Is skipping last chemo bad

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wife2jeff
Posts: 65
Joined: Thu Sep 12, 2019 11:21 pm

Is skipping last chemo bad

Postby wife2jeff » Wed Mar 18, 2020 3:29 pm

My husband was due to have his last chemo last Monday, Yay so happy. However he decided to hold off due to the coronavirus outbreak. His doctor said that would be fine for no longer than 4 weeks. Well here we are today and things are worse. He is really afraid of going in to do it because he is at higher risk because he only has one functioning lung and has an autoimmune disorder. Is it bad to not do the last chemo? he has had 11 treatments of 5fu only, and one of those was with half dose of oxaliplatin, he didn't do oxy anymore due to severe side effects. He has stage III, 5 lymph nodes of 17 infected, surgery July 2019. Would it be a bad idea to not do the last one?

Lee
Posts: 6029
Joined: Sun Apr 16, 2006 4:09 pm

Re: Is skipping last chemo bad

Postby Lee » Wed Mar 18, 2020 4:15 pm

Stage III and only 5FU, was there a reason he was not given the FOLFOX regiment? I know with FOLFOX, there not as worried about getting all 12 cycles. Something about 8-9 cycles and Onc are happy. But with 5FU only, I not sure if that applies.

Would it be possible to have home nurse come and do it? How long is he on 5FU when he does get an infusion?

Good luck,

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!

boxhill
Posts: 491
Joined: Fri Apr 06, 2018 11:40 am

Re: Is skipping last chemo bad

Postby boxhill » Wed Mar 18, 2020 5:46 pm

It sounds like they started with folfox, but then dropped the oxy due to his reaction.

If his cancer center is taking the kind of precautions mine is, I think he'd be safe. With that many bad lymph nodes, I'd want to do it.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
Neulasta 6/28
7/18 CT NED
11/18 CT NED
12/18 MRI 5mm liver mass, 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: many fails before Celebrex helps
12/23/19 CT stable

Lee
Posts: 6029
Joined: Sun Apr 16, 2006 4:09 pm

Re: Is skipping last chemo bad

Postby Lee » Wed Mar 18, 2020 7:29 pm

boxhill wrote:It sounds like they started with folfox, but then dropped the oxy due to his reaction.

.


Yep your are right, some how I missed that one little sentence. That is what happens when doing 2 things at once. Going to call it a day. But I did get my 5FU via a home nurse. Was only at Onc office for my Oxi transfusions.

Agree, I would really try to get that last round of chemo. Then self quarantine for a few weeks.

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!

roadrunner
Posts: 11
Joined: Sun Jan 12, 2020 8:46 pm

Re: Is skipping last chemo bad

Postby roadrunner » Wed Mar 18, 2020 10:46 pm

Not sure what the nature or potential effect of the auto-immune disorder is, but I would consider blood counts in any attempt to try to balance risk. Has the 5-FU suppressed immune function so far? If I recall right, it is generally regarded as significantly less immunosuppressive than FOLFOX. But also consider that there can be suppression for a while after chemo is discontinued (when the virus may be more widespread). Also, things like where you live may be relevant — in the US the rate of infection is much higher in some areas than others, though the data is admittedly still very spotty. It’s a tough call, I wish you the best.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
Switched to neoadjuvant chemorad in 11/19 (Xeloda and approx. IMRT, 60 Gy, 33 fractions)
Trying to achieve cCR.


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