advice on chemo for stage 4 colon cancer pls

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loveandhope
loveandhope Member Posts: 52
edited March 2014 in Colorectal Cancer #1
my dad has been told today that they want to give him a round of chemo every 21 days for 3 months and review after that. how much is a round, one two injections,???? isnt that too little for an advanced stage shouldnt they be attacking it more aggresively?
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  • loveandhope
    loveandhope Member Posts: 52
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    love and hope
    please click on my username under my pic for more details on my dads dx. thx
  • pepebcn
    pepebcn Member Posts: 6,331 Member
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    love and hope
    please click on my username under my pic for more details on my dads dx. thx

    First of all is important to know what kind of
    chemo scheme he's going to have , normally most of schemes for s.4 use to be every 2. weeks, but I have seen some folks here on 1 , 3 and even monthly schemes,concerning to the infusion time, they use to be 4/5 hours at hospital and then 48 hours at home trough a "port a cath", wich is a device they install in your chest and allows you to be connected in to 46 h. infusion pump that you carry with you. Are they going to install him one of this? You must ask about!
    Folks ! any of you had experience in other schemes than the standard 46 h. every two weeks? If yes let's help loveandhope in her doubts!.
    Hugs!
  • John23
    John23 Member Posts: 2,122 Member
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    love and hope
    please click on my username under my pic for more details on my dads dx. thx

    Second opinion?

    Well, dad's had a second opinion, and you mentioned that you
    like the new(er) doctor, but dad's also entitled to get as many
    opinions as he feels he needs.

    The treatments vary, depending on each physician's opinion
    of what he feels is required to do the job. If the physician feels
    that your dad's liver is too weak to take the stress of heavier
    doses of chemo, the doses he desires to try might be best.

    Feeling that "more is better" is always something said out of fear
    of doing less. All too often, the fact that the benefits of chemo
    is measured in weeks, not years, is overlooked, as well as the
    side effects that can often be debilitating and permanent.

    Get dad another opinion pror to beginning treatment. The physician
    should not be a member of the same group or organization, and
    preferably of a different area.

    But please don't feel that "too little" is not enough, or that the
    treatments -must be- aggressive. Making one so sick they wish
    they died instead of having treatments, is not the best way to
    attempt to survive.

    My best to you both.

    John
  • pepebcn
    pepebcn Member Posts: 6,331 Member
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    John23 said:

    Second opinion?

    Well, dad's had a second opinion, and you mentioned that you
    like the new(er) doctor, but dad's also entitled to get as many
    opinions as he feels he needs.

    The treatments vary, depending on each physician's opinion
    of what he feels is required to do the job. If the physician feels
    that your dad's liver is too weak to take the stress of heavier
    doses of chemo, the doses he desires to try might be best.

    Feeling that "more is better" is always something said out of fear
    of doing less. All too often, the fact that the benefits of chemo
    is measured in weeks, not years, is overlooked, as well as the
    side effects that can often be debilitating and permanent.

    Get dad another opinion pror to beginning treatment. The physician
    should not be a member of the same group or organization, and
    preferably of a different area.

    But please don't feel that "too little" is not enough, or that the
    treatments -must be- aggressive. Making one so sick they wish
    they died instead of having treatments, is not the best way to
    attempt to survive.

    My best to you both.

    John

    One important question , is he going to do it through British
    social security? Is he going to do it trough a private insurance or is he going to pay by it's own?.Also do you already know what hospital have you been addressed ?.
    Hugs!.
  • CherylHutch
    CherylHutch Member Posts: 1,375
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    Chemo
    Hi Loveandhope,

    First, I don't think too many can really answer your question until, like some of the others have said, we know just what kind of chemo treatment he is going to be getting. I have just read your profile and shame on that first doctor who told him to pack up his bags and enjoy what is left of his life. Poppycock!! (wonder if the censors will asterisk that word? )

    You just right smartly tell your dad there are more of us Stage 4 Colon Cancer folk out here than not... and we all are going through various treatments and some of us are having a totally normal life, other than the inconvenience of having to go to all these various medical appts ;)

    Yes, it is quite possible that the regime his doctor is putting him on can be once every 21 days for 3 months and then review. For instance, I am going to be starting a new (to me) chemo - Irinotecan. I will be getting a 90 minute infusion every 3 weeks. The plan will be for 6 months... but I will be getting a CAT scan in 3 months and we will review and see how my cancer (mets in the lungs) is responding to it. If I'm doing well, then we will continue for another 3 months... then we will take a break because my oncologist believes after 6 months of this particular chemo, my body will deserve a break. Your mileage may vary... another oncologist may say, "forget the break... this is working, you will remain on it"

    So, is it possible to have a schedule of chemo every 3 weeks? Most definitely. But you will want to know what kind of chemo he will be given so both you and he can prepare for what to expect in the way of side affects. Not that everyone is going to have the same side affects, but at least you will be aware of what might happen and not to freak out when/if they do. Also, how is he going to be given this chemo? Again, depending on what it is, chances are if he's getting it every 21 days then it will be infused... which can be either by IV in his arm or through a port in his chest (which will have to be surgically inserted). We LOVE the port... a bit of a pain having it inserted, but the discomfort only lasts a few days to a week or so. Then when he goes in to get the chemo infused, he doesn't have to worry about collapsing veins, rolling veins or veins that just say, "I'm not going to do this!" (my veins have a major attitude problem)!!

    Do not think for a minute how often one gets chemo makes it better or worse. More is not necessarily better. The schedules are all set up depending on the kind of chemo and how much of that particular chemo one's system can have... then how much time is needed for it to make it's way through your system, how many blood cells it kills off without killing you ... and time for the blood cells to regenerate before you get hit with it again.

    Remember... chemo kills off all cells in it's path... be them good, healthy cells, or bad, cancer-diseased cells. After the chemo has gone running through, killing off everything in it's path, the good cells will regenerate and make up for the ones that were lost. The cancer cells can't regenerate... so ten points for the good guy! :) This is repeated because chemo is systemic and goes through your whole system, not just the diseased parts... and the more cancer cells that are killed off, the smaller the diseased areas (tumours) become.

    So is this all doom and gloom? Absolutely not! It's a long battle, an ongoing battle... and when one chemo stops working, then we try another one. But it doesn't mean the patient is going to be sick and bedridden for years... basically, we are just treating a chronic disease, just as someone with high blood pressure treats that disease or someone with diabetes has to treat that disease. Ongoing and chronically.

    Hope this helps relieve both of your minds!

    Cheryl
  • Betsydoglover
    Betsydoglover Member Posts: 1,248 Member
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    Not sure exactly what chemo
    Not sure exactly what chemo your Dad is on - being every 3 weeks, it might be Xeloda/oxaliplatin and possibly Avastin. We can help more if we know the exact treatment.

    Assuming it something similar to the above, doing 3 months worth and THEN getting scanned sounds quite reasonable. Doesn't mean chemo will end then. But doc wants to see how it doing after that point,

    Betsy

    diag. Stage IV, 5/05, liver met
    lap sigmoid colectomy, 6/05
    6 cycles Xeloda/oxaliplatin/Avastin (NED after 2)
    11/08 9x13mm right lower lobe lung nodule; removed via VATS 4/09
    6 cycles Xeloda + Avastin,
    NED (PET every 3 mo)
    Currently on Avastin only
  • Betsydoglover
    Betsydoglover Member Posts: 1,248 Member
    Options
    Not sure exactly what chemo
    Not sure exactly what chemo your Dad is on - being every 3 weeks, it might be Xeloda/oxaliplatin and possibly Avastin. We can help more if we know the exact treatment.

    Assuming it something similar to the above, doing 3 months worth and THEN getting scanned sounds quite reasonable. Doesn't mean chemo will end then. But doc wants to see how it doing after that point,

    Betsy

    diag. Stage IV, 5/05, liver met
    lap sigmoid colectomy, 6/05
    6 cycles Xeloda/oxaliplatin/Avastin (NED after 2)
    11/08 9x13mm right lower lobe lung nodule; removed via VATS 4/09
    6 cycles Xeloda + Avastin,
    NED (PET every 3 mo)
    Currently on Avastin only
  • herdizziness
    herdizziness Member Posts: 3,624 Member
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    Chemo
    My chemo was every 3 weeks(21 days). 6 to 8 hours on a Tuesday at the oncology department getting my infusions, then Xeloda pills for two weeks, one week off and then back to the chemo.
    My treatment was quite aggressive, my chemos were Oxiplatinin, Avastin and Xeloda. My tumors were attacked enough and shrunk enough that I was able to have surgery. When I was diagnosed, I was told the same thing, go home enjoy what's left of your life. Still here, just had the tumors removed surgically, and still plan on being around for quite some time (according to my onc, he expects me to be around a few more years as well).
    Winter Marie
  • chicoturner
    chicoturner Member Posts: 282
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    Hi, first I would like to
    Hi, first I would like to say welcome, and how fortunate your Dad is to have you by his side! We all really need someone who can listen when we can't! I am doing clinical trials and my Dr. at UCSF was telling me about 3 different trials I might get into. One was 3 weeks on 1 week off, and 2 were 1 treatment every 3 weeks. When I was on treatment at home it was every other week. It just all depends on.....well, the patient, the doc., the meds, the protocal set by the drug company!! Best to you and your Dad! Jean (You or your dad should feel free to ask your dr. this question though!!)
  • loveandhope
    loveandhope Member Posts: 52
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    Hi, first I would like to
    Hi, first I would like to say welcome, and how fortunate your Dad is to have you by his side! We all really need someone who can listen when we can't! I am doing clinical trials and my Dr. at UCSF was telling me about 3 different trials I might get into. One was 3 weeks on 1 week off, and 2 were 1 treatment every 3 weeks. When I was on treatment at home it was every other week. It just all depends on.....well, the patient, the doc., the meds, the protocal set by the drug company!! Best to you and your Dad! Jean (You or your dad should feel free to ask your dr. this question though!!)

    hey guys
    thank you sooo much

    hey guys

    thank you sooo much for all your support and advice. i am truely touched. ill keep u posted. i hope to get to a stage with this where i can be of big support to all of u too. this is very new to me and still in shock but ill never forget all ur support. thx once again. xxxx special thx to pepe!! xx
  • loveandhope
    loveandhope Member Posts: 52
    Options

    hey guys
    thank you sooo much

    hey guys

    thank you sooo much for all your support and advice. i am truely touched. ill keep u posted. i hope to get to a stage with this where i can be of big support to all of u too. this is very new to me and still in shock but ill never forget all ur support. thx once again. xxxx special thx to pepe!! xx

    PS: my dad is getting a
    PS: my dad is getting a flight back to gib tomoro so i will have all the information 1st hand. pls pray for him. i have u all in my prayers too. xxxx
  • pepebcn
    pepebcn Member Posts: 6,331 Member
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    PS: my dad is getting a
    PS: my dad is getting a flight back to gib tomoro so i will have all the information 1st hand. pls pray for him. i have u all in my prayers too. xxxx

    Please Gabrielle keep us informed!
    We will pray for him!
    Hugs!
  • pepebcn
    pepebcn Member Posts: 6,331 Member
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    pepebcn said:

    One important question , is he going to do it through British
    social security? Is he going to do it trough a private insurance or is he going to pay by it's own?.Also do you already know what hospital have you been addressed ?.
    Hugs!.

    can somebody ellse help here?
    Hugs mates!
  • loveandhope
    loveandhope Member Posts: 52
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    pepebcn said:

    Please Gabrielle keep us informed!
    We will pray for him!
    Hugs!

    ok ive just written this but
    ok ive just written this but cant find it in thread so ill writ again. sorry if i repeat myself.... he has been prescribed XELOX and BEVACIZUMAB. (IV) and i also some tablets. i will get more info tomoro. nite nite and thx again xxxxxxxx
  • luvmum
    luvmum Member Posts: 457 Member
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    chemo treatment
    Hi Loveandhope,

    My mum's situation is pretty much the same as your dad, except that her liver met is not operable. Her onc suggested 3-6 rounds of chemo every 21 days too.

    She had her first treatment on 26 Novmber 2010, Oxaliplatin, Avastin infused in 2-3 hours, xeloda (take home but only managed to finish 2/5 of them because she had severe diarrhea and ended up staying in the hospital till christmas eve). Since her side-effects were extremely severe, the onc postponed her 2nd treatment from 17 Dec till 3 Jan 2011. So you can see this is even longer than 21 days. The onc even thought of stopping her chemo because of it, but I said 'she will die' and the onc said 'she will die from chemo too'.

    Anyway, because she looked pretty healthy when she went to see the onc on 29th Dec 2011, so the onc said he will give her another round of chemo but he has changed the regimen from XELOX (Oxaliplain+xeloda and Avastin) to FOLFOX. With FOLFOX, he only infuse 50% of the dosage too. With the 50% of the message, the onc separated the infusion into 2 times (2 injections) as well. She did half of the infusion on 3rd Jan, and the other half next Monday. I don't know how does it work, but the onc keeps saying quality of life is very important!

    I hope this info helps and take care!
    Dora
  • luvmum
    luvmum Member Posts: 457 Member
    Options

    ok ive just written this but
    ok ive just written this but cant find it in thread so ill writ again. sorry if i repeat myself.... he has been prescribed XELOX and BEVACIZUMAB. (IV) and i also some tablets. i will get more info tomoro. nite nite and thx again xxxxxxxx

    Bevacizumab = avastin
    Hi loveandhope,

    It seems your dad's treatment is exactly the same as my mum's first treatment!

    Have a good night sleep!
    Dora
  • John23
    John23 Member Posts: 2,122 Member
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    luvmum said:

    chemo treatment
    Hi Loveandhope,

    My mum's situation is pretty much the same as your dad, except that her liver met is not operable. Her onc suggested 3-6 rounds of chemo every 21 days too.

    She had her first treatment on 26 Novmber 2010, Oxaliplatin, Avastin infused in 2-3 hours, xeloda (take home but only managed to finish 2/5 of them because she had severe diarrhea and ended up staying in the hospital till christmas eve). Since her side-effects were extremely severe, the onc postponed her 2nd treatment from 17 Dec till 3 Jan 2011. So you can see this is even longer than 21 days. The onc even thought of stopping her chemo because of it, but I said 'she will die' and the onc said 'she will die from chemo too'.

    Anyway, because she looked pretty healthy when she went to see the onc on 29th Dec 2011, so the onc said he will give her another round of chemo but he has changed the regimen from XELOX (Oxaliplain+xeloda and Avastin) to FOLFOX. With FOLFOX, he only infuse 50% of the dosage too. With the 50% of the message, the onc separated the infusion into 2 times (2 injections) as well. She did half of the infusion on 3rd Jan, and the other half next Monday. I don't know how does it work, but the onc keeps saying quality of life is very important!

    I hope this info helps and take care!
    Dora

    Dora and "Loveandhope"
    Two issues...

    Re:
    "The onc even thought of stopping her chemo because of it,
    but I said 'she will die' and the onc said 'she will die from chemo too'. "


    It's refreshing to find an honest oncologist, isn't it?

    But:
    "the onc keeps saying quality of life is very important!"

    "Quality of life" is very important, since making a patient get so
    sick from the treatments that they lose the will to live, is not a
    good thing to do.

    But on the other hand, I wouldn't want to be treated with less than
    effective medications, if all they will do is "make me comfortable"
    while I wither away.....

    I never did "Chemo" (chemical therapy), and opted to another
    way to do the job. But had I gone the chemical route, I would
    be delighted to find an oncologist with the caring yours seems
    to have.

    All that said...... Your mom should still get another opinion,
    and even a third, fourth, or more, to make sure she is getting
    the treatment that's best. There are many new surgical techniques
    and methods that have come into being recently, that are not
    chemically or radiation oriented. It's safer to go the newer
    non-chemical/radiation routes, than the toxic chemical routes.

    Oncologists aren't familiar with surgical techniques, and
    colorectal surgeons don't get into chemical therapy. They may
    know "of" each other's practices, but are not usually well
    versed or trained for each practice. They are "specialists",
    and specialize in one sole area of practice.

    Making appointments with different colorectal surgeons of different
    organizational affiliations, would be a good idea (in my opinion).
    Many times, one will know of a way to surgically remove a tumor
    that another surgeon, or an oncologist, has no knowledge of.

    My best to you both,

    John
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900 Member
    Options

    Chemo
    My chemo was every 3 weeks(21 days). 6 to 8 hours on a Tuesday at the oncology department getting my infusions, then Xeloda pills for two weeks, one week off and then back to the chemo.
    My treatment was quite aggressive, my chemos were Oxiplatinin, Avastin and Xeloda. My tumors were attacked enough and shrunk enough that I was able to have surgery. When I was diagnosed, I was told the same thing, go home enjoy what's left of your life. Still here, just had the tumors removed surgically, and still plan on being around for quite some time (according to my onc, he expects me to be around a few more years as well).
    Winter Marie

    great to hear that winter marie
    I love these little pieces of good news that pops up in these posts.
    Stay well,
    Pete
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900 Member
    Options
    John23 said:

    Dora and "Loveandhope"
    Two issues...

    Re:
    "The onc even thought of stopping her chemo because of it,
    but I said 'she will die' and the onc said 'she will die from chemo too'. "


    It's refreshing to find an honest oncologist, isn't it?

    But:
    "the onc keeps saying quality of life is very important!"

    "Quality of life" is very important, since making a patient get so
    sick from the treatments that they lose the will to live, is not a
    good thing to do.

    But on the other hand, I wouldn't want to be treated with less than
    effective medications, if all they will do is "make me comfortable"
    while I wither away.....

    I never did "Chemo" (chemical therapy), and opted to another
    way to do the job. But had I gone the chemical route, I would
    be delighted to find an oncologist with the caring yours seems
    to have.

    All that said...... Your mom should still get another opinion,
    and even a third, fourth, or more, to make sure she is getting
    the treatment that's best. There are many new surgical techniques
    and methods that have come into being recently, that are not
    chemically or radiation oriented. It's safer to go the newer
    non-chemical/radiation routes, than the toxic chemical routes.

    Oncologists aren't familiar with surgical techniques, and
    colorectal surgeons don't get into chemical therapy. They may
    know "of" each other's practices, but are not usually well
    versed or trained for each practice. They are "specialists",
    and specialize in one sole area of practice.

    Making appointments with different colorectal surgeons of different
    organizational affiliations, would be a good idea (in my opinion).
    Many times, one will know of a way to surgically remove a tumor
    that another surgeon, or an oncologist, has no knowledge of.

    My best to you both,

    John

    for me the chemo damage is as sneaky as the cancer
    I choose the chemical and alternative paths. Probably too many paths, but who knows ?????????

    I hope my folfox is working, at 5 of 12 cycles currently.

    I agree with John comments about getting opinions if you
    have the time and money and support. I had heaps of opinions, we all got confused.
    I had many good choices to make, but they all said basically the same thing.

    As my blood tests get progressively worse and worse I know the chemo is helping and hurting me. Ironically I look and feel fine most of the time except when I was in ER for severe dehydration a few weeks ago.

    Good health,
    Pete
  • loveandhope
    loveandhope Member Posts: 52
    Options
    luvmum said:

    chemo treatment
    Hi Loveandhope,

    My mum's situation is pretty much the same as your dad, except that her liver met is not operable. Her onc suggested 3-6 rounds of chemo every 21 days too.

    She had her first treatment on 26 Novmber 2010, Oxaliplatin, Avastin infused in 2-3 hours, xeloda (take home but only managed to finish 2/5 of them because she had severe diarrhea and ended up staying in the hospital till christmas eve). Since her side-effects were extremely severe, the onc postponed her 2nd treatment from 17 Dec till 3 Jan 2011. So you can see this is even longer than 21 days. The onc even thought of stopping her chemo because of it, but I said 'she will die' and the onc said 'she will die from chemo too'.

    Anyway, because she looked pretty healthy when she went to see the onc on 29th Dec 2011, so the onc said he will give her another round of chemo but he has changed the regimen from XELOX (Oxaliplain+xeloda and Avastin) to FOLFOX. With FOLFOX, he only infuse 50% of the dosage too. With the 50% of the message, the onc separated the infusion into 2 times (2 injections) as well. She did half of the infusion on 3rd Jan, and the other half next Monday. I don't know how does it work, but the onc keeps saying quality of life is very important!

    I hope this info helps and take care!
    Dora

    hi dora
    thanks for you

    hi dora
    thanks for you reply. my dads liver is unoperable too. he is having first chemo on 11th january. i hope ur mum tolerates this rojnd of chemo well.

    xxxxxxxxxxx