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Cisplatin/Doxirubicin(Adriamycin) combined chemo

nancygt
Posts: 86
Joined: Jan 2010

Anyone out there who has had this combo. I have my scans(PET and MUGA for heart) next week and am supposed to start chemo Jan. 20th for my second reccurrence with 8 treatments scheduled.Apparently from news articles, the mfrs are shipping Doxirubicin again in limited quantities although FDA does not show shortage as resolved. I believe this 2 drug chemo is my oncologist's preference but he is concerned about having to change midstrean if shortages continue or reappear.I signed consent for these two and also for Doxil if his concerns are not resolved. I have read a lot about Doxil on both this board and ovarian board but do not seem to find much about this combo. I do understand that Cisplatin is very powerful platinum drug and side effects can be worse - although he is encouraged by how well I tolerated carboplatin/taxol before (blood values okay since I could take Neulasta, some neuropathy but not requiring treatment and good effect from Zofrat for nausea). We both want to fight hard for longer remission ( one was 5 months from end of treatment and the next was at 4 months from end of next treatment -both within 20 months or original dx).
So if anyone has had this combo I would love to get your feedback - positive or negative. I always feel better having information and much of that comes from the lovely ladies of this board. The most difficult time that I had emotionally was my first oncologist did not warn me that 70-80% of stage 3 USPC recur within one year and I was floored and devasated at 1st recuurrence - all he talked about was what it meant if I was disease free at 24 months and then at 5 years and that lead to somewhat unrealistic expectations.

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

Cisplatin is considered a more toxic/powerful chemo then carboplatin including side affects
in fact its one of the most harsh chemo's available. Its application for cancer was approved by FDA in late seventies and the contributions of DR Lawrence Einhorn of Univ of Indiana played a big part.

I was treated with cisplatin for 4 rds, 5 times a week = 20 treatments from Oct 2008 to Dec 2008 and had reached the maximum for cisplatin in my body. If the cancer was not eradicated and i was not in remission and stayed there, my options would have been discouraging

I had testicular cancer stage 3 (highest stage for this type and same cancer as Lance Armstrong World Tour cycling Champion many times. For Uterine cancer, the freqency, strength, and duration/rounds of cispatin likely be different, perhaps once every 2 or 3 weeks. I had several blood transfusions during my chemo treatments, progressively more severe nausea, neuropathy, gland damage in eyes, loss of 20 pounds from 160 to 140, GI issues, and constant heavy fatigue. I did have silent heart attack after my 6th chemo treatment due to 1 or more of the chemo meds i was on, those being cisplatin, bleomycine, and etoposide. Ive been in remisison since jan 2009 without any recurrances. I call cisplatin the raging bull. For treating nausea, see if your Dr will prescribe Emend.

nancygt
Posts: 86
Joined: Jan 2010

Thanks for the info. I have been preparing myself that this likely to be a very tough chemo and have heard how powerful Csplatin is (one article said 10 times that of carboplatin so raging bull seems appropriate in several ways). I am glad to hear that it effective as well. I heard from you and a lady , Helen, where she has 20 years of survival (posted article she was featured in today) and she had Cisplatin and Doxirubucin years ago. I do realize it is not often given for unterine but with Stage 3 Papillary Serous (my current oncologist feels it was stage 4 as it recurred quickly in para-aortic lymph nodes where it was treated successfully for the moment with IMRT but quickly recurred again) I am willing to deal with side effects to have hope of longer remission. I do have a MUGA scan for my heart on Wed. as that is one of the scariest potential side effects so hopefully I will be going in heart healthy.However I am curious- did most of your side effects go away after chemo? Except for some GI tract issues(probably from radiation) that seemed to happen last time and it would be encouraging to hope for that this time.

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

Nancy, its good to be prepared for what chemo effects could occur and in the likelihood you tolerate the meds relatively well, then all the better. I would think your schedule for Andriamycin and cisplatin would be staggered such as one day a week with say 2 weeks off or one chemo one day a week and perhaps the 2nd one another week. My schedule with the cancer I had & stage required daily cisplatin along with the other two chemo’s, then a break, then repeated. It felt like an obstacle course as it mimicked a sprint with a condensed and short time frame.

The strange thing about the treatments I had was during the chemo infusion with IV for 3 hrs, I sat during the entire time, relaxed, and felt human. The more treatments, the more cumulative the effects and the more intense the fatigue and nausea, as well as low bone marrow levels of platelets, red and white cells.

I actually had delayed side affects as about 2 months after my last chemo treatment, my glands in my eyes, called lacrimal glands which secrete the aqueous layer of the tear film, dried up and the affects were chronic for 18 months as it got progressively better with Genteal eye drops. I also had neuropathy in all my fingers about a year after my last chemo treatment. My neuropathy and eye gland damage wont be 100% again but I was fortunate to have my kidney’s and liver tolerate the meds without issues. My heart did have a problem after my 6th treatment as I did not have a MUGA test for my heart. Although DR would normally be aware of it, I felt responsible for not knowing about it ahead of time so I could have requested one before chemo began.

My hearing was unaffected from cisplatin and my lungs, while impacted, remained stable despite being on a chemo called Bleomycin which targets ones pulmonary functions harshly. Mu hemoglobin red blood cell levels took 5 months to find normalcy but I did not get any infections as I had neupogen injectors with me at home in a kit to raise WBC. I had labs drawn daily when having chemo daily and every other day on off weeks. My bowel and GI tract was erratic and sudden and the fatigue was heavy, 24/7, no matter what I did. I was able to go back to work Full Time 5 weeks from my last chemo treatment but was not 100% yet.

I lost 20 pounds during treatment from 160 to 140 and most of my muscle. I lost 2 weeks of scheduled treatment due to silent heart attack but still had 13 more scheduled treatments left of cisplatin. i had no chemo brain from treatments.

I look back and say I was fortunate the long term affects of cisplatin and other chemo are now manageable. My medical history was also challenging for my med team as I was on 3 immune suppressant meds for an organ transplant (3rd one) since 2001. I has been a type 1 diabetic for 27 yrs before organ transplant to get off of insulin. i also was a liver donor (segment lobe) some 15 yrs ago to another patient/recipient.

I believe you will do much better with the side effects of cisplatin and glad you will get a MUGA test and hope your heart is stable. As you know Adriamycin can target the heart function and can affect pumping action.

Here are my key points for managing treatment of chemo

First, my chemo regiment was named after the Eagle’s song from 1976 called
“Life in the Fast Lane”, hopefully yours will be at highway speeds that are within the speed limits.

2nd point: Get your labs done religiously for bone marrow values and heart and kidney functionality

3rd point: Makes friends with Neupogen, the White blood cell savior and essential to minimize infections

4th point: Use Emend for nausea and if not covered by Med ins, use out of pocket money, its worth it

5th: Welcome the support from the caring and knowledgeable members from CSN, were here for you.

Steve Heart of Soul, I always have faith in the 4 legged fluffy feelines, we both have many lives, lol

WendyKay's picture
WendyKay
Posts: 19
Joined: Jan 2011

Just to let you know, I had Cisplatin for stage 3b cervical cancer and to tell the truth I LOVED my chemo days (I know I am not normal) but I had no side effects from Cisplatin (I felt great after) it was the radiation that got me.

Good Luck

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

Wendy, Commander Spock from Star Fleet command was only person i knew who LOVED cisplatin, i think because he was part Vulkin. Native Earthling?

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