Cisplatin

Side effects from cisplatin
Sorry you are not getting any responses to your question. I did not use cisplatin but I am using the "next generation drug" carboplatin. Both are platinum-based drugs. A platinum-based drug is considered to be the first-line, standard-of-care treatment for ovarian cancer often combined with taxol or taxotere. So you probably have already been on the carboplatin.

Cisplatin has a shorter half-life (about 3 hours) than carboplatin (about 30 hours) so it leaves the body sooner than carboplatin. My understanding is that the side effects (nausea, bone/joint pain, mouth sores, lowered white blood cell count & anemia) are more severe for cisplatin than carboplatin. The immune system hits it's nadir (lowest point) 3 weeks after treatment and usually rebounds quickly once the therapy is finished.

Most of the platinum leaves the body via urine but some gets deposited into bone marrow.

The chemo nurses have told me that if someone has an allergic reaction to the platinum-based drugs, it usually shows up at the fifth or sixth treatment.

I have read that there is a possibility of irreversible hearing loss (ototoxicity) with all platinum-based chemotherapy drugs. The hearing loss is more likely to occur with doses in the 1800 mg range (I think this was discovered during the clinical trials which is one reason that I am reluctant to do a clinical trial). The carboplatin dose that I was given was less than 1/3 of 1800 mg.

According to what I read, the hearing loss can occur over a long period of time after discontinuing the drug. Often patients don't associate going deaf with chemo or report it to their doctor because it happens many months later.

Ringing in the ears (tinnitus) is an early sign of ototoxicity. I have had ringing in the ears that comes on several days after chemo but anemia and hypothyroidism can cause that, too (and I have both of those issues).

Nevertheless, when my ears are ringing, I take 400 mg of SAME-e (an over-the-counter supplement that contains the amino acid methionine) and the ringing stops but I have NO IDEA if this is preserving my hearing or if I should even be concerned about my hearing. The reason I use SAME-e is that I found some research online that used a sulfur-based drug to prevent hearing loss in children who were given platinum-based drugs. Methionine is a sulfur-based amino acid so I figured it might help and wouldn't hurt.

Another interesting piece of information that I learned about platinum-based chemo is an increase in urinary excretion of serotonin (the "feel good" neurotransmitter). So I think that it is possible that feeling down or depressed would be a possible side effect of therapy. I had about a week of being weepy with low motivation and then I was OK again.

best wishes to you,

Carolen

nancy591 said:

cisplat
Hi,
We were diagnosed at about the same time. I was diagnosed stage 4 in Sept 2008. I had IP cisplat as part of my frontline treatment. I'm not sure if IP cisplat effects you differently then IV cisplat. I had mine infused with lots of fluids right into the abdominal cavity. so, of course I felt bloated. I think cisplat is tougher then carboplat. I hope you do well and I hope it works for you.

Cisplatin vs carboplatin
Sweet Nancy

If I were in your shoes I would HAVE TO KNOW why the doctor is choosing one platinum-based drug over another. Maybe he has a better comfort zone with the older drug and feels confident that he can protect your kidneys. Before the platinum-based chemo came along, the first-line drug was Cytoxen which has a more toxic side-effect profile than the platinum-based drugs.

Can you give me an idea of roughly what age you think your doctor is? I have a theory that changes in medicine happen "one funeral at a time."

By the way, maybe it will help to say something like "So, Dr., what's your rationale for choosing cisplatin over the other platinum-based drugs for me?" Hahahaha! That'll either impress your doctor or piss him off--I don't know your doctor.

best wishes to you,

Carolen

nancy591 said:

me?
I'm not sure if that question is directed to me or to 'fancynancy'
My inital treatment was: 5 rounds IV carbo/taxol, illeostomy reversal, 3 rounds IP cisplat/ IV taxol. I am not sure why cisplat was choosen. I think because the best IP drug is cisplat but I could be wrong.

My doctors age...hmmm... I'm not very good at that. Others here have seen him maybe they have an opinion. I'd guess late 40s early 50s.

For nancy591
Sorry for the confusion, the question was for "fancynancy" and you are both sweet.

BTW: I love seeing the photo of your family! I cannot imagine how I would be managing if I had young ones to care for. My hat is off to you and your husband.

Re: Cis vs carbo

There may be an opinion that cisplatin is a more aggressive chemo and since IP has a lower systemic (total body) side-effect profile, it would be the platinum-based drug of choice for IP.

I have my own opinions about a lot of things and I appreciate feedback & corrections if anyone feels that I am off track about whatever I post. I have put my personal opinions "out there" to see if anyone will "straighten me out" if that needs to be the case.

I really know very little about ovarian cancer compared to most of the people on this discussion board. I just know about me and even then I have to wear rose-colored glassses just to get through to the next day.

Have fun with those kids, they grow up way too fast!

Carolen

Hi Nan,
I had the gold standard (carbo/taxol) for first line and when I recurred 8 months or so later, had another debulk surgery (spleen removed along with a couple other spots) and did cisplatin and gemzar for 6 months. I have to say that, it was like night and day for me. Cisplatin was aweful. I stayed in the hospital for 4 days, I did not eat or drink, and threw up every hour on the hour for the first 2 days. They were concerned about my kidneys and flushed a lot of fluids through me. That was good, as I would have become completely dehydrated otherwise with all the throwing up. I also started to get the high pitched ring in my ears toward the end. 2 months after I was finished, neuropathy set in and never has gone away. I was fatigued for months after I stopped the cisplatin. I would never go on cisplatin again. I really just wanted to die.

That being said, I know others that have used cisplatin and sailed through, with maybe a bit of nausea that they controlled with meds. Overall, I think it is the harsher platinum for side effects. My (Japanese) doctor feels that cisplatin has a slightly better response than the carboplatin, and will often use it first with the taxol, My (US) doctor/surgeon prefers to use carboplatin first, because of the harsh side effects of cisplatin. But, if the patient is strong, he does use the cisplatin for second line, knowing it can sometimes have a better response.

Do ask your doctor why he is choosing cisplatin for you, and not carboplatin.

kathleen

fancynancy said:

Hi.
My dr. is 41.
I usually
Hi.

My dr. is 41.

I usually write down everything he says, but this time I didn't and neither did my husband.
Why we didn't I don't know - but that being the case - I know he mentioned I believe cisplatin but he was going to combine it with something else. That's what I don't remember. It was 3 letters. When they mention chemo brain - I think I'm the poster child.

I'm going to call him on Monday and ask the questions that you all mentioned.

My husband and I are going on a cruise the beginning of April. My dr. said that I'll take the chemo for 2 week and be off 3 weeks before I leave on my trip. He said there shouldn't be a problem. I hope so. That's what concerns me. He doesn't want me to change my plans.

Nan

Planning for cruise
Well then, no matter how you feel during treatment, you should be OK by the time you go on your cruise.

Are you already on something like Prilosec or Pepcid? If not, you might want to keep something like that on hand in case you need it for gastritis while you are away. Maybe you could just get some samples from your family doctor. Gastritis can ruin the fun of enjoying all that food on the cruise.

best wishes,

Carolen

fancynancy said:

cisplatin +
Today was my first day taking cisplatin and cpt. Hopefully this combination will get my CA125 down. It was an all day affair and exhausting.

My dr. mentioned that to make sure that my kidneys are not affected by this chemo they would have to flush out my kidneys and expect to be in the bathroom quite a bit for a couple of days.

Has anyone taken this combo of medications.

Nan

Cisplatin / Taxol
My wife is Stage IV, diagnosed December 21. 2010. She has had debulking surgery and is currently on IV taxol (Day 1), IP Cisplatin (Day 2), then IP Taxol (Day 8). You can follow how she is doing on our blog www.ourovariancancertrip.com. She is just finishing cycle 2. Cisplatin is rough compared to the Taxol! We are getting better at managing the side effects, and it seems to be about 4-5 days for the side effects (nausea, bone pain, abdomen pain) to subside. Cisplatin does have a little better response rate, so we make her go through it! You can follow the mistakes and discoveries as we go through them. My wife wanted me to post it as it really is, so other people might benefit in the future.

kikz said:

Cisplatin/Taxol
That is the same combination I had after surgery except Day 1 Taxol was IP and Day 8 Taxol was IV. I had a hard time getting through the three cycles but as you say I wanted the best possible outcome.

Karen

Hi Nan
I read your question tonight regarding the cisplatin. When my mom was in a medically induced coma following her colostomy surgery the oncologist suggested using a weekly dose of cisplatin. I remember thinking that she was out of her mind because my mom appeared to be o. Her death bed hooked to a ventilator and fighting one infection after the next. At the point that the on oncologist made this suggestion we were kind of thinking "... What the heck... Why not?". So --- we gave the okay. After a few treatments my mom's lung fluid began to lesson and she started to breathe on her own. She came back from the brink of the dead and I truly credit this to the cisplatin. I think it worked and was amazingly well tolerated on the schedule that my mom was on. She did have some vomiting during the tx but it was fairly short lived. I think it can be powerful and can get the job done.

Good luck Nan. My mom was unconscious and only remembers the last tx. I hope your tx goes smoothly.
Wendy