Maintenance Chemo Questions

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tater
Posts: 126
Joined: Wed Jul 19, 2017 5:53 pm

Maintenance Chemo Questions

Postby tater » Tue May 19, 2020 4:19 pm

Hey I am on this forum for my wife. I have been here for a couple of years, though I haven't checked in like I used to. The last time I posted a thread was to talk about strickening that came up on the ureter on my wife's right side. To bring you up to speed last Halloween my wife had a surgery where they removed that section of ureter and her appendix. The small 2 cm tumor was RC as we suspected at here CEA was rising and the PET scan confirmed. The tumor had adhered to her iliac artery I believe so she did not get clean margins. After she healed for four seeks they began 12 rounds of FOLFIRI. SHe took a break a couple of months ago from chemo to have 15 rounds of radiation in that area and she is back on the chemo and has 12 rounds left. Her CEA has dropped 1.2-1.4 depending on week and we plan on having a scan in June hopefully the radiated area has healed enough to give us a good scan. We have done everything we can, at least that is what the doctors feel. It was difficult to find a surgeon who want to do the work, radiation drug there feet because they didn't want to blast it as it was close to the last area so now we are being asked to strongly consider maintenance chemo. I'm looking for help and opinions here on a couple of things, what are some other treatment options its not like we can remove artery and what are some good maintenance chemo options. The Onc says 5FU drip every other week is better and fewer side affects but what about a 5FU pill daily? Who's done this and how has it gone.

Thank you for responding and for your thoughts. Stay Safe
DH to 38 wife w/kids
Stage 3C DX 3/3/17 CEA 29
5-fu and radiation ended May 17, 2017
Stage 4 External iliac node July 17, 2017
FOLFOX + Avistan July 18 2017 CEA 2.3
Nov 9, 2017 Coloanal Anastomosis, Hysterectomy & External Nodes Removed W/ileostomy
Clear Margins NED
CEA 1.5 12/17, 2.1 2/18, 2.3 6/18, 1.1 9/18, 1.3 12/18, 1.8 3/19, 2.5 6/19
Clear CT and MRI on 2/5/2018, 9/18 Clear Scans
Reversal Surgery 6/26/18
Small Spot on right ureter surgery 10/30/19 adhered to artery
Dec. 2 start 12 rounds FOLFIRI

JJH
Posts: 290
Joined: Mon Apr 24, 2017 7:26 am

Re: Maintenance Chemo Questions

Postby JJH » Wed May 20, 2020 6:57 am

tater wrote:... I'm looking for help and opinions here on a couple of things,
  • What are some other treatment options its not like we can remove artery and ...
  • What are some good maintenance chemo options. The Onc says 5FU drip every other week is better and fewer side affects but ..
  • What about a 5FU pill daily? Who's done this and how has it gone.
Thank you for responding and for your thoughts. Stay Safe

Metronomic maintenance regimens
"The darkest hour is just before the dawn" - Thomas Fuller (1650)

tater
Posts: 126
Joined: Wed Jul 19, 2017 5:53 pm

Re: Maintenance Chemo Questions

Postby tater » Thu May 21, 2020 2:07 pm

Thanks for that link I will go check it out. Who here is taking the Xeolda on a daily basis and how are the side effects?
DH to 38 wife w/kids
Stage 3C DX 3/3/17 CEA 29
5-fu and radiation ended May 17, 2017
Stage 4 External iliac node July 17, 2017
FOLFOX + Avistan July 18 2017 CEA 2.3
Nov 9, 2017 Coloanal Anastomosis, Hysterectomy & External Nodes Removed W/ileostomy
Clear Margins NED
CEA 1.5 12/17, 2.1 2/18, 2.3 6/18, 1.1 9/18, 1.3 12/18, 1.8 3/19, 2.5 6/19
Clear CT and MRI on 2/5/2018, 9/18 Clear Scans
Reversal Surgery 6/26/18
Small Spot on right ureter surgery 10/30/19 adhered to artery
Dec. 2 start 12 rounds FOLFIRI

WarriorSpouse
Posts: 217
Joined: Tue Aug 16, 2016 9:02 pm

Re: Maintenance Chemo Questions

Postby WarriorSpouse » Thu May 28, 2020 11:28 am

Hey Tater,
Sorry for the delay in response. I have not been reading these posts as much recently. My wife has been on maintenance chemo a couple of times during her journey. Side effects of Zeloda pills are different for each patient, but my wife has stronger hand and foot issues on these pills. What she does is she drinks more water and used moisturizer to handle the side effects. When she was on the 5FU pump, she tolerated it much better; but mentally she hated hearing the thing work during the night when she was going to bed. She has chosen the Zeloda pills basically because it makes her feel more normal than carrying the pump around. Both have the same effect to keep the cancer in check. It is the different side effects that cause people to choose one over the other. Best of luck going forward.
WS
D/H 47 years old, 10/2014, Stage IV M/CRC, nodes 12/15, para-aortic, 5 cm sigmoid resection, positive Virchow. KRAS mut, MSS, Highly Differentiated, Lynch Neg, 5FU/LV and Avastin 1 YR (Oxi for 5 months), Zeloda/Bev since 01/2016. 02/2019 recurrence para-nodes, back to 5FU/LV Oxy/Bev. It is working again. "...Perseverance is not a long race; it is many short races one after the other."-Walter Elliot

Siti
Posts: 150
Joined: Thu Aug 01, 2019 10:58 am

Re: Maintenance Chemo Questions

Postby Siti » Thu May 28, 2020 4:14 pm

Sorry for the late response, I haven’t been logging on much lately.

My husband was on capecitabine pills + Avastin as maintenance chemo. He had bad diarrhoea and cramps in the beginning but was able to control that with Psyllium husk + Loperamide. He subsequently developed really bad hands and feet syndrome that no amount of moisturiser(s), gloves or acupuncture could help.

His oncologist switched his last cycle to TS-1 (Teysuno). It’s a Japanese chemo (tegafur/gimeracil/oteracil). Tegafur has the active substance of 5-FU, similar to the pump or capecitabine. The pills are taken twice daily, 2 weeks on and 1 week off.
He started about a month ago, so I can’t give you much information on that.

I think it’s about what works best for the patient. All the best moving forward with the decision.
Wife of DH (54) DX on 5/7/19
CEA value: 1.2
T loc: Sigmoid
T type: Adenocarcinoma
T grade: G3
Pos LNs: 30/31
Wild Type for KRAS, NRAS and BRAF
19/7/19 PET-CT Scan: Distant lymph nodes (para-aorta, neck & hip), est. size 0.5-1.5cm.
22/7/19 Surgery: Laparoscopic Colon Resection
26/8/19 Chemo: CAPEOX + Avastin x 9
6/11/19 CT Scan after 3rd cycle, all nodes have shrunk! Yay!!


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