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Folfiri and Nausea HELP PLEASE

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Folfiri and Nausea HELP PLEASE

Postby juliekei » Wed Aug 15, 2012 10:57 am

I had my first round yesterday and had to stop at 60% of the ironotecan because I had diarrhea even :D with atropine given as Premed. They gave me a bag of fluid andI went home with the pump. Been feeling lousy ever since,haven't actually vomited but feel like it at any minute. Took Emend before chemo yesterday, Zofran, Compazine and Ativan. The Ativan worked the best but still sufering. I wold take medical marijuaña but I live in NYC. Any suggestions are welcome, I'm so desperate I'm considering turning the pump off to get some relief...

Thank you to my fellow fighters...
Last edited by juliekei on Wed Aug 15, 2012 11:16 am, edited 1 time in total.
Dx Stage 4 8/10 age 38
Left hemicolectomy 9/10
5FU/Folfox Desensitization rounds 6-12
SBO surgery 8/11
HIPEC#1 6/12
8 rounds of FOLFIRI (lack enzyme)
HIPEC#2 5/13
VATS for 3 lung nodules 1/14
Xeloda & Avastin
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Re: Folfiri and Nausea HELP PLEASE

Postby BrownBagger » Wed Aug 15, 2012 11:00 am

I'd recommend anything made of ginger. Tea, candy, ale, etc. You can even buy some ginger root at the grocery store and eat it in small slices, or get some sushi and eat the pickled stuff. Marijuana works really well, so I'd encourage you to get some and use it if you can. A little red wine might also help with the nausea. It does for me.

Good luck!
Eric, 56
Dx: 3/09, Stage 4 RC
Recurrences: (3/lung)
Major Ops: 5
Chemo Rounds (career): 80
Bicycle miles post-dx 10,346
Motto: Live your life like it's going to be a long one, because it just might, and then you'll be glad you did.
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Re: Folfiri and Nausea HELP PLEASE

Postby SkiFletch » Wed Aug 15, 2012 11:53 am

Call your oncologist, explain, and ask him if it's OK for you to take more anti-emetics. Usually the answer is yes and it can help, but you need to call and ask. Are you keeping any kind of food/liquid in your stomach. Keeping small amounts in there sounds counter-intuitive but it does help. Carbonated beverages help also
11/13/09 5cm Stage IV 9/25 lymph nodes w/2cm peritoneal met at 29 YoA
12/15/09 LA right hemi-colectomy
6/16/10 Folfox FINISHED
8/10/10 Prophylactic HIPEC
10/9/10 got Married :D

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Re: Folfiri and Nausea HELP PLEASE

Postby annalexandria » Wed Aug 15, 2012 11:58 am

So sorry you're going through this. Nausea is the worst of the side effects, imo. How much Ativan are you taking? I was told to do 2 mg, 3x per day. It's likely to put you to sleep for awhile, but it really helped me. If that doesn't work, I'd take BB's advice, and get yourself some pot. It's very effective. The average teenager can probably find you some in about 5 minutes. I've been fortunate to live in WA, where medical mj is legal (in fact, we're voting in November to legalize it across the board for all adults). Hope you feel better soon. Ann Alexandria
Mom, librarian
Dx age 43, Sept. '09, Stage IV Carcinosarcoma of the colon
5 surgeries, 2009-2011:
colon/sm. bowel res., node removal, peritoneum, hysterectomy
FOLFOX/Avastin Feb.'10-Aug '10
Carbo-Taxol Dec. '10-Feb. 2011
NED since Dec. 2011.
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Re: Folfiri and Nausea HELP PLEASE

Postby Merlin » Wed Aug 15, 2012 12:55 pm

I completed 12 rounds of FOLFIRI last week. I found ginger candy that I would buy at whole foods or world market would help a lot. It comes in a green small box or bag with a ginger root cartoon character on it. Hope this helps. Lisa
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Re: Folfiri and Nausea HELP PLEASE

Postby Kathryn in MN » Wed Aug 15, 2012 1:11 pm

You should be able to alternate Zofran and another anti-emetic through the day today and tomorrow to help with your nausea. It is really hard to get a handle on it once it gets out of control, so take them as often as they allow you to - even if you seem to be doing ok (now that you know nausea is a problem for you).

I found that while on FOLFIRI I did better to keep eating as often as I could. (Not so on FOLFOX). Try to eat little bits of something that sounds ok as often as you can, and make sure to stay hydrated - that is the biggest part of it all to help with every side effect.

Please call your doctor and ask what anti-emetics you can take, and how often.

Please know that often the first cycle of chemo is the worst - before you start to tweak things and find what works for you. For me personally, I struggle with higher than normal nausea with chemo. I can't take Compazine, and Zofran gives me really bad headaches (with chemo, but it works for me during radiation - go figure...). I get Emend and Aloxi as pre-meds, as well as Decadron, and have Ativan to take at home. I think the Emend worked better for me when it was IV on infusion day, and pills the next 3 days (for most people it is 2 days, but for me I had an extra day). You might ask about that possibility - it seems to "even out" the medicine in the body and work better rather than getting a 3-day infusion the first day. For some people adding in Decadron (a steroid) can help with the nausea. For others it does the opposite. Trial and error - speak up to your medical team and they will tweak things to find what will work for you.
CRC AUG09 Age 47
Sig Res T4a N2a Mx, KRAS mut codon13
Mets bones & nodes
FOLFOX, FOLFIRI, Avastin, Radiation
Irinotecan, Zaltrap & STAR RFA
APR13 pleurisy & ascites - more chemo & draining
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Re: Folfiri and Nausea HELP PLEASE

Postby Be.Here.Now » Wed Aug 15, 2012 2:43 pm

Some really good suggestions here. I tried just about everything, too, on the first chemo, and had a really tough time. Finally, my onc recommended acupuncture, and it has worked so well that i have continued going for all of my cancer and chemo problems. I continued to use Emend 3 day pack, Zofran and the infusion pre meds in conjunction with weekly chemo and their suggestion of anything ginger i could tolerate. I am lucky in that my PPO BCBS plan covers 70% of the allowed amount, and they have graciously agreed to take that payment as full payment for my treatment.

I am also lucky to find two Chinese sisters, both MD's but only practicing acupuncture in the US. One is a surgeon, the other a pulmonary doctor. They readily incorporate their practice with the regular Western medical approach. Also, they have colorectal cancer close in their family, and routinely have their CEAs checked and colonoscopies, and know more about mCRC than most off field docs.

This, in conjunction with all the antiemetics, truly resolved my nausea about 98%.

Keep trying different combinations, with your onc's knowledge and approval and more than likely you will find the right one for you. Ginger candies and teas from the Phillipines are another good source to Google and fine.

HTH
T.
[color=#0000FF]2009 appendix ca
R cecum tumor|Stage IIIc |FOLFOX6
3x blks 2011 sm bm resection FOLFIRI+Erbitux
2/2012 PET-CT 4+ mets, pelvic periton.
4/12 Avastin+Xeloda 5/12 Vectibix
No further tx failure to respond inclu Trial Currently under Hospice at home tx[color]
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Re: Folfiri and Nausea HELP PLEASE

Postby RixInPhx » Wed Aug 15, 2012 3:59 pm

The nausea isn't so much in your stomach yet (the drugs have bareky begun to kill the protective mucous lining), rather it's in the vomit-control center of your brain as a by-product of the drugs' action.
Next week is when ginger and other stomach-related remedies will help more..

The two 'usual' take-home anti-emetic (anti nausea) pills are Ondansetron (Zofran) every 8 hours (first-line), and Promethazine (Phenergan) every 6 hours (second-line).
Ask your Onc for these prescriptions, and take them on schedule for 2-3 days beginning upon return home from the infusion.

As K in MN stated, you MUST keep to the schedules, and it will be brought under control.

HTH, Rick
M 61, Dx 6/10 CRC st 4, unknown primary CEA 843
2 kg peritoneal mass, met to skull; no surgery
Various regimens of all CRC chemo drugs
Mets to lung 8/11 CEA 135
Folfiri/Erb/Ava 12/11 CEA 320
No progression 5/12 CEA 192
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