Chemo break due to covid-19 outbreak

[jsbsf]

Just wanted to pass this on to anyone concerned about getting chemo during the coronavirus outbreak.

DH had a phone all from his oncologist to check in on his progress. Just completed 8th round of FOLFOX. The conversation started off with him recommending to cancel the 9th round appointment and to pick back up two weeks later.

The oncologist assured him it would make no difference and would allow his immune system a better chance to repair itself, even though he has had no problem bouncing back each time, so far.

It was a precaution and since the cure has not flattened yet in our are, it was a precaution to take while the hospital is implementing procedures to better protect patients and staff.

Please check with your oncologist if you are concerned. Maybe you can also postpone a treatment.

[Siti]

We have checked with our doctor several times and he reassured us that cancer care would be their priority. It seems like the other hospitals in our country are now prioritising Covid19 patients but since our hospital is primarily a cancer hospital, our oncologist said that they’ll try to keep it that way.

So far my husband’s next Avastin and Xeloda is on schedule (next week) but the next cycle seemed to be postponed by 1 week (so 4 weeks cycle instead of 3).

Did the doctor recommend that for the sake of your husband’s immune system or are they overburden?

[jsbsf]

It was recommended with his best interest in mind. He was already scheduled, and the oncology floor is set up specifically for patients to get their infusions. I think it has to do with things like filters in the ventilation system as well as best practices to keep certain areas properly sanitized and COVID-19 patients isolated from everyone else. They already started restricting entry to patients only, and have been wiping down chairs.

Normally, he has to go 2 days before infusion for blood tests. So this is two trips he won’t have to make. Plus where we are, the curve isn’t expected to start flattening for a couple more weeks.

[Siti]

It’s comforting to know that your hospital is proactive about safety measures and care for their patients. Less trips to the hospital, the better.

My husband is due for his next visit this Friday — according to the hospital website, no visitors for radiotherapy but 1 visitor is allowed at outpatient. They’ll take temperature reading at the entrance and supply mask if necessary. Let’s see how it goes!

Meanwhile stay safe and I am happy everything is going smoothly for your hubby

[Mrned82]

My onc cancelled chemotherapy for the next 2 months due to covid ...but no the target therapy...so at the moment I'm having cetuximab every fortnight..!!!
I'm a bit worried about it but he left me no choice..so I stick with his plan and hope to resume Chemotherapy as soon as possible !!;

[zephyr]

The oncologist assured him it would make no difference and would allow his immune system a better chance to repair itself

Here too - taking a two week Xeloda break to give my immune system a boost. I'm more afraid of COVID-19 than I am of the cancer.

[roadrunner]

One thing that really concerns me is that it’s very hard for patients or even oncologists to balance these risks at present. Most of us (or at least our oncologists) have a decent handle on the cancer risk, but the infectious disease risk is evolving and very uncertain and is not in the average oncologist’s sweet spot. It seems as though one may need a consult from an infectious disease specialist and/or an immunologist, at this point, in addition to the onc’s recommendation. I made my own decision to defer chemo (which was for curative intent, and may or may not have been necessary), but I have more (and tougher) decisions coming soon in that regard. Will they be the right ones? We’ll see I guess.

[Punky44]

Just want to share a similar situation in that my mom’s surveillance CT, CEA and colonoscopy are all being pushed back from April to June. It’s tough not knowing what June will bring (will it be pushed back again?) but right now the hospitals don’t think it is safe to risk it and feel like a slight delay in surveillance is better than going out during the peak of a pandemic.

[Siti]

The oncologist assured him it would make no difference and would allow his immune system a better chance to repair itself

Here too - taking a two week Xeloda break to give my immune system a boost. I'm more afraid of COVID-19 than I am of the cancer.

My husband is on the same maintenance chemo. Does it cause you really bad side effects? Aside from terrible hands and feet, he seems very strong and our oncologist said he’s not considered high risk with his current treatment. Now I’m beginning to wonder if we should ask our oncologist again.

[zephyr]

My husband is on the same maintenance chemo. Does it cause you really bad side effects? Aside from terrible hands and feet, he seems very strong and our oncologist said he’s not considered high risk with his current treatment. Now I’m beginning to wonder if we should ask our oncologist again.

I've found Xeloda to be much more tolerable than Folfox and Forfiri but it can still be rough. I also do ok except for the hands and feet which sometimes have bad flares to the point that I can barely walk or bend my fingers. Keeping my hands and feet slathered with thick lotions every 1-2 hours helps get me back on track. I'm going to try to apply henna to my feet this weekend. I've heard from other Xeloda patients that it can really help.

[roadrunner]

Siti:

To the extent you’re asking about the effects of the Xeloda/Capecitabine on the immune system, those are generally considered to be pretty mild, even compared to FOLFOX. As I recall, it *can* be immunosuppressive, but I think that it’s uncommon for such effects to be serious. I finished about 12 weeks of it two months ago, and I don’t think it did too much to my blood counts. It was a little hard to tell, though, because I was taking it with RT, and that did affect my WBC to some extent. The dosage may be different as well. If you’re worried about what it might be doing, the best way to monitor is through the CBC blood test (focusing on the lymphocytes and neutrophils), if the virus hasn’t interfered with those tests in your husband’s case.

[Siti]

Zephyr — thank you! I’ve not heard of henna therapy and will certainly ask him if he’d like to try. Last week his feet were so painful he couldn’t walk. So working from home is definitely quite helpful. He too applies cream minimum 3x a day and sometimes cover with gloves and socks.

Roadrunner — I just double checked his blood reading. All seems within normal range. Maybe that’s why our oncologist did not recommend that he takes a break.

[NHMike]

I had my 3-month surveillance at Dana Farber in Boston in early February and they moved me to 6-month visits. Dana Farber is cancer-only (they do some rare blood disorders too) so I feel better about that and they have been regularly adding restrictions. But I'm not even feeling good about going into Boston.

I've been thinking about going to one of their Satellite offices in New Hampshire for my August appointments if COVID 19 is still raging. The numbers that I'm seeing indicate that we may be peaking but I suspect the peaking is in the hard-hit places with more rural areas peaking later on. Massachusetts is still accelerating, even as they ramp up testing capabilities.

[claudine]

Triage?! Things are not good (and could get worse?!)

https://www.npr.org/sections/health-sho ... -uncertain

[claudine]

This past couple of weeks, DH has been having horrendous pain in his right leg. He can barely walk, sleep. Could be because his damaged vertebrae has collapsed - or because the tumor is active again (although it’s not his back that’s hurting but his leg, so I’m leaning towards nerve impingement). He is scheduled for an MRI on the 10th. I really hope it doesn’t get postponed/cancelled, I can’t see him continuing much longer with so much pain! Fortunately we still have very few cases of C19 locally, but who knows what it’ll be like in a week?