Second chemo run (Cisplatin + 5-FU) for NPC? is that option?

George_0325
George_0325 Member Posts: 8
edited March 2014 in Head and Neck Cancer #1
Hello! everyone,
I was stage III and just finished the radiation treatment combined with the chemo (Cisplatin) once a week.

Following the NCCN Practice Guidelines, one month later, I will start another chemo run ( I called it 2nd run), it will be:

Cisplatin, 80 mg/m2 day 1+ 5-FU, 1000 mg/m2, CI x 4 days; repeat every 4 wk x 3 courses

Is that option?

Who did this chemo run? is it harder than first run (once a week during radiation treatment)?

welcome any comments.

Thank you!

George

Comments

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #2
    Chemo Cycles
    Hi George & Welcome to the CSN Forum,

    My treatment was similar to yours on in reverse. I had STG III tonsil cancer which I was treated for.

    My treatment started as nine weeks (3 cycles) of Cisaplaten, Taxotere and 5FU (5FU pumped 24/7 for four days. After those nine weeks I started the concurrent chemo/radiation.

    Carbo platen once a week for seven weeks, with radiation every day of those same weeks (35 rads).

    Acytually as far as I'm concerned the radiation was the worst of the treatment. I could recover by the third week with just the chemo. The radiation starts you cooking good around week 4 and last until 3 - 4 weeks after you're finished. But it also keeps on giving lasting effects for several months.

    John
  • George_0325
    George_0325 Member Posts: 8
    #3
    Skiffin16 said:

    Chemo Cycles
    Hi George & Welcome to the CSN Forum,

    My treatment was similar to yours on in reverse. I had STG III tonsil cancer which I was treated for.

    My treatment started as nine weeks (3 cycles) of Cisaplaten, Taxotere and 5FU (5FU pumped 24/7 for four days. After those nine weeks I started the concurrent chemo/radiation.

    Carbo platen once a week for seven weeks, with radiation every day of those same weeks (35 rads).

    Acytually as far as I'm concerned the radiation was the worst of the treatment. I could recover by the third week with just the chemo. The radiation starts you cooking good around week 4 and last until 3 - 4 weeks after you're finished. But it also keeps on giving lasting effects for several months.

    John

    Any side effects on your chemo therpy?
    Thank you, John!

    Did you have any side effects on your first chemo therpy?

    After each of chemo during my concurrent treatment of radiation/chemo, I always got vometing and weak.

    Thanks,

    George
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #4
    George_0325 said:

    Any side effects on your chemo therpy?
    Thank you, John!

    Did you have any side effects on your first chemo therpy?

    After each of chemo during my concurrent treatment of radiation/chemo, I always got vometing and weak.

    Thanks,

    George

    Sides Orders....
    Depends I guess, on what you are having...

    I had all of the usuals, fatigues, hair loss, lack of saliva, no taste.... I didn't get sick though. I would get fatigued and almost flu like symptoms from the Neulasta (the shot for bone morrow regeneration a week after the big chemo cycles)

    What type of cancer were you diagnosed with?

    JG
  • Kent Cass
    Kent Cass Member Posts: 1,898 Member
    #5
    Skiffin16 said:

    Sides Orders....
    Depends I guess, on what you are having...

    I had all of the usuals, fatigues, hair loss, lack of saliva, no taste.... I didn't get sick though. I would get fatigued and almost flu like symptoms from the Neulasta (the shot for bone morrow regeneration a week after the big chemo cycles)

    What type of cancer were you diagnosed with?

    JG

    NPC
    George- there are a number of us active on this forum who had/have NPC, and I think some have had your kinda treatment. I had Cisplatin and FU5, but my delivery was a little different, and getting rad in 20 places/session at the same time. The scheduled 7-weeks became 8, but have had no follow-up treatment. Hondo, who is also NPC, only got the rads his first time of treatment, and another round of treatment was required a couple years later, and has been told he now needs another round.

    Stay with us, George, and good luck.

    kcass
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #6
    Skiffin16 said:

    Sides Orders....
    Depends I guess, on what you are having...

    I had all of the usuals, fatigues, hair loss, lack of saliva, no taste.... I didn't get sick though. I would get fatigued and almost flu like symptoms from the Neulasta (the shot for bone morrow regeneration a week after the big chemo cycles)

    What type of cancer were you diagnosed with?

    JG

    NPC
    Sorry George, I missed the NPC reference in your Topic Line....
  • cjamesfu
    cjamesfu Member Posts: 14
    #7
    Option for a second chemo run
    During the treatment for NPC, I took a combination of chemo and radiation. When the onc doctor wanted me to do a second run chemo with +5FU, I refused. I knew it is in protocol. But my concern was I am diabetic and I don't want to take too much cicplatin that could damage my kidney. Somehow, the doc was convinced and let me skip the the second run. I am now in the sixth year of remission. My kidney is healthy.
  • George_0325
    George_0325 Member Posts: 8
    #8
    Skiffin16 said:

    NPC
    Sorry George, I missed the NPC reference in your Topic Line....

    Thanks a lot
    John, you provided me helpful informtion. Thanks a lot.
  • George_0325
    George_0325 Member Posts: 8
    #9
    Kent Cass said:

    NPC
    George- there are a number of us active on this forum who had/have NPC, and I think some have had your kinda treatment. I had Cisplatin and FU5, but my delivery was a little different, and getting rad in 20 places/session at the same time. The scheduled 7-weeks became 8, but have had no follow-up treatment. Hondo, who is also NPC, only got the rads his first time of treatment, and another round of treatment was required a couple years later, and has been told he now needs another round.

    Stay with us, George, and good luck.

    kcass

    NPC
    Hi, KCass,

    That's interesting, it looks like some of us in this board got different treatments.

    Good luck to all of us!

    George
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #10
    George_0325 said:

    Thanks a lot
    John, you provided me helpful informtion. Thanks a lot.

    Being Sick During and After Chemo
    George,

    I forgot to mention, they had me take Emend the day of and next two days after the large doses of Chemo (Cisplaten, Taxotere, and 5FU). It comes in a 3-Pak first day is stronger that he next two days. It's pricey, but I never got sich at all during chemo. If I remember for the Carboplaten, I just took Zofran when needed....

    Best of Luck,
    John
  • George_0325
    George_0325 Member Posts: 8
    #11
    cjamesfu said:

    Option for a second chemo run
    During the treatment for NPC, I took a combination of chemo and radiation. When the onc doctor wanted me to do a second run chemo with +5FU, I refused. I knew it is in protocol. But my concern was I am diabetic and I don't want to take too much cicplatin that could damage my kidney. Somehow, the doc was convinced and let me skip the the second run. I am now in the sixth year of remission. My kidney is healthy.

    Good opinion...
    Thank you! cjamesfu, I am thinking how deal with my onc doc to skip it.

    Good Luck to All of Us!

    George
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #12
    George_0325 said:

    Good opinion...
    Thank you! cjamesfu, I am thinking how deal with my onc doc to skip it.

    Good Luck to All of Us!

    George

    Skipping
    Hi George, are you diabetic or having something else going on, just curious? I know that all of these drugs are nasty, but I went through it with Cisplaten. Taxotere, 5FU (5FU from a pump 24/7 for four days) and then Carboplaten.

    I didn't have any after effects and all of my blood, GFR (kidney filtration) and all are back in normal ranges.

    When I was doing the Cisplaten, they also give you solutions and such to keep you urinating a lot to flush it out of your system. Hydration is also a big part to contribute to that flushing also....just saying.

    I guess a lot depends on your trust and relation ships with your doctors. Of course you are your own best advocate, nobody takes care of you better than you...

    Good Luck, God Bless,
    John
  • George_0325
    George_0325 Member Posts: 8
    #13
    cjamesfu said:

    Option for a second chemo run
    During the treatment for NPC, I took a combination of chemo and radiation. When the onc doctor wanted me to do a second run chemo with +5FU, I refused. I knew it is in protocol. But my concern was I am diabetic and I don't want to take too much cicplatin that could damage my kidney. Somehow, the doc was convinced and let me skip the the second run. I am now in the sixth year of remission. My kidney is healthy.

    My problems

    I was diagonized as NPC IIIA on Feb. 2010. The treatment's protocol is 35radiation+7Chemo (Cisplatin) for the first round, then 3 weeks Cisplatin+5Fu in the next 3 months for the 2nd round. I just finished the first round 2 weeks ago. I will have ENT doctor checkup on middle of May. Also I was told that my PETScan will be on middle of June.


    My big problems are:
    1.Painful throat, it causes a lot of mucus and coughing so that I can not sleep well.
    2 I feel ear pressure on my left ear and my radiation oncologist said it better to have ear fluid drainage.
    3.I can only whisper, my voice is worse than 1 week ago.

    Do you have the above symptoms and how do you cope with that?

    Thank you and wish the best!
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #14
    George_0325 said:

    My problems

    I was diagonized as NPC IIIA on Feb. 2010. The treatment's protocol is 35radiation+7Chemo (Cisplatin) for the first round, then 3 weeks Cisplatin+5Fu in the next 3 months for the 2nd round. I just finished the first round 2 weeks ago. I will have ENT doctor checkup on middle of May. Also I was told that my PETScan will be on middle of June.


    My big problems are:
    1.Painful throat, it causes a lot of mucus and coughing so that I can not sleep well.
    2 I feel ear pressure on my left ear and my radiation oncologist said it better to have ear fluid drainage.
    3.I can only whisper, my voice is worse than 1 week ago.

    Do you have the above symptoms and how do you cope with that?

    Thank you and wish the best!

    Cycles
    Your cycles are probably similar to mine in reverse. I had my big cycle of chemo first (nine weeks of three cycles). I would have all of mu chemo (cisplaten, taxotere) on Monday waering a pump with 5FU home and ending that on Friday morning. Then I would skip chemo of two weeks and start the next cycle.

    After those nine weeks I started seven weeks of Carboplaten and the 35 rads like you. Carbo platen only on the Mondays of those seven weeks.

    I had all of the throat stuff, my most painful period was around the 4th week of chemo through about 3 - 4 weeks after my last rad treatment.

    My voice was very hoarse during that time, if I talked much at all, I'd lose my voice for that day pretty much.

    I didn't get a lot of mucous, but did cough a lot because of being so dried out. No ear pluggage or drainage either.

    If you are at all like me, you have been through the worst. The chemo is a breeze compared to the concurrent, and more specifically the radiation.

    I'd lose my taste, or everything just tasted bad, even water tasted like sweat.... I'd lose the taste for about 2 weeks and get it back. But unfortunately with you, you proabbaly have significant damege already from the rads...a lot of that will come back in time as will some saliva. But more than likely it'll take several months after everything before you reach that state....

    Keep in touch, and stay strong.
    John
  • elsa1
    elsa1 Member Posts: 1
    #15
    Skiffin16 said:

    Cycles
    Your cycles are probably similar to mine in reverse. I had my big cycle of chemo first (nine weeks of three cycles). I would have all of mu chemo (cisplaten, taxotere) on Monday waering a pump with 5FU home and ending that on Friday morning. Then I would skip chemo of two weeks and start the next cycle.

    After those nine weeks I started seven weeks of Carboplaten and the 35 rads like you. Carbo platen only on the Mondays of those seven weeks.

    I had all of the throat stuff, my most painful period was around the 4th week of chemo through about 3 - 4 weeks after my last rad treatment.

    My voice was very hoarse during that time, if I talked much at all, I'd lose my voice for that day pretty much.

    I didn't get a lot of mucous, but did cough a lot because of being so dried out. No ear pluggage or drainage either.

    If you are at all like me, you have been through the worst. The chemo is a breeze compared to the concurrent, and more specifically the radiation.

    I'd lose my taste, or everything just tasted bad, even water tasted like sweat.... I'd lose the taste for about 2 weeks and get it back. But unfortunately with you, you proabbaly have significant damege already from the rads...a lot of that will come back in time as will some saliva. But more than likely it'll take several months after everything before you reach that state....

    Keep in touch, and stay strong.
    John

    Side effects of cisplaten 5fu/radiation
    After my treatment, i was feeling ok but soon after my first month of recovery the side effects of chemo/radiation theraphy start coming out. I'd lost my taste for food. Everything taste like paper or sand. It took good six months for me to have a little bit of taste, it's either salty or sweet. Had difficulty swallowing for about 2 years even up to now i can only eat soft watery food.I even experienced anxiety and panick attack for almost 6 months (what a horrible feeling, dry mouth, bussing sound on my (L) ear and dry mouth.Also, I forgot to mention about the other side effect,forgetfulness, it's terrible.
    The short term and long term memory has been damage too but eventually it will come back slowly but frustrating because there are things that you want to know and you can't remember. You learn to live with it, the important thing is you survive without any dissabilities. The new side effect that i'm going through right now is dry, itchy face.
    I been to several dermatologist nothing work. When it's too hot or cold your face will be so dry and itchy. Stay away from the sunlight cause it will burn your face.
  • BonnyKay
    BonnyKay Member Posts: 8
    #16
    My husband just finished the
    My husband just finished the same treatment you're going through. About 30 days ago, he finished the Cistplatin/5FU ... although the last treatment they swapped out Carboplatin for the Cistplatin because his body was just too weak.

    The first round of 5FU wasn't too bad. He was tired but bounced right back. The second round of 5FU was bad ... he developed sores in his mouth and was very fatigued. The third round really knocked him for a loop. Like I said, it's been nearly a month and the mouth sores are nearly gone ... but he's still in deep recovery mode.

    In our case, the main issue seems to be anemia. Back in November, he was down to 8.4 and they suggested he have a blood transfusion. Now he's back down again to 8.4 and they suggested he get one the Tuesday before Christmas ... but he wanted to try iron pills instead. There doesn't seem to be any improvement ... so I'm not sure what we'll do at this point.

    I agree with something one of the other posters wrote ... the Cistplatin/5FU was bad ... but it was NOTHING compared to the concurrent radiation/chemo. He spent the last week of that up at the hospital because he literally could no longer swallow. If you can get through that, you can get through anything. :)
  • Hondo
    Hondo Member Posts: 6,636 Member
    #17
    George_0325 said:

    My problems

    I was diagonized as NPC IIIA on Feb. 2010. The treatment's protocol is 35radiation+7Chemo (Cisplatin) for the first round, then 3 weeks Cisplatin+5Fu in the next 3 months for the 2nd round. I just finished the first round 2 weeks ago. I will have ENT doctor checkup on middle of May. Also I was told that my PETScan will be on middle of June.


    My big problems are:
    1.Painful throat, it causes a lot of mucus and coughing so that I can not sleep well.
    2 I feel ear pressure on my left ear and my radiation oncologist said it better to have ear fluid drainage.
    3.I can only whisper, my voice is worse than 1 week ago.

    Do you have the above symptoms and how do you cope with that?

    Thank you and wish the best!

    Hi George
    I too had NPC, I am a little over 4 ½ years out of my last treatment.

    Did they do your Chemo and Radiation at the same time, I did 35 treatments of Radiation at the same time as my chemo with the chemo finishing about one month after the last radiation. I only had a 25% chance of it working as it was my second treatment for NPC. I am still here and doing very well.

    All the best to you and welcome to CSN

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