I will of course ask oncologist tomorrow, but i was hoping some here could reassure me that taking six at once is actually a potentially correct method.
CRguy wrote:HEY homie
I have combined your 2 topic posts into one thread because now, all the discussion will relate to your questions.
Oral Xeloda IS timed in relation to the radiation treatment = Check specifically with your own Oncs.
I took Xeloda 24/7 and only had radiation 5 days per week.
The precise dosing is based on a number of factorsI will of course ask oncologist tomorrow, but i was hoping some here could reassure me that taking six at once is actually a potentially correct method.
PLEASE ... YES check with Oncs as to exact instructions !!!!!!
BUTT IME ... the morning and evening doses were the same dosage.
IF your docs / Oncs / nurses have NOT made all this clear to you already .....
MAKE them give you the specific instructions or print them out so you have it at hand
YEAH chemo is serious business and the medical team NEEDS to make sure patients and caregivers KNOW what they are supposed to do !
... AND patients and cargivers in return .. NEED to know what the Docs told them to do !
WORD !
CRguy
Rock_Robster wrote:Hi SilverWedding, I’ve just finished 5 weeks of this so happy to help where I can!
Firstly, you’re correct - what you are doing is called neoadjuvant chemoradiation therapy (CRT).
Dosage:
As others have said, please double-check with your onc or pharmacist on this. I was on 1500 mg, twice a day (175 lb guy) - so three of each twice a day sounds like a reasonable dose (1950 mg twice daily), though oddly specific (not sure why they wouldn’t just give 4 x 500mg...).
The morning and evening doses are usually the same.
Handling:
As far as I’m aware they’re safe for non-patients to handle, but obviously keep it to a minimum and wash hands afterwards.
Timing:
Most oncs will just say twice a day, roughly 12 hours apart. Within 30 mins after a proper meal is important too - did they mention that? I found two studies looking at timing vs radiation treatment - one showed no significant difference, another showed a small increase in response if Xeloda was taken 1-2 hours before radiation (ie targeting peak plasma concentration). The reason here is that Xeloda is cleared very quickly from the body. So I booked all my radiation treatments in the mornings, and took my morning dose an hour before I drove in. Figured why not. If this doesn’t suit though it doesn’t seem to matter a great deal - the main thing is that you get the doses in on radiation days. My onc also had me not take it on non-radiation days (i.e. weekends), but I’d check this too.
Good luck!
Green Tea wrote:SilverWedding -
Would you be able to update your signature so that it contains all of the recent important information that you have learned from your doctors and from the written reports that you have now received? Right now there are a number of data items missing from your signature for a patient who is aready at the point of starting chemo/radiation. Your husband was diagnosed over a month ago, and by now should have received most of the data items for preliminary staging and treatment selection.
Also, could you give more details from the information sheet(s) you were given for the chemo/radiation phase? You should have been given an information sheet describing the overall procedure and the protocol being used, for example like this one:
https://www.beatson.scot.nhs.uk/content/mediaassets/doc/Radiotherapy_or_Chemoradiation_for_Rectal_Cancer.pdf
or like this one:
http://www.londoncanceralliance.nhs.uk/media/37186/CRC_CAPECITABINEplusRADIOTHERAPY_protocol_V1.0.pdf
or like this one:
http://necn.nhs.uk/wp-content/uploads/2012/12/Capecitabine-Radiation-CNTW-protocol-CRP09-CR018-V1.3.pdf
Also, you should determine your husband's Body Surface Area (BSA), since all dosing for Xeloda is based on BSA measured in meters squared (m2).
For a standard chemo/radiation protocol, the dose is usually set at 825mg/m2, which is 2/3 the normal dose used later in post-surgery administration of Xeloda . The reduced dose used in the chemo/radiation phase is mainly to facilitate the impact of the radiation. It is not considered as a full therapeutic dose. In other words, the low dose used in chemo/radiation is for purposes of "radio-sensitization" to make the cancer cells more vulnerable to radiation.
Also note that a "dose" is defined as the amount of Xeloda administered at one point in time. For chemo/radiation, there are always two doses given per day, one in the morning and one in the evening . Each of the two doses would be 825mg/m2 if they are using the standard chemo/radiation protcocol. In your husband's case, each dose consists of 6 tablets: three 500mg tablets and three 150mg tablets, for a total of 1,950mg each dose, or a grand total of 3,900mg per day. If you divide 1,950 by 825, this gives 2.36m2, which suggests that the doctor has calculated your husband's BSA at 2.36, which is at the top of the chart. You can verify this yourself by using your husband's actual height and weight in the online BSA calculator:
BSA Calculator
http://www.medcalc.com/body.html
SilverWedding wrote:Thank you, Green Tea. I don’t know why I don’t have any paperwork!! So, I signed into the cancer center’s patient portal - as of yesterday, nothing is entered. I think I’ll write down all those items you mentioned and call nurses in both oncology and radiation. Thank you. I dont even have bloodwork and was hoping I could track that CEA number you all use. I wonder why we have nothing while all of you have all kinds of details. Do you all just get that on paper automatically at visits, or is everyone on some kind of a patient portal to view it all?
SilverWedding wrote:Thank you, Green Tea. I don’t know why I don’t have any paperwork!! So, I signed into the cancer center’s patient portal - as of yesterday, nothing is entered. I think I’ll write down all those items you mentioned and call nurses in both oncology and radiation. Thank you. I dont even have bloodwork and was hoping I could track that CEA number you all use. I wonder why we have nothing while all of you have all kinds of details. Do you all just get that on paper automatically at visits, or is everyone on some kind of a patient portal to view it all?
"..You will be assigned a nurse navigator and a social-work team. This team will follow you during your entire course of treatment. The nurse navigator acts as the team leader and provides support, education and a comprehensive assessment..."
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