Are your chemo IVs in a Glucose solution?

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Cured
Posts: 498
Joined: Thu Nov 27, 2008 10:53 pm
Location: MO

Are your chemo IVs in a Glucose solution?

Postby Cured » Sat Oct 20, 2018 1:20 am

Since I am doing the Keto Diet to combat cancer I am observant to sugar intake. The FOLFIRi treatment I am doing: the pharmacy is mixing both Irentecane and Lucovoren in 5% glucose solution.
Since this throws me out of Ketosis* I asked if they can use saline instead. After checking with pharmacists the RN said they could - but don't want to.

What is your all experiences? Are they compounding your chemo in glucose, in the IV Drip bags?

PS: Either FOLFIRi is fairly easy to tolerate, or being in Ketosis is a big help in tolerating this chemo. (I am only through 2 doses, so I may be talking differently a month from now).

*According to my breath-analyzing Keto meter it took me a week to get back to Ketosis: using fat instead of glucose to feed cells.
5-08:Stage 3 Rectal: 6/14 Nodes
Ace Surgeon Removed 90%Rectum & lots of Colon-Full Incision
Ileo Rev'd @6 Mos.
Radiation+5fu Pre-Surgery
FOLFOX 8 Cycles Done 1-09
Clear Scope 8-17; Clear CEA 2-18
Glory to God! Healed by prayers of many: for 10 years
7-18: tumor pressing against brain. Removed.
Metastatic to lung. CEA 6.9 Began Folfiri
CEA dropped to 4.5 after 1 dose of chemo!

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Atoq
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Re: Are your chemo IVs in a Glucose solution?

Postby Atoq » Sat Oct 20, 2018 1:40 am

I don’t have experience with IV chemo, but I was wondering what do you mean exactly about feeding cells with fat instead than glucose? Don’t at the end all cells use respiration as mean to produce ATP with the formula O2 + glucose = CO2 + ATP? I guess fat is transformed into glucose at the end?

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
CEA 1.8
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal
26.06.18 wedge VATS surgery
24.08.18 CAT scan, clear
12.09.18 scope, ok. CEA 1.6

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Atoq
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Re: Are your chemo IVs in a Glucose solution?

Postby Atoq » Sat Oct 20, 2018 1:47 am

Ok, I got it, the cells use fat to make ketones :)

All the best

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
CEA 1.8
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal
26.06.18 wedge VATS surgery
24.08.18 CAT scan, clear
12.09.18 scope, ok. CEA 1.6

Cured
Posts: 498
Joined: Thu Nov 27, 2008 10:53 pm
Location: MO

Re: Are your chemo IVs in a Glucose solution?

Postby Cured » Sat Oct 20, 2018 1:56 am

Correct tern is glycogen (not glucose)
We know cancer feeds on sugar. Below is a description & links.
It is sad that Medical Oncologists don't seem to study & give credence to this. As I now have metastatic cancer I'm not going to ignore conventional therapy, but there is a body of knowledge that fasting and diets can have benefits.

"The human body only has two fuel sources, fat and glycogen (sugar). When we have a lot of sugar stored in the body (from consuming carbohydrates, for example, which turn into sugar), our body uses that sugar to feed our brain and other organs, providing the energy they need to function."
See https://www.collective-evolution.com/20 ... enic-diet/

https://www.ketonutrition.org
5-08:Stage 3 Rectal: 6/14 Nodes
Ace Surgeon Removed 90%Rectum & lots of Colon-Full Incision
Ileo Rev'd @6 Mos.
Radiation+5fu Pre-Surgery
FOLFOX 8 Cycles Done 1-09
Clear Scope 8-17; Clear CEA 2-18
Glory to God! Healed by prayers of many: for 10 years
7-18: tumor pressing against brain. Removed.
Metastatic to lung. CEA 6.9 Began Folfiri
CEA dropped to 4.5 after 1 dose of chemo!

heiders33
Posts: 306
Joined: Sat Nov 04, 2017 11:08 am

Re: Are your chemo IVs in a Glucose solution?

Postby heiders33 » Sat Oct 20, 2018 4:50 am

Yes, they gave me dexamethasone last year and when I start Folfiri in a few weeks they will again, I believe. This increases blood sugar. I am interested in trying the Keto Diet when I start chemo in order to mitigate side effects. I can’t do full on fasting because that would mean fasting for at least four days each time, which is too long for me. So I think the Keto Diet might be a good alternative, and I’m glad to hear you are seeing good results. If you don’t mind, I’d love to PM you to get more details on what you’ve done. It’s too bad the Dex puts you out of ketosis. It seems like you could refuse it - they can’t force you to take it.
36 year-old female
May 2017: Dx rectal cancer at T3N2M0
MSS, KRAS G12A
June-July 2017: 28 days of XEL/radiation
Sep 2017: laparoscopic LAR/loop ileostomy
Oct 2017 - February 2018: XELOX six rounds
Mar 2018: reversal
Apr 2018: CEA 2.1, normal blood counts
May 2018: CT liver spot
Aug 2018: Abnormal PET, CEA 2.4
Sep 2018: robotic and laparoscopic liver resection with HAI pump
Oct 2018: Clear CT and colonoscopy, CEA 1.7, begin six months FUDR and FOLFIRI

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Atoq
Posts: 319
Joined: Wed Oct 25, 2017 9:31 am

Re: Are your chemo IVs in a Glucose solution?

Postby Atoq » Sat Oct 20, 2018 10:40 am

Gluconeogenesis is the metabolic process by which the liver converts gluconeogenic amino acids (from protein) and glycerol (from stored fat) into sugar as a way to fuel the cells that need it. Unfortunately, this glucose can also fuel cancer cells and may diminish some of the beneficial effects that the keto diet can have for cancer patients.

Seems like it is not so simple to starve the cancer cells.

But a lot of ongoing studies are still to be published. So there is hope for more clarity.

I found this link very useful:
https://www.ruled.me/ketogenic-diet-can ... -research/

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
CEA 1.8
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal
26.06.18 wedge VATS surgery
24.08.18 CAT scan, clear
12.09.18 scope, ok. CEA 1.6

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CRguy
Posts: 9642
Joined: Sun Feb 10, 2008 6:00 pm

Re: Are your chemo IVs in a Glucose solution?

Postby CRguy » Sat Oct 20, 2018 7:43 pm

Cured wrote:What is your all experiences? Are they compounding your chemo in glucose, in the IV Drip bags?

Just FYI, I applaud you for taking an integrative approach in using the keto paradigm to enhance your "western" treatments.

As you may know I am a western trained vet with "eastern / alt" training, which I cherry pick to brand my own method of INTEGRATIVE medicine !!! We may not agree on all issues ... BUTT I am generally on your side homie !!!!!

OK personal OP/ED comments aside .....
the keto thing has validity in a lot of situations and for a lotta reasons = WORD !
the whole Warburg derived ..." sugar feeds cancer " diatribe .... ummmm not so much IME and IMO
(( I will save this discussion for another time, 'cos I have already BTDT ... many times :(
I did a grad course in organic biochemistry with a guy from Switzerland
whose mother actually WORKED in Otto Warburg's LAB !!! ))

BUTT ... yes you just KNEW there had to be at least ONE BUTT here :shock: :mrgreen:
BUTT anything and everything YOU can bring to bear on YOUR sitrep, which works for YOU = YES !!!!!!!
I can really see the keto thing being a positive for you.

Now the science / vet / western med part ... :evil:

I have a shitload of experience with compounding pharmacies/pharmacists AND the Oncological pharmacists
IMO and IME
are some of the most talented and brilliant pharmacos around, coming from both the vet world = me as a doc
and the human world = me as a patient

I would ask specifically IF :
are there issues with actual chemo metabolism with changing the IV fluid content ?
are there issues with osmolality / absorption / distribution with changing ?
are there solubility / drug interaction issues ?
are there issues with additives / preservatives / stabilizers in one IV versus another, which would impact any of the above questions ?

Ya see there are a LOTTA things to be considered in an IV ...
ESP for cancer chemo and they may not want to make changes without absolute good cause.

D5W can be slightly hyperosmolar
dextrose in half strength saline is isotonic
0.9% physiological saline is isotonic

"tonicity" can affect infusion rate, infusion outcomes, volume overloads and bioavailability of important molecules = CHEMO !

My fallback position is always : " Use your experts."
in this case I would heartily encourage you to ask all these questions,
assess the info, and then let your experts work for you.

BUTT we are all free agents on this ride
JMO .... BTDT ..... many times

Cheers and Harmony and
MEGA best wishes

CRguy on the Journey
Caregiver x 3
Stage IV A rectal cancer/lung met
11 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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wwroam
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Re: Are your chemo IVs in a Glucose solution?

Postby wwroam » Mon Oct 22, 2018 11:36 pm

Last year my chemos ( Gemcarb and Carbo Taxol) came in glucose solution ( for NSCLC.)
From an initial position of zero Dexmethasone I negotiated to 8 mg / infusion. At my first diabetic blood test after I had finished chemo my HbA1c had risen to 6.1. It has now stabilized at 5.60 so I'm happy with that.
On diabetic forums are many advocates of LCHF diets ( ketogenic ). I have never found it necessary. In fact on my first introduction I thought it the silliest thing I had heard for a long time. My advice was to make an appointment with a gastro-enterologist.
Stage 3a DX 25/06/07
Folfox complete 30/01/08
7 years NED
Port scheduled for removal 8/02/10 Gone.
PSA .54 No prostate problems
Diagnosed Type 2 Diabetic
SO diagnosed CC Stage IV Liver Mets 23/03/15

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GrouseMan
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Location: SE Michigan USA

Re: Are your chemo IVs in a Glucose solution?

Postby GrouseMan » Tue Oct 23, 2018 9:19 am

As a chemist that did drug discovery research in oncology - I have to agree with CRGuy about the "...Sugar feeds cancer diatribe" Sugar no more feeds cancer than it does your normal cells - its just because of cancers hyper metabolism it burns through sugar much faster hence the ability to use a radioactive tracer or glucose in PET scans. Removal of sugars and carbohydrates probably isn't going to slow your cancer down as much as the chemo in the glucose solution. Also I have to add while the glucose is feeding the cancer cells - The chemo is doing more damage because the cells will be feeding if you will running the machinery that causes them to divide and grow which is usually where drigs like 5-FU Oxaliplatin and Irinotecan do the most damage. As Atoq says its not so easy to starve cancer cells.

Additionally - these formulations are not to be taken lightly - as CRGuy says IV drug formulations are compounded in such a way as to maintain stability and maximize absorption, and what are known as Pharmacodynamic characteristics. An example though not in cancer drugs is an old one. Dilantin a drug used for a long time for treatment of epilepsy. Only one manufacturer made it, and generic manufacturers tried for a long time to do so, but failed to come up with a working oral formulation. The main active chemical compound is known, well published and included in the patents of the manufacturer. What is not known was that a particular crystal structure/formulation is what made its proper oral absorption take place. It was a trade secret how it was formulated. Even the manufacturer had an issue once when a new plant manager tried to change the procedure slightly to save some costs, and the drug turned out to be less effective. They had to revert to the old process!

So - There is usually a reason that a particular formulation is specified.

Good luck in your treatment....

GrouseMan
DW 53 dx Jun 2013
CT mets Liver Spleen lung. IVb CEA~110
Jul 2013 Sig Resct
8/13 FolFox,Avastin 12Tx mild sfx, Ongoing 5-FU Avastin every 3 wks.
CEA: good marker
7/7/14 CT Can't see the spleen Mets.
8/16/15 CEA Up, CT new abdominal mets. Iri, 5-FU, Avastin every 2 wks.
1/16 Iri, Erbitux and likely Avastin (Trial) CEA going >.
1/17 CEA up again dropped from Trial, Mets growth 4-6 mm in abdomen
5/2/17 Failed second trial, Hospitalized 15 days 5/11. Home Hospice 5/26, at peace 6/4/2017

Cured
Posts: 498
Joined: Thu Nov 27, 2008 10:53 pm
Location: MO

Re: Are your chemo IVs in a Glucose solution?

Postby Cured » Tue Oct 30, 2018 10:04 pm

Guys, thanks for the insight and good advice.
I went with the flow and accepted the normal compounding with glucose.

Since I was in a higher state of Ketosis, I was able to stay in a light state of Ketosis, if my meter can be believed.

My blood counts were up slightly and Absolute Neutrofils are good. So far my body is handling the treatments well, after 3 rounds. I am starting to get mouth sores, so I know the chemo is doing its thing. Otherwise, this is easy!
(Sure the bowels aren't normal, but manageable)

Who can say what benefit is from the diet?

I do enjoy making a cappuccino in the morning with whole cream: tasty :) :)
5-08:Stage 3 Rectal: 6/14 Nodes
Ace Surgeon Removed 90%Rectum & lots of Colon-Full Incision
Ileo Rev'd @6 Mos.
Radiation+5fu Pre-Surgery
FOLFOX 8 Cycles Done 1-09
Clear Scope 8-17; Clear CEA 2-18
Glory to God! Healed by prayers of many: for 10 years
7-18: tumor pressing against brain. Removed.
Metastatic to lung. CEA 6.9 Began Folfiri
CEA dropped to 4.5 after 1 dose of chemo!


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