Capecitabine pills 3,000 mg -anal cancer - localized

Fran1
Fran1 Member Posts: 42
in Anal Cancer #1

Hello Everyone, 

I was wondering, if there are any past or present patients w/localized anal carcinoma. No lymph nodes or organs involvement. My oncologist is prescribing 3,000 mg of Capecitabine and 28 radiation treatments. 

I went on the NCCN.org website to research treatment needed for localized anal carcinoma. 

Localized cancer: 

Capecitabine + Mitomycin + RT

Capecitabine 825 mg/m2 PO BID, Monday-Friday on each day that RT is given, throughout the duration of RT (28 treatment days), Mit 10 mg/m2 days 1 and 29, Concurrent radiotherapy or

Capecitabine 825 mg/m2 PO BID days 1-5 weekly x 6 weeks, Mitomycin 12 mg/m2 IV bolts day 1, Concurretnt radiotherapy

Can someone please explain the dosage of 3,000 mg of Capecitabine?

My Oncologist said he goes by the guidelines and does not set-up the treatment plan. Does the treatment plan go by height and weight? 

I start treatment on Monday, Apr. 11th. 

Thank you ahead time for responding. It's very much appreciated. 

Fran

 

Comments

  • mp327
    mp327 Member Posts: 4,440 Member
    #2
    Fran1

    I cannot answer your question about the dosage of Capecitabine.  I do believe many (possibly all) chemo drugs are dosed on a case by case basis and that height and weight of the patient does factor into it.  There is quite a discrepancy in the amount given in the NCCN guidelines and the amount your doctor has prescribed.  I would definitely ask for clarification on this.  Please let us know what you find out. 

    Martha

  • Fran1
    Fran1 Member Posts: 42
    #3
    mp327 said:

    Fran1

    I cannot answer your question about the dosage of Capecitabine.  I do believe many (possibly all) chemo drugs are dosed on a case by case basis and that height and weight of the patient does factor into it.  There is quite a discrepancy in the amount given in the NCCN guidelines and the amount your doctor has prescribed.  I would definitely ask for clarification on this.  Please let us know what you find out. 

    Martha

    Martha

    Thank you for responding. I did ask the Dr why such a high dose and, also asked, if I could I take a lower dose. His reply "Why would you want to do that." My reply " I don't like having toxic medication in my body." His reply "Do you want a Colostomy." 

    He never really answered why he was giving such a high dose for localized anal cancer. 

    Fran

  • mp327
    mp327 Member Posts: 4,440 Member
    #4
    Fran1 said:

    Martha

    Thank you for responding. I did ask the Dr why such a high dose and, also asked, if I could I take a lower dose. His reply "Why would you want to do that." My reply " I don't like having toxic medication in my body." His reply "Do you want a Colostomy." 

    He never really answered why he was giving such a high dose for localized anal cancer. 

    Fran

    Fran

    Hmmmmmm.  That doesn't seem like a very good answer to your question.

  • eihtak
    eihtak Member Posts: 1,473 Member
    #5
    Fran1 said:

    Martha

    Thank you for responding. I did ask the Dr why such a high dose and, also asked, if I could I take a lower dose. His reply "Why would you want to do that." My reply " I don't like having toxic medication in my body." His reply "Do you want a Colostomy." 

    He never really answered why he was giving such a high dose for localized anal cancer. 

    Fran

    Fran.....

    Hi, this seems to me like something I would further question as I often remind people that our doctors work FOR us and we have every right to hold our employees to high standards.  It doesn't matter if we are private pay, personal insurance coverage, or state aid,.....you should expect to receive clear understandable answers.  While there may be an explanation for this dosage, you clearly do not yet have that. This is probably just common sense but copied this portion from the ACS:

    Planning chemotherapy treatments

    Most chemotherapy (chemo) drugs are strong medicines that have a fairly narrow dose range for safety and effectiveness. Taking too little of a drug will not treat the cancer well and taking too much may cause life-threatening side effects. For this reason, doctors must calculate chemo doses very precisely.

    Determining chemo doses

    Depending on the drug(s) to be given, there are different ways to determine chemo doses. Most chemo drugs are measured in milligrams (mg).

    The overall dose may be based on a person’s body weight in kilograms (1 kilogram is 2.2 pounds). For instance, if the standard dose of a drug is 10 milligrams per kilogram (10 mg/kg), a person weighing 110 pounds (50 kilograms) would get 500 mg (10 mg/kg x 50 kg).

    Some chemo doses are determined based on body surface area (BSA), which doctors calculate using height and weight. BSA is expressed in meters squared (m2).

    Sometimes in the rush of this journey, we here things different than they were intended, so please do ask for clarification on this issue and let us know what you find.

    katheryn

     

  • Fran1
    Fran1 Member Posts: 42
    #6
    eihtak said:

    Fran.....

    Hi, this seems to me like something I would further question as I often remind people that our doctors work FOR us and we have every right to hold our employees to high standards.  It doesn't matter if we are private pay, personal insurance coverage, or state aid,.....you should expect to receive clear understandable answers.  While there may be an explanation for this dosage, you clearly do not yet have that. This is probably just common sense but copied this portion from the ACS:

    Planning chemotherapy treatments

    Most chemotherapy (chemo) drugs are strong medicines that have a fairly narrow dose range for safety and effectiveness. Taking too little of a drug will not treat the cancer well and taking too much may cause life-threatening side effects. For this reason, doctors must calculate chemo doses very precisely.

    Determining chemo doses

    Depending on the drug(s) to be given, there are different ways to determine chemo doses. Most chemo drugs are measured in milligrams (mg).

    The overall dose may be based on a person’s body weight in kilograms (1 kilogram is 2.2 pounds). For instance, if the standard dose of a drug is 10 milligrams per kilogram (10 mg/kg), a person weighing 110 pounds (50 kilograms) would get 500 mg (10 mg/kg x 50 kg).

    Some chemo doses are determined based on body surface area (BSA), which doctors calculate using height and weight. BSA is expressed in meters squared (m2).

    Sometimes in the rush of this journey, we here things different than they were intended, so please do ask for clarification on this issue and let us know what you find.

    katheryn

     

    Katheryn

    Thank you so much for replying and for the explanation on dosage. The Oncologist I have been referred to is one that I believe is too overbooked with patients. I wait 1.15 hours to see him and, when he comes into the room, he's there for no more than 15 mins. Both times, I have seen the Dr, there is a knock on the door and, he has to leave, returns, relays what I will be taking and leaves. Ugh!!! 

    Thank you again for the information. It's really appreciated. 

    Fran

     

     

     

  • mp327
    mp327 Member Posts: 4,440 Member
    #7
    Fran1 said:

    Katheryn

    Thank you so much for replying and for the explanation on dosage. The Oncologist I have been referred to is one that I believe is too overbooked with patients. I wait 1.15 hours to see him and, when he comes into the room, he's there for no more than 15 mins. Both times, I have seen the Dr, there is a knock on the door and, he has to leave, returns, relays what I will be taking and leaves. Ugh!!! 

    Thank you again for the information. It's really appreciated. 

    Fran

     

     

     

    Katheryn

    Great information--thanks for posting!

    Martha

  • Fran1
    Fran1 Member Posts: 42
    #8
    mp327 said:

    Fran

    Hmmmmmm.  That doesn't seem like a very good answer to your question.

    Martha

    Thank you for replying. Wishing you a wonderful day.

  • TraceyUSA
    TraceyUSA Member Posts: 316
    #9
    Fran1 said:

    Katheryn

    Thank you so much for replying and for the explanation on dosage. The Oncologist I have been referred to is one that I believe is too overbooked with patients. I wait 1.15 hours to see him and, when he comes into the room, he's there for no more than 15 mins. Both times, I have seen the Dr, there is a knock on the door and, he has to leave, returns, relays what I will be taking and leaves. Ugh!!! 

    Thank you again for the information. It's really appreciated. 

    Fran

     

     

     

    Fran

    It does sound like this oncologist has too much going on.  I think he should be able to answer your questions and take time to explain things to you.  This is your body and you need to be able to make the decisions and feel good about them.  Is it possible to get a second opinion and see a different oncologist?

    -Tracey

  • qv62
    qv62 Member Posts: 434 Member
    #10
    Fran1

    I will look back and see if I can find documentaion on my dosage info from 2014 to share with you. I agree it most likely goes by height, weight, and most likely the staging. I will go look for the info now and post back

  • qv62
    qv62 Member Posts: 434 Member
    #11
    qv62 said:

    Fran1

    I will look back and see if I can find documentaion on my dosage info from 2014 to share with you. I agree it most likely goes by height, weight, and most likely the staging. I will go look for the info now and post back

    Fran1

    ok I found a copy of the label, each pill was 500mg and I believe I took it twice a day if my chemo brain serves me correctly 4 in the am and 3 in the pm ? that would be a daily dose of 3500 mg Hope this helps

  • Fran1
    Fran1 Member Posts: 42
    #12
    qv62 said:

    Fran1

    ok I found a copy of the label, each pill was 500mg and I believe I took it twice a day if my chemo brain serves me correctly 4 in the am and 3 in the pm ? that would be a daily dose of 3500 mg Hope this helps

    QV62

    Thank you so much for sharing your dosage. If you don't mind me asking, what stage was your anal cancer? My cancer is stage 2, localized, no lymph nodes or organs involved. Also, did you have side effects? Of course, every person is different when it comes to the side effects. 

    Thank you so much for sharing. It's very much appreciated. 

    Fran

  • Fran1
    Fran1 Member Posts: 42
    #13
    TraceyUSA said:

    Fran

    It does sound like this oncologist has too much going on.  I think he should be able to answer your questions and take time to explain things to you.  This is your body and you need to be able to make the decisions and feel good about them.  Is it possible to get a second opinion and see a different oncologist?

    -Tracey

    TraceyUSA

    Thank you for replying. I have decided, if the Chemo pills are causing too many side effects, I will stop taking and ask for a lower dose. If the Oncologist does not want to lower the dose, then I will find another Oncologist. 

    Thank you again for replying to my message. I really apreciate all the help I have been receiving from the CSN members. Hopefully in the near future I can help someone on the anal cancer forum. 

    Fran

  • qv62
    qv62 Member Posts: 434 Member
    #14
    Fran1 said:

    QV62

    Thank you so much for sharing your dosage. If you don't mind me asking, what stage was your anal cancer? My cancer is stage 2, localized, no lymph nodes or organs involved. Also, did you have side effects? Of course, every person is different when it comes to the side effects. 

    Thank you so much for sharing. It's very much appreciated. 

    Fran

    so happy to help, my

    so happy to help, my situation was actually the same as yours, stage 2 no nodes or organs. My major side efect was fatigue, there were honestly days when I couldn't lift my head. I was pretty much bionic before that so forgive me for saying but it did kick my ****. It also kicked the cancer out of my **** too lol so it was worth it. I took 2 anti-naseua meds to control that but I did have my bouts. I am heading out for the day, my daughter is visiting from out of state but I will check in this evening, feel free to ask away and you can even private message me and I will get back to you

  • tanda
    tanda Member Posts: 174 Member
    #15
    capecitabine

    Hi Fran,

     

    Your protocol is  similiar to the one I had...it's the Canadian one listed in the NCCN Guidelines

      I had Mitomycin-1 on Day 1 and capecetebine and radiation Monday-Friday for about 5/12 weeks.  I  think I took two pills in the morning and 3 in the evening.Chemotherapy Drug name Dose Route Schedule Dose Reducti
    Mitomycin 10 mg/m2 = 18.5 mg IV Day 1 No 1
    capecitabine 825 mg/m2 twice daily= 2500 mg/day PO Monday - Friday throughout XRT

    There may be some slight variation in the dosage and the number of radiation treatments, but I don't know how and why

     

     

     

     

     

     

  • Fran1
    Fran1 Member Posts: 42
    edited April 2016 #16
    Tanda

    Hello, 

    Thank you for responding and for the information. It's very much appreciated. 

    Fran

  • ellend
    ellend Member Posts: 109 Member
    #17
    Capecitabine dosage

    Hi Fran,

    I recently finished radiation treatments with the capecitabene that is supposed to make radiation work better. It almost sounds like this is a "standard" treatment for some types of cancer. I also went through 28 radiation sessions M-F and was prescribed 3000mg of the capecitabene - 3 pills 2x a day, but my oncologist wanted me to take the chemo 7 days a week, not just the days I had the radiation. I got somewhat nauseous but that wasn't too bad. Toward the end of the course, I started getting  peripheral neuropathy in my hands and feet, so they told me not to take the drug on the Saturday/Sunday before the last 3 radiation treatments. Also, I started getting very fatigued, but that was only the last week and it seems to take awhile for the damage from the radiation to heal, still painful.

    They prescribed this treatment because my tumor is very close to the anal verge and they wanted to try to shrink it before surgery. Fortunately, it seemed to have worked well, the surgeon said he could barely tell the tumor is there anymore, but I am still getting the resection. Good luck to you.

    Ellen

  • annie4145
    annie4145 Member Posts: 218 Member
    edited July 2018 #18
    This is an old thread, but it

    This is an old thread, but it has also come up for me:  From my doctor’s notes: Chemotherapy consists of mitomycin C 10mg/m2 (capped at total of 15 mg because of obesity) on days 1 and 29 of treatment, and capecitabine (Xeloda) 825mg/m2 daily on days of radiation therapy

     

    I have been told I will receive 7 pills per day. (which would be 3,500 mg.)   But when I did the actual calculations it looks like my Body Surface area ranges from 2.1 to 2.4) it looks like my dosage should be:  1806.75.... I assume 2 x per day, which would be 3,610.  I will have to ask why they are rounding down instead of up.

     

     

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