what should I expect on the first day of chemo?

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JudiB
Posts: 62
Joined: Sun Mar 05, 2017 5:30 am

Re: what should I expect on the first day of chemo?

Postby JudiB » Mon Jun 19, 2017 8:00 am

Tdubz
Great news to share with your family, must be a big relief. A third of the way.. a milestone!
Most important thing is to try to focus on the positives.....this is just a little detour in our lives, which, hopefully, will soon be just a memory, reminding us how lucky we have been dicing with this stuff!!
Bring on those coloscopies!!! 8) 8) :lol:
May 2004 Breast cancer lumpectomy followed by radiotherapy, Tamoxifen 5 years, then Femara 2 years.

Jan 2017 resection around colo-rectal junction
T2bN1 M0
March 2017 Chemo Folfox started
June 2017 clear scan

benben
Posts: 115
Joined: Fri Apr 28, 2017 3:18 pm
Location: Washington State

Re: what should I expect on the first day of chemo?

Postby benben » Mon Jun 19, 2017 8:36 am

Tdubz wrote:Hopefully the shot works for you and you don't have to delay treatment. How low did your WBC counts have to go for them to give you a shot?


My Neutrophil count was 1.05 at day 14 after first treatment (2nd infusion day). Bottom line for my clinic is 1.0 to do treatment, and they are aggressive - normal counts are 1.9-7.4.
Typically by day 14 they should be back close to normal range, mine weren't. So Neupogen boost was deemed required. During Nadir, those counts can be extremely low. So it's important they are up prior to treatment.
I had first injection yesterday. Relatively non-eventful, thankfully. It's a shot that really stings going in. So RN did a good job at pre-warming and slowly injecting. I took claritan as suggested to minimize bone pain which is the most common side effect. So far haven't really experienced any of that. Go in for second shot today and we'll see tomorrow what the results are on the WBC. If back up it'll be a go for 3rd treatment, if not probably have to postpone for a week.

Happy 33.33% point to you.
----------------------
3/29/17 diagnosed CRC - 44 y/o Male
4/17/17 ULAR - Straight anastomosis - no ostomy.
Path: low grade T3n1m0 - moderate diff.
KRAS - NO, MLH1/PMS2/MSH6/MSH2 - Normal.
5/3 med port install
5/22 folfox - first treatment.
3rd treat, delayed - low ANC - reduced to 90% OXI
Granix given, Now Zarxio treatments every session.
Current - 6 treatments done, LOW WBC/ANC/Platelets.
Attempting to reach at least 8 sessions. Treat 7 most likely delayed

Tdubz
Posts: 74
Joined: Sun May 07, 2017 11:01 am

Re: what should I expect on the first day of chemo?

Postby Tdubz » Mon Jul 03, 2017 8:48 pm

Round 5 now under my belt and I hang out with the pump for a few days awaiting all the fun side effects. Neruapathy and cold sensitivity were much worse on round 4, lasted til thurs of off week, nausea was the least that it's been, but fatigue set in a lot more. Went to work on my off week, mon through wed was fine but I could feel myself getting tired by the end of wed. Thurs I didn't really want to get out of bed. So tired. I think when I'm at work I forget to drink as much as I'm supposed to so I might have been a bit dehydrated.

If the neurapathy continues to last longer, they will probably lower the oxy dosage on one of the upcoming rounds.

Round 5 seems a bit different, usually day one seems like a normal day for me. I usually don't feel the nausea and tiredness til the end of day 2, but I'm already feeling pretty tired right now and maybe the slightest bit of nausea.

Still on reduced doses of 5FU. I'll see the cardiologist again next week to do a stress test and then possibly wear a heart monitor during the next round of chemo. My onc said the chest pain is pretty rare and he's only seen it a handful of times in all his years. So not only am I one of the youngest people at my oncs office, I also get the rare side effects. Yeah. Hopefully the cardiologist will have some further insight after the stress test.

Getting real close to the halfway point so that's exciting. Can't wait til wed to disconnect lol.

Happy 4th of July everyone!

Lee
Posts: 4973
Joined: Sun Apr 16, 2006 4:09 pm

Re: what should I expect on the first day of chemo?

Postby Lee » Mon Jul 03, 2017 9:00 pm

Tdubz wrote:Getting real close to the halfway point so that's exciting. Can't wait til wed to disconnect lol.
Happy 4th of July everyone!


Congratulations on almost hitting the 1/2 mark. MAJOR milestone. So very happy to know you were able o get this far with the heart issues.

Keep up the awesome job and yes, Happy 4th of July.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

benben
Posts: 115
Joined: Fri Apr 28, 2017 3:18 pm
Location: Washington State

Re: what should I expect on the first day of chemo?

Postby benben » Mon Jul 03, 2017 9:20 pm

Tdubz wrote:Round 5 now under my belt

Happy 4th of July everyone!


Way to go Tdubz. Glad to hear you're almost half way through and that you're getting to the cardiologist.
My heart rate seems to do the opposite and increases. I'm usually 75-80 bpm, but after chemo and growth factor shots jumps up to 90's and even 100+ a few times.
I try for round 4 on the 6th - depending on blood test results as seems like something is a bit off on each session. I feel good though, getting lots accomplished.

Happy 4th.
----------------------
3/29/17 diagnosed CRC - 44 y/o Male
4/17/17 ULAR - Straight anastomosis - no ostomy.
Path: low grade T3n1m0 - moderate diff.
KRAS - NO, MLH1/PMS2/MSH6/MSH2 - Normal.
5/3 med port install
5/22 folfox - first treatment.
3rd treat, delayed - low ANC - reduced to 90% OXI
Granix given, Now Zarxio treatments every session.
Current - 6 treatments done, LOW WBC/ANC/Platelets.
Attempting to reach at least 8 sessions. Treat 7 most likely delayed

Tdubz
Posts: 74
Joined: Sun May 07, 2017 11:01 am

Re: what should I expect on the first day of chemo?

Postby Tdubz » Mon Jul 03, 2017 9:38 pm

My biggest fear is having to miss a treatment to low counts, but I must have some crazy blood, because my counts seem to always be better than the treatment before it. I'm due to finish the week before my daughters birthday so any set backs would really ruin those bday plans lol.

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Maia
Posts: 2393
Joined: Fri Aug 24, 2012 8:00 am

Re: what should I expect on the first day of chemo?

Postby Maia » Mon Jul 03, 2017 9:49 pm

Tdubz, just in case you didn't read, this is from past June, at the ASCO meeting. I don't know if it is your case, but it might be worth mentioning to your doctor.

Stage III: 3 months of FOLFOX was nearly as effective as 6 months


Shorter Chemo Duration for Colon Cancer May Spare Patients Toxicity

News | June 04, 2017 | ASCO, Colorectal Cancer

CHICAGO—Patients may be able to simplify their course of chemotherapy after surgery for stage III lymph node–positive colon cancer, according to a new analysis of six clinical trials (abstract LBA1). The data, presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 2–6, suggest that some patients may only need half of the longstanding standard course of chemotherapy.

The researchers examined data on 12,834 patients and found that 3 months of chemotherapy was nearly as effective as 6 months in patients with relatively lower recurrence risk. The findings suggest that this new schedule results in fewer side effects, particularly nerve damage.

“The side effects were dramatically lower and so this will change the standard of care,” said senior study author Axel Grothey, MD, an oncologist at the Mayo Clinic Cancer Center in Rochester, Minnesota.

Since 2004, the standard adjuvant therapy after surgery has been a combination of chemotherapies (FOLFOX or XELOX) given over a period of 6 months. The goal of this study, which pooled data from 6 studies conducted in North America, Europe, and Asia, was to determine if 3 months of chemotherapy was as effective as 6 months.

The analysis showed that a 3-month course of chemotherapy was associated with a lower chance of being colon cancer free at 3 years compared with the standard 6-month course (74.6% vs 75.5%). In patients considered low risk for cancer recurrence (60% of patients in the study), the difference was even smaller (83.1% in patients receiving a 3-month course vs 83.3% in patients receiving a 6-month course).

“It is very good news. It will decrease long-term side effects that would affect quality of life,” said Grothey. He noted that patients with higher-risk colon cancer should discuss these results with their clinicians to tailor a course of therapy optimal for them, taking into account their preference, age, and ability to tolerate chemotherapy.

Nerve damage was substantially less common in patients receiving a 3-month course of chemotherapy compared with a 6-month course (15% vs 45% with FOLFOX and 17% vs 48% with XELOX). For all patients combined, the rate of disease-free survival at 3 years was slightly lower with 3 months of chemotherapy vs 6 months of chemotherapy (74.6% vs 75.5%). The type of chemotherapy regimen selected affected the difference in 3-year disease-free survival between the 3-month and 6-month treatment durations (75.9% vs 74.8% with XELOX and 73.6% vs 76.0% with FOLFOX). Patients were followed for a median time of 39 months.


http://www.cancernetwork.com/asco/short ... s-toxicity

Tdubz
Posts: 74
Joined: Sun May 07, 2017 11:01 am

Re: what should I expect on the first day of chemo?

Postby Tdubz » Mon Jul 17, 2017 7:38 pm

Round six in the books. Can't believe I'm at the halfway point already! However I feel a lot worse than previous rounds. Usually day 1 is just like any other day for me but this time around I've got some severe heartburn and I feel super tired with headaches and joint pain. I'm hoping this doesn't mean days 2 through 5 are going to be worse too lol.

I might be able to stop iron infusions since anemia seems to be getting under control but we will discuss that next week, so that's good, should save me about 30 min of infusion time.

I also get to do an echo on my heart this week. Hopefully that will give me some answers as well. The light at the end of the tunnel is definitely getting brighter! i hope these last few rounds stay on schedule like the first 6. My daughters birthday is the week after my last treatment and I'm determined to make that party!

Question about neuropathy. do you guys have fingers/toes that are constantly tingling? I seem to only experience it when I'm typing or texting or doing things with my hands, sometimes I feel it in my toes when walking, but it's never been a constant thing, even though it lasted until yesterday, I still got the full dose of oxy today. The last time I had cold sensitivity was Thursday. If you had oxy reduced, what were the symptoms you had that made the onc reduce?

benben
Posts: 115
Joined: Fri Apr 28, 2017 3:18 pm
Location: Washington State

Re: what should I expect on the first day of chemo?

Postby benben » Mon Jul 17, 2017 10:50 pm

Tdubz wrote:Round six in the books. Can't believe I'm at the halfway point already! However I feel a lot worse than previous rounds. Usually day 1 is just like any other day for me but this time around I've got some severe heartburn and I feel super tired with headaches and joint pain. I'm hoping this doesn't mean days 2 through 5 are going to be worse too lol.

I might be able to stop iron infusions since anemia seems to be getting under control but we will discuss that next week, so that's good, should save me about 30 min of infusion time.

I also get to do an echo on my heart this week. Hopefully that will give me some answers as well. The light at the end of the tunnel is definitely getting brighter! i hope these last few rounds stay on schedule like the first 6. My daughters birthday is the week after my last treatment and I'm determined to make that party!

Question about neuropathy. do you guys have fingers/toes that are constantly tingling? I seem to only experience it when I'm typing or texting or doing things with my hands, sometimes I feel it in my toes when walking, but it's never been a constant thing, even though it lasted until yesterday, I still got the full dose of oxy today. The last time I had cold sensitivity was Thursday. If you had oxy reduced, what were the symptoms you had that made the onc reduce?



TDUBZ - CONGRATULATIONS on making the half way 6 rounds!
At least now you've made it to what the recent ASCO report suggests is nearly as good as the entire 12 rounds.

I got heart burn pretty bad my last round which was #4. To be honest I had been slacking on my prilosec(omez), as well as the few supplements my ONC said I could continue taking.
I definitely need to make sure I'm keeping those up, especially with round 5 coming Wednesday for me - provided the WBC is up. I got my single zarzio shot today. So far no bone pain.

As for Oxy reduction. I had mine reduced starting round 3 to 90%. The symptoms that my ONC stated we should reduce for were mainly some slight pervasive numbness in my hands/forearms - but the biggest reason
was the significant trashing of my WBC count all the way down to 420, even after 2 granix shots after round 2. So I had a 2 day delay for round 3 and reduction of OXY. I had 2 zarzio shots between round 3 and 4 and my WBC skyrocketed up to 5500 on the ANC and about 11k total WBC. So they decided to try 1 zarzio this round. I'll see how that panned out Wednesday morning during pre-infusion blood draw. Hoping round 5 continues that way I don't have to go to hospital during weekend for disconnect as the cancer center here is closed on weekends. Aside from the hospital screwing up the billing on my insurance, I don't like having to bring home the pump! It gives me a bad taste in my mouth every time I see it. I dunno - I just like the complete separation during my good week:).

On the symptom side of things, with reduction of the oxy and continued CBD/THC use, my symptoms are significantly less. Where round 2 I had numbness in my feet all the way up my calf muscles for about 15 minutes one day. I still experience some slight numbness in my hands and forearms, but nothing that seems to be interfering with much. I'm still capable of working and typing at least 60 words per minute. I use my hands ALOT for work. I can also still play guitar, which I really enjoy and find it very therapeutic.

I'm interested to hear what your heart results were. I hope everything turns out good for you. I did notice round 4, directly after disconnect my blood pressure dropped pretty low as well as my heart rate.
Normally I run between 125/70 - 135/85 with bpm of 75-85. 3 days during disconnect it had dropped to 103/60 with bpm low of 57. I talked to Nurse that gave me my injection today and said that's not really normal and should bring it up with the nurse during blood draw on Wednesday.


May you have continued minimal symptoms with the last half of treatment! Climb Onward.
----------------------
3/29/17 diagnosed CRC - 44 y/o Male
4/17/17 ULAR - Straight anastomosis - no ostomy.
Path: low grade T3n1m0 - moderate diff.
KRAS - NO, MLH1/PMS2/MSH6/MSH2 - Normal.
5/3 med port install
5/22 folfox - first treatment.
3rd treat, delayed - low ANC - reduced to 90% OXI
Granix given, Now Zarxio treatments every session.
Current - 6 treatments done, LOW WBC/ANC/Platelets.
Attempting to reach at least 8 sessions. Treat 7 most likely delayed

Tdubz
Posts: 74
Joined: Sun May 07, 2017 11:01 am

Re: what should I expect on the first day of chemo?

Postby Tdubz » Tue Jul 18, 2017 7:28 am

My heart had been all over the place throughout this ordeal. Normally I'm 120/80 and 80 resting hr, but the day after chemo I drop down to 90/50 and about 50 bpm. I hadn't been paying much attention to my hr during the second week much but last week I had a stress test done. The morning of the stress test I noticed my hr was 155 just from getting out of bed and getting dressed. Pretty much any activity will make my hr jump super high. I could only do about 6 min on the treadmill and my hr got up to 175. The ekg report showed my heart still in perfect rythym and everything was normal except the high hr. So now I have really high and really low hr to deal with.

User avatar
horizon
Posts: 1403
Joined: Tue Apr 12, 2011 10:10 pm

Re: what should I expect on the first day of chemo?

Postby horizon » Wed Jul 19, 2017 10:40 am

Tdubz wrote:Question about neuropathy. do you guys have fingers/toes that are constantly tingling? I seem to only experience it when I'm typing or texting or doing things with my hands, sometimes I feel it in my toes when walking, but it's never been a constant thing, even though it lasted until yesterday, I still got the full dose of oxy today. The last time I had cold sensitivity was Thursday. If you had oxy reduced, what were the symptoms you had that made the onc reduce?



Tell your onc about all symptoms! The second I started feeling tingling in my fingers I told him and if I remember correctly they reduced the Oxi dosage after that. I don't have any lingering neuropathy issues.
I'm just a dude who still can't believe he had a resection and went through chemo (currently 6 years NED). Is this real life?

Tdubz
Posts: 74
Joined: Sun May 07, 2017 11:01 am

Re: what should I expect on the first day of chemo?

Postby Tdubz » Thu Jul 27, 2017 11:02 pm

So good news, echo came back and everything looked normal. Still no word on what's causing the chest pains, but hopefully my onc will have some more information about it when I go in on Monday.

Neuropathy has been much worse this round, hands and feet are tingling all the time now. I'm on day 11 of this treatment and I've felt it pretty much all day.

I've also been experiencing some back pain. It feels just like a sore muscle right in the middle of my back. I've had this for a few weeks now and thought it was just because I've been lying down a lot more, but it's still there even on off treatment weeks so maybe it's related to chemo?

Yesterday my thighs felt really weak. Felt almost like what you'd expect your legs to feel like after a really hard leg workout, and today my thighs are really sore. I haven't done anything this week but go to work and come home. No exercising at all so it's weird my legs would be feeling like this. Any of y'all have these symptoms?

benben
Posts: 115
Joined: Fri Apr 28, 2017 3:18 pm
Location: Washington State

Re: what should I expect on the first day of chemo?

Postby benben » Fri Jul 28, 2017 8:54 pm

Tdubz wrote:So good news, echo came back and everything looked normal. Still no word on what's causing the chest pains, but hopefully my onc will have some more information about it when I go in on Monday.

Neuropathy has been much worse this round, hands and feet are tingling all the time now. I'm on day 11 of this treatment and I've felt it pretty much all day.

I've also been experiencing some back pain. It feels just like a sore muscle right in the middle of my back. I've had this for a few weeks now and thought it was just because I've been lying down a lot more, but it's still there even on off treatment weeks so maybe it's related to chemo?

Yesterday my thighs felt really weak. Felt almost like what you'd expect your legs to feel like after a really hard leg workout, and today my thighs are really sore. I haven't done anything this week but go to work and come home. No exercising at all so it's weird my legs would be feeling like this. Any of y'all have these symptoms?


Hey Tdubz!
Great news I'd say on the heart front.

I get some chest pains too, but I know it's more GERD related. Close to my esophagus and Gall bladder regions.
So I need to keep up with the prilosec, and double dose it during the chemo week and that helps big time for me.

As for muscle weakness. I'm starting to get that more too, so you're not alone.
Try to keep up with some walking. This helps me with the jello leg feeling.

Good luck as you enter the later half of treatment.
----------------------
3/29/17 diagnosed CRC - 44 y/o Male
4/17/17 ULAR - Straight anastomosis - no ostomy.
Path: low grade T3n1m0 - moderate diff.
KRAS - NO, MLH1/PMS2/MSH6/MSH2 - Normal.
5/3 med port install
5/22 folfox - first treatment.
3rd treat, delayed - low ANC - reduced to 90% OXI
Granix given, Now Zarxio treatments every session.
Current - 6 treatments done, LOW WBC/ANC/Platelets.
Attempting to reach at least 8 sessions. Treat 7 most likely delayed


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