Anyone with Stage IVa just do Xelolda or 5-fu?

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Achilles Torn
Posts: 90
Joined: Fri Dec 16, 2016 2:41 pm

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby Achilles Torn » Mon Nov 20, 2017 4:15 pm

FOLFOX is hard on the liver so adding alcohol seems to be discouraged. I had a few beers during some cycles and it showed up in my liver numbers on bloodwork. That being said an occasional drink isn’t going to shift the needle that much.

It wasn’t until about cycle 4 that my Liver numbers started to trend up out of the norm so maybe it won’t be an issue for him.

Hope that helps
AT
40 yo Male. BC Canada. Sigmoid Colectomy Dec. 2016
Pathology T3N2bM1 19 of 24 Nodes Positive + tumour deposits
PET scan - Para-Aortic and Iliac Lymph node spread. Stage VI.
Moderately differentiated. MSS. KRAS/BRAF Wild.
Mutations: TP53, ERBB4, MLL3, PDCD1LG2, PRKDC, SMAD3
FOLFOX Commenced Jan 9/2017 - Avastin(Bev) added after round 1.
June 2017 Dose Reduction on Round 11 due to Neuropathy.
Good PET Scan July 2017 - on maintenance 5FU/Bev every 2 weeks until progression.

mpbser
Posts: 313
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby mpbser » Mon Nov 20, 2017 4:26 pm

Thanks, everyone! Much appreciated!
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm width T1 N0
CEA: 1.4 Pre-op; 2.1 2 days Post-op
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal expression of MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53

cbsmith
Posts: 47
Joined: Sat Nov 28, 2015 11:45 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby cbsmith » Mon Nov 20, 2017 5:52 pm

When I was on folfox and now I’m folfiri my oncologist said I could have a couple drinks at the end of my 2week cycle if I wanted. She advised not drinking heavily and not doing it during the first part of my cycle when I was getting the actual drugs, not that I would have wanted to then.

I do have the odd drink or two as she approved, sometimes it takes my mind off everything, sometimes I just crave something to drink that doesn’t taste funny. I find my taste of water for a while after every treatment tastes different, but for some reason beer always tastes normal.
06/14-DX with FAP as 36yo Male
07/14-total colectomy, rectum removal, permanent ileostomy
08/14-DX Stage IIIC colon cancer KRAS mutant, MSS
09/14-12 rounds of FOLFOX
04/15-ended FOLFOX
07/15-CT showed one para-aortic lymph node, onc thought inflammation and said wait 3 mths
10/15-DX Stage IV, CT showed lymph node tripled in size and 1 small lung met
11/15-FOLFIRI + Avastin
06/16-lymph node is stable, now have a 2nd lung met
01/16-lymph node is stable, lung mets grown 2mm. Still on FOLFIRI + Avastin

mpbser
Posts: 313
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby mpbser » Wed Nov 22, 2017 12:19 pm

Husband decided he wouldn't bother, for now. He's thankfully not the kind of person who "deals" with stress by drinking. He's at the cancer center now having infusion #3. Oncologist says his bloodwork looks great and he seems to be handling this one well, so far.

3 down, 1 to go (until the Spring, maybe)
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm width T1 N0
CEA: 1.4 Pre-op; 2.1 2 days Post-op
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal expression of MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53

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LPL
Posts: 312
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby LPL » Wed Nov 22, 2017 6:04 pm

Hi mpbser,
Your update sounds very good :-)
Best of luck finishing this ’4 chemo’ treatments.
To answer your question, my DH was not given any advice to Not drink alkohol during his treatments.
Perhaps it is different with folfox compared to the xeloda + oxi? Or maybe it is different in France :wink: We normally have vine to our dinner and hubby did not change that during the treatment periods.
Kind Regards /L
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets

mpbser
Posts: 313
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby mpbser » Sat Dec 02, 2017 3:57 pm

Just popping in for a quick update. Husband will be completing Cycle 3 on Wednesday and he is doing really great. The only noticeable side effect at the moment is darkness under his eyes. He LOOKS exhausted but he claims to be feeling great. He has loads of energy the past couple of days. He still works 6 days a week and isn't showing any signs of slowing down anytime soon.

I've been making sure he gets supplements that are designed specifically to align with his chemo rounds, so maybe that is helping with his energy level.

He had blood drawn for a doctor appointment he has coming up (had to reschedule due to his work) and it all looks really wonderful.

Very interestingly, his LDL was ~60 and HDL also was ~60. I have never seen such low numbers in my life!
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm width T1 N0
CEA: 1.4 Pre-op; 2.1 2 days Post-op
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal expression of MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53

User avatar
LPL
Posts: 312
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby LPL » Sat Dec 02, 2017 5:18 pm

Hi mpbser,
Your update sounds good :)
I presume the worry about chemo is not so bad now when everything seams to go well. Great that it doesn’t affect his ability to work!
So what is the reference numbers at your lab for LDL & HDL? Are your DH’s numbers normal?
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets

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LeonW
Posts: 318
Joined: Sun May 03, 2015 4:59 pm
Location: Amsterdam, Netherlands

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby LeonW » Sat Dec 02, 2017 5:56 pm

mpbser wrote:. . . Husband will be completing Cycle 3 on Wednesday and he is doing really great . . .

Thanks for the update. Congrats that round 3 is almost under the belt.
Hope that things continue to be manageable and that you can celebrate more victories.
Best wishes, L
Dec 2012 - Dx CC; MM 65yrs, 2 unresect liver mets, CEA 41.8
Jan 2013 - colectomy @ spleen (IVa T3N1bM1a) 2/26 nodes, MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, shrinkage from #3
Sept - 2x failed Portal Vein embolization
Oct 2013 - R liver resect 28 hosp days (liver failure, bad delirium, emboli, encephalopathy) pCR; cancer gone
2014/15 - recovery; benign polyp
Apr 2016 - new house/town/life
clean CTs and 1.3/1.4 CEAs: 4x2014, 4x2015/16, 2x2017
next: June 2018 w scopy - 5yr getting close

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby NHMike » Sat Dec 02, 2017 6:41 pm

mpbser wrote:Just popping in for a quick update. Husband will be completing Cycle 3 on Wednesday and he is doing really great. The only noticeable side effect at the moment is darkness under his eyes. He LOOKS exhausted but he claims to be feeling great. He has loads of energy the past couple of days. He still works 6 days a week and isn't showing any signs of slowing down anytime soon.

I've been making sure he gets supplements that are designed specifically to align with his chemo rounds, so maybe that is helping with his energy level.

He had blood drawn for a doctor appointment he has coming up (had to reschedule due to his work) and it all looks really wonderful.

Very interestingly, his LDL was ~60 and HDL also was ~60. I have never seen such low numbers in my life!


It sounds like things are well under control with his cancer and I attribute that to all of your hard work in the early days and I'm sure that it's still a fair amount of work managing things.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

mpbser
Posts: 313
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby mpbser » Sun Dec 03, 2017 6:46 am

Thanks, everyone. Re: the question about his labs, his total cholesterol was 150 mg/dL (RANGE < 200 mg/dL), LDL was 61 mg/dL (<100 Optimal), HDL was 65 mg/dL (RANGE 40-60 mg/dL). I don't understand why his medical center uses that range for HDL as I believe the higher the better for HDL. My doctor uses a bottom threshold of some number like 90 or 100 for HDL. If mine falls under that, he reminds me of the risk associated with low HDL. I will be looking at my medical records later today to see if the measuring unit is mg/dL because I am very curious about this rather wide discrepancy.

Chemo is said to be hard on the liver... and since the liver is the CPU for cholesterol, my husband's numbers are showing one of the ways chemo can affect it. Very interesting!
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm width T1 N0
CEA: 1.4 Pre-op; 2.1 2 days Post-op
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal expression of MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53

sdino
Posts: 44
Joined: Tue Mar 28, 2017 5:32 pm

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby sdino » Sun Dec 03, 2017 12:25 pm

Wife was on Xeloda (3000 mg/day) + Avastin IV since 8/2/17. Been through 6 full treatments. CT scan showed slight growth in lung mets.
Caregiver for Wife 52 yrs old
DX:11/16-CC sigmoid colon 3 cm, Lung Adenocarcinoma Stg IV
Mets: 1.2 cm now 7 mm lung w/14 other nodules less than 6 mm. 7/17 growth in Mets
MSS, KRAS-mut G12D; TP53;
Completed 12 rounds Folfox/Avastin + Oxi 11/16 to 5/17
8/17 Start Xeloda + Avastin
CT Scans: 11/16; 1/17 lung mets/colon shrinkage; 5/17 colon & lung met shrinkage, 7/17 and 11/17 disease progression lungs/colon
CEA: 16 - 11/16; 4 – 12/16; 0.5 – 2/17; 0.6 - 5/17; 2.6 - 7/17; 10/17 - 1.9, 11/17 - 2.6

mpbser
Posts: 313
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby mpbser » Mon Dec 11, 2017 5:46 pm

Just stopping in for a quick update. Husband saw his primary care doctor today. He wasn't alarmed by his A1C being a 7 and attributed the diabetes setback primarily to the chemo. Husband has gone off his strict diet somewhat in the past couple of months, but I suppose not horribly. All the rest of the bloodwork is looking phenomenal for someone who has had three rounds of chemo. His doctor was extremely optimistic and told husband he is going to beat this.

Husband has his fourth infusion on Wednesday, just in time for 18 degree F temperatures to hit our region. He had cold sensitivity the last round which lasted a few days, so he will be very careful this round. I have reserved the day to take care of him and the rest of week for my work will be kept light.

Also on a positive note, his work has brought him closer to home for the next couple of weeks so he won't have to commute 3 hours every day, 6 days a week for work. I feel like god is protecting him, despite my religious skepticism.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm width T1 N0
CEA: 1.4 Pre-op; 2.1 2 days Post-op
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal expression of MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby NHMike » Mon Dec 11, 2017 6:27 pm

mpbser wrote:Just stopping in for a quick update. Husband saw his primary care doctor today. He wasn't alarmed by his A1C being a 7 and attributed the diabetes setback primarily to the chemo. Husband has gone off his strict diet somewhat in the past couple of months, but I suppose not horribly. All the rest of the bloodwork is looking phenomenal for someone who has had three rounds of chemo. His doctor was extremely optimistic and told husband he is going to beat this.

Husband has his fourth infusion on Wednesday, just in time for 18 degree F temperatures to hit our region. He had cold sensitivity the last round which lasted a few days, so he will be very careful this round. I have reserved the day to take care of him and the rest of week for my work will be kept light.

Also on a positive note, his work has brought him closer to home for the next couple of weeks so he won't have to commute 3 hours every day, 6 days a week for work. I feel like god is protecting him, despite my religious skepticism.


The low in my area this week is forecast at 7 degrees. Then it warms up into the 20s. I'm pretty curious as to how this is going to feel as we're looking at a pretty cold winter and I typically clear off one roof after snowstorms. Also, clearing ice off of windshields will be interesting. I'm also planning on working from home a lot (my commute is only 20 minutes) because my office becomes an echo chamber of coughing when there's a cold or flu going around. I just got a new project that's going to keep my quite busy for the next two months and I'll need to move my home office because it's in an unheated part of the house. Or get a space heater.

There are a lot of people that commute from my area into Boston every day. It's a one-hour trip with no traffic and probably two with traffic in busy times and worst-case three. I really have no idea as to how people do that kind of commute but they do. I've seen it in my trips to Dana Farber, Brigham and Women's and Mass General. Fortunately the trips aren't very frequent and hopefully they will be fewer going forwards.

Your husband has made remarkable progress.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

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susie0915
Posts: 551
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby susie0915 » Mon Dec 11, 2017 6:55 pm

NHMike wrote:
mpbser wrote:Just stopping in for a quick update. Husband saw his primary care doctor today. He wasn't alarmed by his A1C being a 7 and attributed the diabetes setback primarily to the chemo. Husband has gone off his strict diet somewhat in the past couple of months, but I suppose not horribly. All the rest of the bloodwork is looking phenomenal for someone who has had three rounds of chemo. His doctor was extremely optimistic and told husband he is going to beat this.

Husband has his fourth infusion on Wednesday, just in time for 18 degree F temperatures to hit our region. He had cold sensitivity the last round which lasted a few days, so he will be very careful this round. I have reserved the day to take care of him and the rest of week for my work will be kept light.

Also on a positive note, his work has brought him closer to home for the next couple of weeks so he won't have to commute 3 hours every day, 6 days a week for work. I feel like god is protecting him, despite my religious skepticism.


The low in my area this week is forecast at 7 degrees. Then it warms up into the 20s. I'm pretty curious as to how this is going to feel as we're looking at a pretty cold winter and I typically clear off one roof after snowstorms. Also, clearing ice off of windshields will be interesting. I'm also planning on working from home a lot (my commute is only 20 minutes) because my office becomes an echo chamber of coughing when there's a cold or flu going around. I just got a new project that's going to keep my quite busy for the next two months and I'll need to move my home office because it's in an unheated part of the house. Or get a space heater.

There are a lot of people that commute from my area into Boston every day. It's a one-hour trip with no traffic and probably two with traffic in busy times and worst-case three. I really have no idea as to how people do that kind of commute but they do. I've seen it in my trips to Dana Farber, Brigham and Women's and Mass General. Fortunately the trips aren't very frequent and hopefully they will be fewer going forwards.

Your husband has made remarkable progress.

Mike I have a big walk in closet that gets so cold in the winter it's over the garage and the vent in there doesn't do a great job. We got an edenpure space heater and it does a great job. My closet it 24 ft long and I can feel the heater all the way at the other end. Before it was like an ice box. Maybe it would be good for your office this winter. I don't think it's very expensive. Wear warm slippers, boots hats and gloves when you're outside. You may want to cover your face if you're out in the cold for long.
58 yr old mother of 3 Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks of chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. 3 1/2 weeks in hospital,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc thinks scar tissue
monitored for autoimmune disorder/interstitial lung disease
7/17 no change lung nodule
10/17 Clear CT
11/17 CEA<.5

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susie0915
Posts: 551
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby susie0915 » Mon Dec 11, 2017 6:56 pm

mpbser wrote:Just stopping in for a quick update. Husband saw his primary care doctor today. He wasn't alarmed by his A1C being a 7 and attributed the diabetes setback primarily to the chemo. Husband has gone off his strict diet somewhat in the past couple of months, but I suppose not horribly. All the rest of the bloodwork is looking phenomenal for someone who has had three rounds of chemo. His doctor was extremely optimistic and told husband he is going to beat this.

Husband has his fourth infusion on Wednesday, just in time for 18 degree F temperatures to hit our region. He had cold sensitivity the last round which lasted a few days, so he will be very careful this round. I have reserved the day to take care of him and the rest of week for my work will be kept light.

Also on a positive note, his work has brought him closer to home for the next couple of weeks so he won't have to commute 3 hours every day, 6 days a week for work. I feel like god is protecting him, despite my religious skepticism.

I'm so glad he's doing well. It must've felt good to hear optimism from his doctor.
58 yr old mother of 3 Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks of chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. 3 1/2 weeks in hospital,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc thinks scar tissue
monitored for autoimmune disorder/interstitial lung disease
7/17 no change lung nodule
10/17 Clear CT
11/17 CEA<.5


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