Anemia while taking xeloda and avastin

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ktwmn
Posts: 342
Joined: Tue Aug 02, 2011 9:41 am

Anemia while taking xeloda and avastin

Postby ktwmn » Sat Feb 24, 2018 1:50 pm

Has anyone experienced gradually becomic anemic while on xeloda and avastin? I’ve been on this combo for over a year, with a couple breaks from avastin, and my RBC, HGB, and HCT had been good until the past few months where they have started to tank. I understand that the side effects are cumulative with this (I’ve noticed that arthritis like pain as well as digestive issues are more frequent) but my concern is that the anemia is not side effects but one of my mets activating. Onc didn’t seem too concerned and put in for iron and B12 testing. Let me know if anyone has experienced similar! Thx!
Dx 7/11, Stage IIIc CC
12 txs Folfox 8/2011-2/2012
MSS, KRAS-mut G12D
NED until 3/2015, mets to liver and peritoneum
April-December 2015: 15 txs folfiri+avastin
Liver mets resolved; pelvic met remains
January-May 2016: folfox+avastin; allergic rxn to oxi
June-August 2016: 5FU+avastin
October 2016: looking into immuno trial
January 2017: maintenance chemo xeloda + avastin

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betsydoglover
Posts: 894
Joined: Mon Aug 14, 2006 2:31 pm
Facebook Username: Betsy Lindh Williams
Location: Maryland - outside DC

Re: Anemia while taking xeloda and avastin

Postby betsydoglover » Sat Feb 24, 2018 2:55 pm

You are doing right getting your onc to run tests. I've been on Xeloda twice and on Avastin for 2 years, but never had altered red blood counts. But that's just me, I'm sure your doc can get to the bottom of this - many chemos can reduce RBC counts in some people,

Take care,
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
NED
6 cycles Xeloda + Avastin
Avastin only 10/09-5/11
Still NED 11/17

rp1954
Posts: 1286
Joined: Mon Jun 13, 2011 1:13 am

Re: Anemia while taking xeloda and avastin

Postby rp1954 » Sat Feb 24, 2018 8:20 pm

ktwmn wrote:Has anyone experienced gradually becomic anemic while on xeloda and avastin? I’ve been on this combo for over a year, with a couple breaks from avastin, and my RBC, HGB, and HCT had been good until the past few months where they have started to tank.

Any 5FU combo or additive could do it, whether due to deterioration of GI or combination of things. Extra folic acid's added 5FU toxicity appeared to do it for my wife - dr almost stopped chemo earlier on. Btw any fortified, processed carb binges lately? For RBC and HGB, besides ruthlessly eliminating folic acid sources, she added two things: two tablespoons of liver (spread) per day, and PSK for RBC. A problem is that a Japanese paper showed poor OS benefits between ultralow CEA and PSK, so maybe not PSK. If she wants to show off, she can drive her Hgb up to 15 on chemo and liver (and the other supplements).

I understand that the side effects are cumulative with this...

until you fix them

(I’ve noticed that arthritis like pain as well as digestive issues are more frequent) but my concern is that the anemia is not side effects but one of my mets activating.

We used IV vitamin C, glutamine, glucosamine and nacinamide with a little zinc carnosine and magnesium chelates for GI and mucosal repair for 5FU related damage. IV vitamin C, megavitamin K2, megavitamin D3 for arthritis, as well as the chondrotin-glucosamin-MSM-fish oil-GLA type formula. Funny thing, my wife was always anemia and arthritis prone decades before cancer. Now she's not - even on chemo.

Various test results suggest that her megavitamin MK4 (humanized K2), D3, IV vitamin C help her daily 5FU inhibit or dissolve her cancer features, presumably the CA199, KRAS mut or AFP related ones, as well as some medical papers and reports. Multitasked vitamins.

my concern is that ... one of my mets activating

Of course, your onc has been carefully tracking CA199, LDH, MCV, maybe AFP and some of the other off label markers and support panels (ESR, hsCRP, PT/INR, HgbA1C, thyroid) while on maintenance, right ???
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC

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ktwmn
Posts: 342
Joined: Tue Aug 02, 2011 9:41 am

Re: Anemia while taking xeloda and avastin

Postby ktwmn » Sat Feb 24, 2018 9:17 pm

Thanks for these great replies!

One of the things I noticed on my report is a very high RDW (22). MCV is normal but has been higher than normal in past months. This seems to suggest macrocytic anemia.

When initially diagnosed, I was anemic but RDW and MCV were both in normal ranges.
Dx 7/11, Stage IIIc CC
12 txs Folfox 8/2011-2/2012
MSS, KRAS-mut G12D
NED until 3/2015, mets to liver and peritoneum
April-December 2015: 15 txs folfiri+avastin
Liver mets resolved; pelvic met remains
January-May 2016: folfox+avastin; allergic rxn to oxi
June-August 2016: 5FU+avastin
October 2016: looking into immuno trial
January 2017: maintenance chemo xeloda + avastin

rp1954
Posts: 1286
Joined: Mon Jun 13, 2011 1:13 am

Re: Anemia while taking xeloda and avastin

Postby rp1954 » Sun Feb 25, 2018 12:01 pm

Sometimes secondary uses of blood panel can have much different ranges and meaning under specific conditions, especially as a series of measurements. We use MCV series as a measure of chemo activity, where I did a fair amount of digging for chemo-cancer-MCV papers, and it has been very useful. I haven't worked much with RDW, our local lab didn't report it the first 6 years.

Basically MCV goes up with chemo activity, and papers' stats reflect it as a differential measurement, delta MCV (current MCV - dx/prechemo baseline) where larger is better, and absolute values, values over 103 especially desired where the % survivors was largest. With extra dietary (natural) folates, MCV is more related to chemo activity on the cancer rather than folate deficiency. The initial buildup of MCV for for a successful treatment is typically slow, months, but fast in decline. When my wife is under dosed on critical items, MCV can fall like a rock but rebuild fairly quickly. Having multiple markers has been the better way,for both speed of detection, and sorting possibilities and nuances.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC

User avatar
ktwmn
Posts: 342
Joined: Tue Aug 02, 2011 9:41 am

Re: Anemia while taking xeloda and avastin

Postby ktwmn » Sun Feb 25, 2018 7:05 pm

Interesting. Unfortunately my MCV fell along with the HGB RBC and HCT, the only thing that rose was the RDW. I noticed that during my week off I feel fatigued for about 5 days, which makes me think that is when my nadir hits (I do one week on, one week off). 2-3 good days and it’s time to start again.

I’ve been doing this routine for awhile, have basically been on chemo of some sort for the past 3 years with no real break (an extra week here and there but that’s it).
Dx 7/11, Stage IIIc CC
12 txs Folfox 8/2011-2/2012
MSS, KRAS-mut G12D
NED until 3/2015, mets to liver and peritoneum
April-December 2015: 15 txs folfiri+avastin
Liver mets resolved; pelvic met remains
January-May 2016: folfox+avastin; allergic rxn to oxi
June-August 2016: 5FU+avastin
October 2016: looking into immuno trial
January 2017: maintenance chemo xeloda + avastin

rp1954
Posts: 1286
Joined: Mon Jun 13, 2011 1:13 am

Re: Anemia while taking xeloda and avastin

Postby rp1954 » Tue Feb 27, 2018 5:05 pm

Luvinlife was going to quit folfiri because of her side effects until she got IV vitamin C and supplements, she was able to radically improve her QOL despite 3 more years of folfiri.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC


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