Irinotecan experiences?

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Shana
Posts: 401
Joined: Sun Jul 30, 2017 9:45 pm
Location: Sonoma, CA

Irinotecan experiences?

Postby Shana » Fri Aug 04, 2017 11:33 pm

I am on second week of Irinotecan + Cetuximab. The flood gates opened this week with pretty significant diarrhea for the past two days. I called oncologist office and was told to double up my immodium dosage and see how that works for me. I have a colostomy so I can only gauge by how often and quickly that fills up... I feel tied to my house now because I have no idea how quickly it's going to fill and I dread that thought of a spill in public.

Are there other anti-diarrhea drugs that I should ask for? I am trying to keep hydrated and eat but everything is just running right through me. Feeling okay otherwise, some fatigue that I didn't have last week but overall pretty good except for the continuous runs.

Any suggestions and advice appreciated!

Thanks,

Shana
DX - 12/16
MSS - KRAS wild
Well-differentiated adenocarcinoma at splenic flexure
Stage IV CC with liver mets
5FU - Failed twice - 1/17 and 3/17
Irinotecan + Cetuximab: 8/17
Irinotecan and Erbitux ran it's course. CEA rising
Primary tumor invaded tail of pancreas and spleen. Liver mets major concern
Y-90 radioembolization on 9/17/18, liver enzyymes have dropped. 10 Radiation treatments to primary tumor completed too. CT scan Nov to assess overall situation...

Lovenothate
Posts: 38
Joined: Tue Aug 16, 2016 3:13 am
Facebook Username: Emily.guzman

Re: Irinotecan experiences?

Postby Lovenothate » Fri Aug 04, 2017 11:55 pm

Hi Shana!

I know before transfusions my mom gets an iv anti-diarrhea medication along with zofran. Afterwards, her onc recommended Imodium depending on how her body is reacting.
Although I know there are others who have had more experience with folfiri. :)

Em
daughter to DM dx Stage IV CRC @47 July 2016
total hysterectomy b/c ovarian mets abscites 6/16
Colostomy
Folfox 7/16
Lung spots 2mm each 9/16
Xeloda & Avastin 1/17
Shrinkage to lungs spots! 4/17
Break from Avastin/ Xeloda continued 7/17
Omentum mets/ lungs mets stable(possibly not malignant)
Folfiri 8/17
1 lung spot all along-clear abdomen scans chemo break until 4/4/17

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MikeManess
Posts: 90
Joined: Fri Apr 01, 2016 3:56 pm
Location: Forney, Texas

Re: Irinotecan experiences?

Postby MikeManess » Sat Aug 05, 2017 12:23 am

I had significant diarrhea with Folfox + Avastin, and even more with Foilfiri + Avastin. The Avastin and Irinotecan combined to give me massive, watery diarrhea - sometimes 10 times per day. My oncologist put me on Tincture of Opium. That stuff works and works very well. It's a tincture, so there isn't enough Opium to feel it, but it does cause opium induced constipation in normal people. With diarrhea, it more or less normalizes my bowel movement to remove the watery part, and I go 2-4 times per day with a loose movement instead of 10 times per day. I could have taken 0.6 ml per dose, 4 times per day. I chose to only take it twice per day, and three times per day when things are intense. I'm not a brown bagger, so your mileage may vary.
3/11/16 Colonoscopy - 9 benign polyps, 1 large cancerous tumor in right ascending colon
4/19/16 Right colectomy
6/3/16 Two liver spots detected, added Avastin to Folfox
12/20/16 Liver surgery. Pathology shows no active cancer cells
6/7/17 Final chemo
12/5/17 Port removed
05/23/18 Liver tumor discovered in scans
04/04/19 Radiation treatment
08/15/19 Additional radiation treatment
08/21/19 NED again

KElizabeth
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Joined: Sat Oct 31, 2015 12:41 pm
Facebook Username: KElizabeth
Location: Omaha

Re: Irinotecan experiences?

Postby KElizabeth » Sun Aug 06, 2017 9:41 pm

I did irinotecan for almost two years and the best help for diarhea was a once monthly injection of sandostatin. It works on hormones that somehow affects tour bowels.
Limotil also was helpful in combination with Imodium to keep things quite for a few hours at a time.
Really it's just part of the fun but irinotecan really kicked butt for me for quite awhile. Stay hydrated when it hits and keep up on the electrolytes to avoid cramps.
Sorry you are having trouble.
Hang in there.
Female age 39- ,2 teens.
Colon Cancer - DX March 2013
Age 34 at DX - Stage III B
Resection surgery -May 2013
FOLFOX - June, 2013 to Sept, 2013
5FU plus leukavorin Sept, 2013 to Dec, 2013
METs liver and lungs discovered Sept, 2015
KRAS - MSS
FOLFIRI plus Avastin - Sept, 2015 - July 2017
Durvalumab and Cediranib Sept 2017 Dec 17
FOLFOX with desensitization protocol - current

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Shana
Posts: 401
Joined: Sun Jul 30, 2017 9:45 pm
Location: Sonoma, CA

Re: Irinotecan experiences?

Postby Shana » Mon Aug 07, 2017 5:52 pm

Lovenothate wrote:Hi Shana!

I know before transfusions my mom gets an iv anti-diarrhea medication along with zofran. Afterwards, her onc recommended Imodium depending on how her body is reacting.
Although I know there are others who have had more experience with folfiri. :)

Em



Thank you for the feedback, Em. I appreciate the information. I just had chemo this morning and will see how it goes. I am taking next week off and then back in the saddle again on 8/21.

Shana
DX - 12/16
MSS - KRAS wild
Well-differentiated adenocarcinoma at splenic flexure
Stage IV CC with liver mets
5FU - Failed twice - 1/17 and 3/17
Irinotecan + Cetuximab: 8/17
Irinotecan and Erbitux ran it's course. CEA rising
Primary tumor invaded tail of pancreas and spleen. Liver mets major concern
Y-90 radioembolization on 9/17/18, liver enzyymes have dropped. 10 Radiation treatments to primary tumor completed too. CT scan Nov to assess overall situation...

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Shana
Posts: 401
Joined: Sun Jul 30, 2017 9:45 pm
Location: Sonoma, CA

Re: Irinotecan experiences?

Postby Shana » Mon Aug 07, 2017 6:01 pm

MikeManess wrote:I had significant diarrhea with Folfox + Avastin, and even more with Foilfiri + Avastin. The Avastin and Irinotecan combined to give me massive, watery diarrhea - sometimes 10 times per day. My oncologist put me on Tincture of Opium. That stuff works and works very well. It's a tincture, so there isn't enough Opium to feel it, but it does cause opium induced constipation in normal people. With diarrhea, it more or less normalizes my bowel movement to remove the watery part, and I go 2-4 times per day with a loose movement instead of 10 times per day. I could have taken 0.6 ml per dose, 4 times per day. I chose to only take it twice per day, and three times per day when things are intense. I'm not a brown bagger, so your mileage may vary.



HI Mike,

Thanks for all the info. I had chemo today and we decided to take a week off and resume on 8/21. I got a prescription for Lomotil to see how that works. I will ask about tincture of Opium at my next visit if needed. I couldn't tolerate Folfox, it ended up giving me colitis and eventually the necessary bag... I haven't tried Avastin. Glad to read that you are NED! It's always uplifting to hear that from others.

Had to laugh at YMMV because I was quite the frequent flier before this grounded me. I hope to be able to travel again once I have the disease well managed. I am hopeful :)
DX - 12/16
MSS - KRAS wild
Well-differentiated adenocarcinoma at splenic flexure
Stage IV CC with liver mets
5FU - Failed twice - 1/17 and 3/17
Irinotecan + Cetuximab: 8/17
Irinotecan and Erbitux ran it's course. CEA rising
Primary tumor invaded tail of pancreas and spleen. Liver mets major concern
Y-90 radioembolization on 9/17/18, liver enzyymes have dropped. 10 Radiation treatments to primary tumor completed too. CT scan Nov to assess overall situation...

User avatar
Shana
Posts: 401
Joined: Sun Jul 30, 2017 9:45 pm
Location: Sonoma, CA

Re: Irinotecan experiences?

Postby Shana » Mon Aug 07, 2017 6:10 pm

KElizabeth wrote:I did irinotecan for almost two years and the best help for diarhea was a once monthly injection of sandostatin. It works on hormones that somehow affects tour bowels.
Limotil also was helpful in combination with Imodium to keep things quite for a few hours at a time.
Really it's just part of the fun but irinotecan really kicked butt for me for quite awhile. Stay hydrated when it hits and keep up on the electrolytes to avoid cramps.
Sorry you are having trouble.
Hang in there.


Hi KElizabeth,

Thanks for the info, I've never heard of sandostatin. I just picked up a bottle of Lomotil at the pharmacy and will see how that works. I am also taking a break next week and resuming Irino + Cetux on the 21st. Did the diarrhea continue for the entire 2 years of treatment? I would definitely opt for a monthly shot to keep it under control over that long time. I need something to kick butt for me so I hope Irinotecan is the ticket this time around. My goal is a short trip to Disneyland with my daughters and a girlfriend. I need some happy times to look forward to. Thanks for the encouragement, I appreciate it more than I can say.

Take care,

Shana
DX - 12/16
MSS - KRAS wild
Well-differentiated adenocarcinoma at splenic flexure
Stage IV CC with liver mets
5FU - Failed twice - 1/17 and 3/17
Irinotecan + Cetuximab: 8/17
Irinotecan and Erbitux ran it's course. CEA rising
Primary tumor invaded tail of pancreas and spleen. Liver mets major concern
Y-90 radioembolization on 9/17/18, liver enzyymes have dropped. 10 Radiation treatments to primary tumor completed too. CT scan Nov to assess overall situation...

KElizabeth
Posts: 400
Joined: Sat Oct 31, 2015 12:41 pm
Facebook Username: KElizabeth
Location: Omaha

Re: Irinotecan experiences?

Postby KElizabeth » Thu Aug 10, 2017 11:38 pm

Shana wrote:
Hi KElizabeth,

Thanks for the info, I've never heard of sandostatin. I just picked up a bottle of Lomotil at the pharmacy and will see how that works. I am also taking a break next week and resuming Irino + Cetux on the 21st. Did the diarrhea continue for the entire 2 years of treatment? I would definitely opt for a monthly shot to keep it under control over that long time. I need something to kick butt for me so I hope Irinotecan is the ticket this time around. My goal is a short trip to Disneyland with my daughters and a girlfriend. I need some happy times to look forward to. Thanks for the encouragement, I appreciate it more than I can say.

Take care,

Shana


Shana,
Unfortunately the late Diarhea did continue throughout treatment but the Sandostatin was a life saver. My oncologist had never heard of it until he hired a pharmacist to prepare chemo for the patients. The pharmaciShana, seen good results from it at his previous place of employment. I was the first patient my oncologist had prescribed it for. Since it worked so well for me he has prescribed if for others. I don't think I have any noticeable side effects so it really is a useful drug.
Best wishes.
Elizabeth.
Female age 39- ,2 teens.
Colon Cancer - DX March 2013
Age 34 at DX - Stage III B
Resection surgery -May 2013
FOLFOX - June, 2013 to Sept, 2013
5FU plus leukavorin Sept, 2013 to Dec, 2013
METs liver and lungs discovered Sept, 2015
KRAS - MSS
FOLFIRI plus Avastin - Sept, 2015 - July 2017
Durvalumab and Cediranib Sept 2017 Dec 17
FOLFOX with desensitization protocol - current

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Shana
Posts: 401
Joined: Sun Jul 30, 2017 9:45 pm
Location: Sonoma, CA

Re: Irinotecan experiences?

Postby Shana » Fri Aug 11, 2017 1:30 pm

Hi Elizabeth,

I am going to talk to my oncologist about it on my next appointment. The diarrhea is becoming a real pain and affecting my ability to function normally. I seem to be handling the chemo well (so far) other than the Big D!

I found a website about diarrhea meds that might be of interest to you and others. http://jhoponline.com/jhop-issue-archiv ... ea-options

Octreotide is the other name for Sandostatin. The article really shows good resolution for many patients. Thanks again for the info!

Shana
DX - 12/16
MSS - KRAS wild
Well-differentiated adenocarcinoma at splenic flexure
Stage IV CC with liver mets
5FU - Failed twice - 1/17 and 3/17
Irinotecan + Cetuximab: 8/17
Irinotecan and Erbitux ran it's course. CEA rising
Primary tumor invaded tail of pancreas and spleen. Liver mets major concern
Y-90 radioembolization on 9/17/18, liver enzyymes have dropped. 10 Radiation treatments to primary tumor completed too. CT scan Nov to assess overall situation...

Joecool1983
Posts: 44
Joined: Sat Jun 11, 2016 12:45 pm
Facebook Username: Joseph Piazzola

Re: Irinotecan experiences?

Postby Joecool1983 » Sun Aug 13, 2017 6:04 am

I was on Avastin+Irinotecan from March until July. It made me extremely ill for at least a week. I am talking 1 week straight of severe nausea and vomiting. And severe diarrhea. Plus extreme fatigue. And this was only half dose. I did 5 rounds. My Oncologist and I made the decision to switch me to Capecitabine/Xeloda. Just started that Friday.
Last edited by Joecool1983 on Sun Aug 13, 2017 6:09 am, edited 1 time in total.
Diagnosed 12/17/15- 32 years old- Tumor 3"x1.5" at the Rectosigmoid Colon
Stage IIIA T3N1M0
Radiation and chemotherapy(Xeloda pill form) January 2016- February 2016
4/11/16- Surgery to remove the tumor/colon resection. Robotic LAR/Dissection of Lymph Node. 1/19 showed any involvement
5/16-10/16- Follow up chemotherapy- FOLFOX, 8 Treatments
1/17- Routine CT scan found 3 Metastases on my Liver
4/17-8/17- 5 Treatments Avastin/Irinotecan

Joecool1983
Posts: 44
Joined: Sat Jun 11, 2016 12:45 pm
Facebook Username: Joseph Piazzola

Re: Irinotecan experiences?

Postby Joecool1983 » Sun Aug 13, 2017 6:09 am

I am starting to feel nauseous from the Capecitabine. Just took some Ativan. Hoping it helps.
Diagnosed 12/17/15- 32 years old- Tumor 3"x1.5" at the Rectosigmoid Colon
Stage IIIA T3N1M0
Radiation and chemotherapy(Xeloda pill form) January 2016- February 2016
4/11/16- Surgery to remove the tumor/colon resection. Robotic LAR/Dissection of Lymph Node. 1/19 showed any involvement
5/16-10/16- Follow up chemotherapy- FOLFOX, 8 Treatments
1/17- Routine CT scan found 3 Metastases on my Liver
4/17-8/17- 5 Treatments Avastin/Irinotecan

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Shana
Posts: 401
Joined: Sun Jul 30, 2017 9:45 pm
Location: Sonoma, CA

Re: Irinotecan experiences?

Postby Shana » Sun Aug 13, 2017 12:50 pm

Joecool1983 wrote:I was on Avastin+Irinotecan from March until July. It made me extremely ill for at least a week. I am talking 1 week straight of severe nausea and vomiting. And severe diarrhea. Plus extreme fatigue. And this was only half dose. I did 5 rounds. My Oncologist and I made the decision to switch me to Capecitabine/Xeloda. Just started that Friday.


Hi Joe,

I haven't been on Avastin as yet. Currently on Irinotecan+Erbitux. I've had severe diarrhea for the past 10 days. I am also on half dose for 3 weeks and then 1 week off. I'm frustrated that they are only offering Lomotil and Immodium so far since I know there are other medication options. My oncologist is on vacation so I am dealing with one of her colleagues. I can't go back to Xeloda since I had such a terrible reaction to that.

If you have Zofran that might help with the nausea too. Good luck to you, this all sucks :(
DX - 12/16
MSS - KRAS wild
Well-differentiated adenocarcinoma at splenic flexure
Stage IV CC with liver mets
5FU - Failed twice - 1/17 and 3/17
Irinotecan + Cetuximab: 8/17
Irinotecan and Erbitux ran it's course. CEA rising
Primary tumor invaded tail of pancreas and spleen. Liver mets major concern
Y-90 radioembolization on 9/17/18, liver enzyymes have dropped. 10 Radiation treatments to primary tumor completed too. CT scan Nov to assess overall situation...


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