IV chemo versus oral

02021992

Any one who has gone through the AC treatment,  IV chemo versus oral or pill chemo, any experience? 

mp327

02021992

I received 2 rounds of chemo with the drugs that were standard at that time (2008), Mitomycin by infusion at the cancer center and 5FU via pump for 96-hours.

Pat42

Wife had the pills (Capecitabine/Xeloda)

Both the port/IV and the pills have been shown through many studies to be very effective, with no significant difference in cure rates.  My wife didn't like the idea of the port, and there are several studies that show the pills may result in fewer and less severe side effects (should be able to google those up, let me know if you have any trouble finding them).  Unlike the pills, you don't have the 5FU drip for the whole treatment time.  Melissa did get VERY tired of taking the pills every week day for 6 weeks, the main side affect for her other than fatigue was that nothing tasted good.  Foods that kept her going, and from losing hardly any weight: Ensure (350 cal version), grapes tasted great although not many calories, Arby's mozzarrella sticks, Wendy's frosties.  She will be marking a year from initial diagnosis on 7 Dec, and is pretty much back to normal physically.  She is still glad she did the pills instead of the IV, but she definitely doesn't want to see one of those pills ever again.

 

 

02021992

Thank you very much for

Thank you very much for sharing, I talked to radiation oncologist today, he told me that Xeloda? pills are for colon cancer rather then anal cancer, but I haven't talked to oncologist in details yet,  I remember 10 days ago he said IV 5FU and Mitomyicin C. I'm so worried about toxicity...but what choice do I have?

I don't think I'm brave enough to go to Mexico for alternative treatments, not even talking about cost involved. 

mp327

02021992

While having the standard chemo of 5FU and Mitomycin sounds unpleasant and a bit frightening, it is very doable and has a proven track record of being effective in making the radiation more successful, as it weakens the cancer cells, making them more susceptible to the radiation treatment.  I do not know what "alternative" treatments are offered in Mexico, but I would carefully weigh any decision to do that.  This is just my opinion, but I would go with the standard treatment that is known to be successful.

Pat42

02021992 said:

Thank you very much for

Thank you very much for sharing, I talked to radiation oncologist today, he told me that Xeloda? pills are for colon cancer rather then anal cancer, but I haven't talked to oncologist in details yet,  I remember 10 days ago he said IV 5FU and Mitomyicin C. I'm so worried about toxicity...but what choice do I have?

I don't think I'm brave enough to go to Mexico for alternative treatments, not even talking about cost involved. 

some reading links for you

While your rad oncologist is correct that it is a standard treatment for colorectal cancer, he is definitely not correct in saying that it isn't used for anal cancer also.  This might be a question better addressed to the medical oncologist, if you have one (the one in charge of chemo). Here are a few links:

An abstract on a study of 237 cases compared between IV 5FU and Capecitabine:

http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.680

(short quote: "Conclusions: This population-based study demonstrates a preference for capecitabine use in place of 5-FU in the curative management of anal cancer. Survival outcomes are similar between the two treatment groups, but capecitabine may be better tolerated."  "patients who received capecitabine were less likely to report adverse effects (51% vs 26%, p < 0.001) than those who underwent 5-FU.")

From what I've read, both these treatments are very effective.  Our radiation oncologist kept emphasizing that this treatment is very effective, the key is to finish it.  Having less side effects might help.

NCCN standards of diagnosis, staging, treatment, and followup for 2016:

http://www.tri-kobe.org/nccn/guideline/colorectal/english/anal.pdf

Our docs constantly referred to this document, you can see from the listing of institutions on the first page that these are heavy hitters.  Capecitabine is discussed throughout this document, starting on page 5 listed as a primary treatment along with 5 FU.  page 19 specifically addresses similar results of capecitabine and lower toxicity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963381/  300 patient study similar results for %FU and capecitabine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453727/

This is a lot of reading, and there's a lot more out there.  I know my wife didn't want to read any more about it than she had to, she understandably didn't want to dwell on it.  I'd been through a previous cancer myself, and wanted to know as much as possible.  If you just read this forum, you'll find quite a few people that have done the pill form.  It is really the same drug targeting the tumor.  It is DEFINITELY a standard treatment, not a "WAY OUT THERE" or "now for something completely different" treatment.  You should not have to go to Mexico for this treatment.  As far as I know, no one on this forum did.  Not that there is anything wrong with a Mexican visit, but I think I would save it for after you've finished the treatment/1

Whichever way you choose, they are both effective. The real key I think is to commit to finishing the treatment as well as you are able.

This forum really helped me help my wife.  She didn't want to read it, but she was glad to have me tell her about others making it through, and ideas that helped ease the treatment effects.  You'll find a lot of those here.

 Best of luck to you! You can do this!

 

02021992

Thanks for the sharing, I

Thanks for the sharing, I must get through it and heal my body, I appreciate your time answering. Be healthy! 

tanda

02021992

Like Pat's wife, I opted for Xeloda/capecetabine( which is 5FU in pill form).  I thought it would be easier taking pills than having infusions via a fanny pack.  I was also influenced by an abstract of a presentation from  ASTRO(major radiation society). Study was done at Sloan Kettering where they have been using Xeloda for several years.  Outcome was similar to MitomycinC/5FU and there was less toxicity. 

also, the nccn.org guidelines for anal cancer, list MitomycinC on Day1 and 29 or on day 1 only and capecetebine 5 days a week concurrent with radiation, as one of 3 recomended protocols.

.  I had no appetite...NO mouth sores or nausea or vomiting; I only lost about 3 lbs and my white counts did not plummet and I was not hospitalized. Others on this site, did have some problems with xeloda....everyone is different.

I was told to eat what ever I wanted ...protein was important.  Active treatment is only about 6 weeks , and if you had a desire for "forbidden goodies" forget it...eat what you want and can...I also ate puddings and mashed potatoes (which I rarely ever eat) yoghurt, The dieticisn discouraged supplements, altho a probiotic was optional

It's the radiation that is difficult; but we all did it and it is usually very effective.

 

 

tanda

tanda said:

02021992

Like Pat's wife, I opted for Xeloda/capecetabine( which is 5FU in pill form).  I thought it would be easier taking pills than having infusions via a fanny pack.  I was also influenced by an abstract of a presentation from  ASTRO(major radiation society). Study was done at Sloan Kettering where they have been using Xeloda for several years.  Outcome was similar to MitomycinC/5FU and there was less toxicity. 

also, the nccn.org guidelines for anal cancer, list MitomycinC on Day1 and 29 or on day 1 only and capecetebine 5 days a week concurrent with radiation, as one of 3 recomended protocols.

.  I had no appetite...NO mouth sores or nausea or vomiting; I only lost about 3 lbs and my white counts did not plummet and I was not hospitalized. Others on this site, did have some problems with xeloda....everyone is different.

I was told to eat what ever I wanted ...protein was important.  Active treatment is only about 6 weeks , and if you had a desire for "forbidden goodies" forget it...eat what you want and can...I also ate puddings and mashed potatoes (which I rarely ever eat) yoghurt, The dieticisn discouraged supplements, altho a probiotic was optional

It's the radiation that is difficult; but we all did it and it is usually very effective.

 

 

In the last week or two I did

In the last week or two I did get hand and foot disease, which is quite painful; it resolved after treatment with Xeloda ended.  Not everyone gets this side effect; in fact, some

breast cancer patients take Xeloda for many months with no significant problems because the dosing is different.

tanda

tanda said:

02021992

Like Pat's wife, I opted for Xeloda/capecetabine( which is 5FU in pill form).  I thought it would be easier taking pills than having infusions via a fanny pack.  I was also influenced by an abstract of a presentation from  ASTRO(major radiation society). Study was done at Sloan Kettering where they have been using Xeloda for several years.  Outcome was similar to MitomycinC/5FU and there was less toxicity. 

also, the nccn.org guidelines for anal cancer, list MitomycinC on Day1 and 29 or on day 1 only and capecetebine 5 days a week concurrent with radiation, as one of 3 recomended protocols.

.  I had no appetite...NO mouth sores or nausea or vomiting; I only lost about 3 lbs and my white counts did not plummet and I was not hospitalized. Others on this site, did have some problems with xeloda....everyone is different.

I was told to eat what ever I wanted ...protein was important.  Active treatment is only about 6 weeks , and if you had a desire for "forbidden goodies" forget it...eat what you want and can...I also ate puddings and mashed potatoes (which I rarely ever eat) yoghurt, The dieticisn discouraged supplements, altho a probiotic was optional

It's the radiation that is difficult; but we all did it and it is usually very effective.

 

 

Tanda

In the last week or two I did get hand and foot disease, which is quite painful; it resolved after treatment with Xeloda ended.  Not everyone gets this side effect; in fact, some

breast cancer patients take Xeloda for many months with no significant problems because the dosing is different.

Ohmy

The PICC line for my chemo

The PICC line for my chemo was also used to give me fluids.  I was given IV fluids during the two weeks I had chemo and the week after my treatment ended.  I think the IV fluids got me through it all without any hospital stays.