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Stage IV - FolFri Chemo Treatment

ksachvie
Posts: 4
Joined: Aug 2007

Hi,

I posted about a month ago regarding my Dad who recently within 2 months has been diagnosed and had resection surgery on his colon.

Hear is the situation

I would like to thank everyone for all there advice and attempt to answer a few questions;

1. We are Canadian and Live in Winnipeg Manitoba. Dad flew to Calgary Alberta and had his resection surgery at the Peter Lougheed Hospital in Calgary.
2. Transferred back to Winnipeg about 2 weeks ago is currently in the Care of Cancer Care Manitoba, Oncologist is Dr.Wong.
3. After Surgery was able to eat for a few days without bringing anything up. Problem was he was not passing anything through his bowls and his stomach became distended (Hard and bloated)
4. After 4 1/2 weeks a palliative care specialist in Calgary change his MEDS and put him on a steroid and Maxeran (excuse spelling) to help his system to get going and open up. It work in about 12 hours and he was having bowl movements and passing gas. 1 Week later he was completely unhooked from all IV, TPN drip, and pain and was eating on his own, everything appeared to finally be working.
5. Flew home on July 27th, was at home for a week eating on his own when his system started to back up and something was causing a blockage. Pain came and we had him back in the hospital. Been in the hospital for about 2 1./2 weeks now. (7 weeks in total since the surgery)

6. Doctors believe there is a blockage but are not sure where or what is causing it. sent him for multiple CT's and Xrays.

7. Dad met with oncologist Dr. Wong who has prescribed the CHEMO treatment FOL-FIRI to help him shrink tumors and open the blockage.

8. Dad has an appetite and would love to eat. He is drinking about 500 ml of fluid a day and is currently hooked up to a saline drip to keep him hydrated (no TPN feed). He take things in without immediately throwing up, but his stomach becomes hard and bloated and pain occurs.
9. The oncologist believes the CHEMO (starts on Wednesday) will help shrink the tumors which will in turn relieve the pressure on the colon and help dad get his normal functions back, which in turn will enable him to be able to eat and pass the food normally.

UPDATE:

11. Dad went for three days of 8 hour Chemo Treatments (FolFri). He has had minor nausea, and his worst side-effect is mouth soars.

12. He has still not been able to eat anything in 7 weeks. He is very week, and is now sleeping 18-20 hours a day.

We are wondering if anyone can report on there own expirenece with the Chemo treatment Fol-Fri and what there side effects were. Dad has been in the hospital since his suregery, unable to eat and very week. There is some type of blockage causing presure on the colon and making it impossible for him to pass gas and fecies. He has recieved 1 3 day treatment of fol-fri and is extremely week and sleeping almost all day... Will it get any better, are these normal reactions, does the chemo cause you to sleep, should we be trying other things.

ANY HELP PLEASE

Any thoughts or ideas if we are headed in the right direction. The problem is in Canada we dont get any real specialty care when the circumstances are not normal.

kbienapfl's picture
kbienapfl
Posts: 61
Joined: Sep 2006

Hi...I am sorry I do not know anything about what your father is experiencing.

Just wanted to let you know you are in my prayers for answers and insight.

oneagleswings
Posts: 425
Joined: Jan 2005

Hello from a fellow Canadian (Ontario)
After each of my husband's surgeries (re-section then ileostomy reversal 1 mos later)he developed ileus with the same symptoms as your father...maxeran did help..but the best was a nasogastric tube...I have not kept up with earlier posts from you..did the resection get clear margins or is there still tumour tissue in the colon?
I know how hard it is to watch these symptoms (at my husband's worst he was bringing up fecal material...(3 year ago now)..so hang in and hope they get it all straightened out..have they done a "flow through type of test with a dye to see if it in fact is a blockage or a paralyzed bowel?email me if you'd like..take care.'Bev

kmygil
Posts: 881
Joined: Feb 2007

Hi Sweetie,

Your father is weak because he is obviously nutritionally compromised. It also doesn't take very long lying in a bed to become weak. I don't know anything about the treatment, but I saw that "Oneagleswings" suggested an NG tube. Although it becomes uncomfortable after a lengthy insertion, it does help with the nausea, since the stomach is empty and the acids & bile are removed. Feeding is done by tube. If there truly is a blockage of some kind, you need to find out if it is in fact tumors or an artifact of surgery.

Hang in there. I am praying for you and your Dad.

Hugs,
Kirsten

ksachvie
Posts: 4
Joined: Aug 2007

I appreciate all your kind words and encouragement.

To provide a little more info. Dad was recently hooked up to an NG tube and his stomach has been emptied. Since the surgery he has had this NG put in and taken out approx 3-4 times already. Given that he has not physically eaten anything of substain substance in the last 7 weeks we are beginning to worry that his blockage will never open up. The first session on CHEMO (FOLFRI) went well but is taking its toll on his energy and his mental state. He has been sleeping around 18-20 hours a day and when he is awake he is very groggy. We have asked the dotor about “TPN” to provide dad with some energy.

I realize I am asking very broad questions, but the family is extremely concerned and we are just wondering if this type of symptoms are normal for a cancer patient with my dads situation.

To answer a few Q’s about his surgery:

On approximately June 1, 2007 Dad was diagnosed with Sigmoid Cancer - invading pelvic sidewall, peritoneal studding, and metastasis cancer on the liver.

On June 22nd doctors performed an anterior resection with en bloc resection of the pelvic sidewall removing the tumour from Dad’s colon completely, as well they performed a partial omentectomy.

He spent 5 1/2 weeks post surgery trying desperately to get his stomach and bowls working so to pass gas and be able to eat. Doctors put him on a steroid, and maxeran which helped him open up. He was able to eat and keep things down, as well his bowls began to work. Dad came home.

Dad was able to sustain his eating and regular bowl movements until Wednesday August 1st when he noticed his stomach was becoming distended and he had not had a bowl movement or passed gas in a few days. He became nauseated and was unable to eat as well as threw up every time he put something in his system. We emitted Dad into the Hospital on Friday August 3rd at the direction of his GP. Dad has become very week over the last 4 weeks and has gone through a few episodes of severe pain. The doctors have been trying to manage his pain with Hypo-Morphine drip and some type of pain patch.

On August 10th Dad met with a Medical Oncologist at the hospital. The oncologist felt that dad was strong enough to receive Chemotherapy despite the fact that he has been unable to eat. Dad has had his first treatment of Chemo (Folfri). He handled the first treatment pretty well with very little nausea and the worst side effect being mouth soars. He sleeps 18-20 hours a day and is extremely week. He is currently only receiving a Selene drip, and we are wondering if we should request a TPN (nutrient) drip to feed him. Just the other day doctors inserted an NG tube to drain his stomach as he has been unable to open up on his own.

Dad’s colon is completely clear of cancer, and has been described by the technicians as remarkable. The problem exists in his parateneum, and omenteum. (spelling) were there are cancer tumours causing pressure on his colon or some type of blocage. Dad also has mestatic cancer traces on his liver. The oncologist feels that the chemo will help shrink the remaining tumours to allow dad to open and function normally. Once the tumours are shrunk they can go back in to remove the cancer in his liver and his other areas, or at least reduce them so that Dad can live a decent life.

I am looking for advice as to the current situation of my father. Are his symptoms somewhat normal. Is there anything we can be asking or doing in order to help things along. Is the sleeping for 20 hours something to be concerned about. Any help would be greatly appreciated.

Thanks

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