The Colon Club

Hi all,

My husband is getting his eighth Folfox treatment this Wednesday. After each treatment when his pump is removed, he receives the Neulasta shot. I know the side effects from the shot state "flu-like" symptoms. Bruce's worst side effects with the chemo are fatigue and diarrhea. Once the pump is removed, he crashes. It used to be for two or three days after, but now it's lasting almost one week. He also had such bad abdominal cramping, we almost went to the hospital. The pains eventually subsided.

Also, Bruce not only had seven chemo treatments, he's also had five and a half weeks of radiation and chemo (Xeloda). First five chemo infusions, followed by chemoradiation, and five more chemo infusions (going on #3 of 5). He will hopefully be finished around August 19 or 20.

My questions are: 1. Do you get the Neulasta shot after each chemo treatment?
2. As treatments progress, does your fatigue get worse?
3. Could some of these side effects be due to the Neulasta shot?

Thanks in advance for replying.
-Nanette

I had to get 3 nuelasta shots throughout my treatment(12 treatments of folfox) I had similar side affects as your husband. the first few were easy just a little tired but as they went on the fatigue and achiness got pretty bad. I also had nueropathy. The last 3 treatments I started having severe stomach pain, like some one was ripping my stomach out. The last two weeks of treatment I lost 10 lbs and it took a month to regain my energy. I think the only side affect I had from the nuelasta was severe bone pain. Thankfully Lortab took care of that. I believe it depends on your white blood count whether or not you get Nuelasta.

Hi...I did get a shot after every treatment. My pump would be removed on Wed, and then on Monday I would get the shot. The fatigue and side effects of chemo did get worse with every treatment. I think the effects were cumulative and got worse for me because I just couldn't rebound between treatments. The days that I would feel good between treatments dwindled and I just dreaded the next one. I too had bad stomach cramps, and terrible heartburn. I think the shots made me feel crappy for that much longer. When I stopped the oxi after treatment 8, the chemo was a little easier, but the shots knocked me down again. But without the shots, I couldn't get the chemo. For me, it was a necessary evil.

I get a neulasta shot 24 hours after I am disconnected from my pump. I take FOLFIRI with Avastin. I have completed 10 out of 12 treatments and have my 11th tomorrow. I am nauseous and tired but I don't know if the neulasta contributes to it or not. I just know that I need to keep my counts up or they won't let me have chemo. Symptoms have gotten progressively worse but I am determined to complete all 12 without a break because I have this idea in my head that if I saturate my system with chemo, the cancer cells will have no where to hide.

I am on FOLFOX for small bowel cancer that was removed through surgery. After treatment #8, I ended up in ER feeling so sick. I was given fluids and potassium which helped me feel better. Treatment #9 was reduced in strength and I was better able to tolerate it. Same with treatment #10. After #10, 24hrs after my disconnect, I was given Neulasta. No real side effects. I went ahead with #11 2 weeks later, as per my schedule. Again, another Neulasta shot, but the following week I hit bottom again. I felt sick, couldn't eat, no energy. I was told my WBC count was high going into #11 and when it gets too high, your body can have an adverse reaction to it which was my case. It seems to me now that if your WBC count is high going into your next treatment, a Neulasta shot is not needed. That's my opinion. I honestly felt that after treatments #9 and 10 that my recovery from chemo would progress rather quickly but that second shot set me back.

I get the shot after every treatment, the same day the pump comes off. When I first started chemo, the shot would cause mild spasms in my lower back whenever I first sat down, but they weren't bad, and when I realized what they are, they were kind of funny. I haven't had those in several months. Occasionally I get achy/restless legs from the shot,nothing a little ibuprofen couldn't handle. Other than that, I haven't had any side effects. I've seen mentioned here that some people have been told they shouldn't be taking ibuprofen with our kind of cancer or chemo, but it was actually my oncology nurses who said to take it. They said if I didn't have a fever, I could take 3 pills "and no more" but if I have a fever, don't take anything, because they don't want the fever to be lowered in case there's an infection. If I get a fever higher than 100.5 I have to call them immediately or go to the ER if they're closed. Thanks be to God, that's only happened one time in 7+ months of chemo.

My fatigue has gotten worse with each treatment, but I just went back to work for the first time since March, and I really think the activity has helped me with the fatigue. I sit all day at work, but the walk from the parking lot to my desk is pretty long, and seems to be just the right amount of activity to help the fatigue and not make it worse.

I only had to have one shot of Neulasta and that was after my 8th treatment. By then the cumulative effects from chemo were pretty bad, especially after my 48 hr infusion. When I had the Neulasta shot I was told I might have lower back pain and possibly chest pain, but not to worry that it was a heart attack! Just what I needed to hear.LOL I not only had back pains but it was all over, just like flu symptoms on top of the way I felt from the chemo. Towards the end of chemo it seemed as if there were fewer days in between that I felt good. At that point, after being "unhooked" from my infusion, I could barely stand up, so I worked even less. Once chemo was finished it took a few months before I started to feel better, but I did get there.

Nannette,

I had twelve Folfox treatments but never had a Neulasta shot. I did have to delay treatment twice and on the second delay they offered a series of Neupogen shots but I declined. I have always wanted to minimize the drugs that I receive. I cut Benadryl from my pre-meds because I didn't like the feeling that it gave me. I have cut Decadron out of my post-meds with my current regimen because I don't need it. I always clear it with my onc, but I feel that less is sometimes more when it comes to drugs. Is your husband's white blood cell count low? If so then Neulasta may be appropriate. If it is normal I would hold off on Neulasta until it drops.

My WBC count has been normal so far so I don't get any shots. I'm on oxi, avastin and xeloda. I am getting more and more tired and "just don't feel good" after each treatment. I will get #6 next Monday and then I'm off of the oxi for 4 months. I get a lot of gas pains which I think is from the Xeloda and taking gasX helps quite a bit. So, most of your symptoms are probably form the chemo. I thought achiness in the sternum and legs was a common side effect of the neulasta (which you do get with the flu also).