shots.

When we pulled the 5-FU and went to just Irinotecan and Avastin 5 tx ago, we dropped the Neulasta shot. My white counts have been slowly declining every two weeks. I wondered if they would be good enough for chemo last Friday. But then I was severely ill so it was cancelled anyway. We'll see what my counts are tomorrow. With almost an extra week between tx, maybe they will have rebounded again.

They basically try to kill us with the highest dose of chemo tolerable, figuring if we don't tolerate it, they will reduce till we find the level we can tolerate. So don't worry about a reduction. You probably don't need to get as much as they have been giving you anyway.

pepebcn

Kathryn_in_MN said:

yes
I had the bolus pulled out after the first round of FOLFOX due to severe neutropenia. And added Neupogen shots for 3 days each cycle (which later was reduced to just 2 days). Later towards the end of tx's I had the dosage lowered a few different times to help alleviate severe side effects and neutropenia.

We tried the bolus again with FOLFIRI and my first cycle my neutrpenia was even more severe. I had to wait an extra 2 weeks before I could get treament again. We pulled the bolus and added Neulasta shots.

When we pulled the 5-FU and went to just Irinotecan and Avastin 5 tx ago, we dropped the Neulasta shot. My white counts have been slowly declining every two weeks. I wondered if they would be good enough for chemo last Friday. But then I was severely ill so it was cancelled anyway. We'll see what my counts are tomorrow. With almost an extra week between tx, maybe they will have rebounded again.

They basically try to kill us with the highest dose of chemo tolerable, figuring if we don't tolerate it, they will reduce till we find the level we can tolerate. So don't worry about a reduction. You probably don't need to get as much as they have been giving you anyway.

Thank you kath I was specially interested in your opinion since
I know your onc is trying and playing with your dosage in a successful and wisdom way!.I'm now worried about you say you were seriously ill, anything important? are you better now? .
Hugs and prayers!

Kathryn_in_MN

pepebcn said:

Thank you kath I was specially interested in your opinion since
I know your onc is trying and playing with your dosage in a successful and wisdom way!.I'm now worried about you say you were seriously ill, anything important? are you better now? .
Hugs and prayers!

better now
I am better now. Chemo tomorrow. It was awful - fevers and totally uncontrollable diarrhea and vomiting. I could not even keep sips of water down. It was way worse than the worst chemo days. I don't know if it was food poisoning or I picked up some stomach bug/bacteria. I had been running a fever for several days before I got sick, so maybe I had some bacteria my body was trying to fight off, but it was just too weak? I'm just glad it is over. I'm not looking forward to nausea/possible vomiting (I don't always vomit with chemo) and days of diarrhea again... but it comes with the territory if I want to keep the cancer from growing.

relaxoutdoors08

Yes skipped one treatment and Lowered last two treatments
Pepe,
I had to skip my 6th folfox treatment due to low blood levels and I was afraid that would lower my chances of survival. Then a nice chemo nurse told me I would be OK that 80% was the level needed so if I missed a treatment I would be OK. Later due to toxic levels in my liver based on liver function tests during the last treatments of Folfox #10 was delayed, treated my blood and then lowered to 80% Folfox #11, and Folfox 12. You need to trust your doctor who is weighing and balancing your total health and the chemo dosage. NED so far.

Best to you,
NB

relaxoutdoors08

Kathryn_in_MN said:

better now
I am better now. Chemo tomorrow. It was awful - fevers and totally uncontrollable diarrhea and vomiting. I could not even keep sips of water down. It was way worse than the worst chemo days. I don't know if it was food poisoning or I picked up some stomach bug/bacteria. I had been running a fever for several days before I got sick, so maybe I had some bacteria my body was trying to fight off, but it was just too weak? I'm just glad it is over. I'm not looking forward to nausea/possible vomiting (I don't always vomit with chemo) and days of diarrhea again... but it comes with the territory if I want to keep the cancer from growing.

Kathryn Glad you are Better
Good to see you posting and feeling better. Prayers for feeling better and good results with your chemo.
NB

marqimark

Yes
My Onc lowered my dosage almost right away.
He said the same as yours; maxium your body can handle, but more than you really need.
He said my symptoms were those of someone who had eight infusions, not two.
The chemo really kicked my butt.