Deciding if I should take Irinotecan and Cyramza

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aqmdtran
Posts: 5
Joined: Tue Oct 03, 2017 5:36 pm

Deciding if I should take Irinotecan and Cyramza

Postby aqmdtran » Tue Oct 03, 2017 6:29 pm

Hello everyone, newcomer to this forum. Unfortunately not new to colon cancer been dealing with it since Aug 2012. Had it in control with 5FU and Vectibix but it starting
to stick it little head again so doctor wants to change it to Irinotecan and Cyramza. Hearing all the side effect of Irinotecan I don't know if I want to take it. Also going to talk to some doctors about immunotherapy clinical trials Oct 9. Any advice on any of this will be truly appreciated.

I had stage 3a in Aug 2012. Had surgery removed 8 inches no other issues. Fight it off initially with alternative method, diet, supplements and then some. Was good until the end of 2014 when I thought i was cancer free and slowly stop my diets and supplement. Well it head showed up at beginning of 2015. Went to Mexico for alternative therapy but it didn't work...so been on the initial chemotherapy with oxa...can't spell it 5FU and vectibix. Had to stop oxa about 6 months ago because neuropathy started to come in. Was stable with the 5FU and vectibix. Last scan showed a 2.5 cm in the liver that was not there last time. The problem was for the last 2 months I've been dealing with women issues where I was bleeding too death. In fact tomorrow is getting an ablation to try to stop it. Not only was my immune system down but they put me on progesterone cancer promoting hormone to control my bleeding. Try to plead with my ONC to keep the same therapy until I fix my problem first. He won't do it.

Have anyone reject the suggested therapy and insist on doing the same therapy? Can the ONC keep the same therapy? I know they have a protocol they have to follow. Have anyone fought against it because I'm about to do it.

Hoping to get a lot of input...have to make decision by next week already had to skip one treatment because he will not give it to me.
Last edited by aqmdtran on Wed Oct 04, 2017 8:10 am, edited 1 time in total.
Stage 3A Colon Cancer, Surgery 8 inches remove. No other complication.
2015 It came back METS to lungs, liver, and one spinal bone.
Started chemo May 2016.
Bone Radiation - Scar ; Lungs - stable ; Liver - was stable, 9/26/17 - 2.5 cm popped out.

Steph20021
Posts: 553
Joined: Sat Dec 27, 2014 4:58 pm
Location: Ontario, Canada

Re: Deciding if I should take Irinotecan and Cyramza

Postby Steph20021 » Wed Oct 04, 2017 12:02 am

I don't have experience with rejecting oncologists suggested treatment, but I can share with you that irinotecan as part of my folfiri cocktail has been helping keep me stable for over a year and the side effects for me have been tolerable. I'm still able to work part time in a desk job that requires a lot of reading, writing and mental work. I'm only in bed sleeping for about three to four days every two weeks and that's when I'm on the iv chemo. I've lost some hair but I'm feeling ok. Why not give it a try and see how you tolerate it before trying something else?
DX 1/31/14 @ 33- SPS-T4a(invades visceral peri), N2a(6/106 LN), M1a(ovary) (Stage 4a) MSS; BRAF V600E
2/1/14-subtotal col, lost R ovary, temp ileo
3/14-9/14- folfox; sepsis
11/14-CT/PET: L ovary met, pelvic met, (?)ghost liver met(?)
12/14-folfiri -13 rds kept me stable from 3/15-6/15
8/15-HIPEC, NED
09/15- cea 0.9
05/16- recurrence in abdo wall and lymph nodes
01/17- pulmonary embolism
02/17- 1 wk radiation to abdo wall
08/16- on folfiri
01/18-folfox
11/18- Beacon trial-encorafenib & cetuximab

aqmdtran
Posts: 5
Joined: Tue Oct 03, 2017 5:36 pm

Re: Deciding if I should take Irinotecan and Cyramza

Postby aqmdtran » Wed Oct 04, 2017 8:26 am

Unfortunately I'm the bread winner in my family and can't afford to work part time. However I am blessed with a job that I can work from home for a little bit. However I feel like I'm taking advantage of my work when I do that. Please share your experience with irinotecan? Do you really have bad diarrhea? How does everyone handle working with that side effect? Also looks like the cyramza can cause diarrhea too, double dose.
Stage 3A Colon Cancer, Surgery 8 inches remove. No other complication.
2015 It came back METS to lungs, liver, and one spinal bone.
Started chemo May 2016.
Bone Radiation - Scar ; Lungs - stable ; Liver - was stable, 9/26/17 - 2.5 cm popped out.

SweetC80
Posts: 103
Joined: Fri Sep 01, 2017 1:28 pm

Re: Deciding if I should take Irinotecan and Cyramza

Postby SweetC80 » Wed Oct 04, 2017 9:56 am

I will give you my mother's experience with Irinotecan (she has only had one infusion so far), but I wanted to let you know that she didn't handle the FOLFOX well, so she is very susceptible to symptoms and I know her reactions are not always the normal. She has an ostomy bag, but she had an extremely high output of pure liquid for days. She was in the hospital at the time and they were able to control it but it took maybe 3 days to get everything back in order. They were literally emptying her bag every 20 mins and at times it kind of exploded a couple of times because it' kept filling so fast. She had extreme vomiting for 2 days after the infusion. She was extremely weak and unable to walk (but again she was weak and collapsing after the FOLFOX infusions). Her Hgb dropped so low she needed a blood transfusion. Her Onc has postponed her treatment 4 weeks to get her back on her feet before infusion 2. She is set to do another round of Irinotecan this coming Tuesday, and hopefully she is stronger and tolerates it better.

Again I think my mom is the exception not the norm, but wanted to give you an honest answer regarding somebody who did have a lot of symptoms.
My Mom
12/16 Stage IIIb Rectal Ca CEA 1.2
1/17-2/17 Chemoradiation CEA 4.4
5/17 Entire Colon, Rectum & Anus removed Perm Ileostomy Bag
7/17 FOLFOX
9/17 Stage IVb 9cm Liver Met & 7mm Lung Nodule CEA 197
9/17 FOLFIRI CEA 160
10/17 Confirmed KRAS Pos CEA 210
11/17 Met growths Liver 10cm & Lung 8mm CEA 425
12/17 FOLFOX again Met growths Liver 13cm & Lung 1cm CEA 405
12/17 Xifaxan due to Hepatic Encephalopathy
12/17 New 2cm liver Met
1/18 CEA 992
2/8/18 Passed Peacefully

aqmdtran
Posts: 5
Joined: Tue Oct 03, 2017 5:36 pm

Re: Deciding if I should take Irinotecan and Cyramza

Postby aqmdtran » Wed Oct 04, 2017 10:19 am

Thanks for sharing and praying that your mom will take the next treatment better. I've been blessed that I haven't had any bad side effects with all my treatment so that is why I am so scare to change anything. Anyone convinced their ONC to stay with the same treatment at least until the next scan? Feeling very blessed with these input.
Stage 3A Colon Cancer, Surgery 8 inches remove. No other complication.
2015 It came back METS to lungs, liver, and one spinal bone.
Started chemo May 2016.
Bone Radiation - Scar ; Lungs - stable ; Liver - was stable, 9/26/17 - 2.5 cm popped out.

Steph20021
Posts: 553
Joined: Sat Dec 27, 2014 4:58 pm
Location: Ontario, Canada

Re: Deciding if I should take Irinotecan and Cyramza

Postby Steph20021 » Thu Oct 05, 2017 12:47 am

Irinotecan is not giving me any diarrhea trouble, and very little tingles in my hands, usually it's with warm or hot water that I may feel a bit of tingles. Mostly it's sleepiness for me.
My vision has also gotten worse, but I've been on it for a year now. I didn't notice change in vision right away or anything drastic like that.

I was also the breadwinner amd still am, but I was forced to go down to part time because treatment takes up so much of my time. We are managing, but of course I'd rather be fulltime.
DX 1/31/14 @ 33- SPS-T4a(invades visceral peri), N2a(6/106 LN), M1a(ovary) (Stage 4a) MSS; BRAF V600E
2/1/14-subtotal col, lost R ovary, temp ileo
3/14-9/14- folfox; sepsis
11/14-CT/PET: L ovary met, pelvic met, (?)ghost liver met(?)
12/14-folfiri -13 rds kept me stable from 3/15-6/15
8/15-HIPEC, NED
09/15- cea 0.9
05/16- recurrence in abdo wall and lymph nodes
01/17- pulmonary embolism
02/17- 1 wk radiation to abdo wall
08/16- on folfiri
01/18-folfox
11/18- Beacon trial-encorafenib & cetuximab

RichieTheK
Posts: 13
Joined: Mon May 29, 2017 11:27 am

Re: Deciding if I should take Irinotecan and Cyramza

Postby RichieTheK » Thu Oct 05, 2017 3:51 am

Everyone's reaction to a chemotherapy drug is different. I have a genetic mutation that allows me to tolerate a higher dose of irinotecan than normal. I have been getting that higher dose as part of FOLFIRI and have experienced only minimal side effects. I do not experience any diarrhea, nor palmar-plantar (hand-foot) syndrome. I have lost hair and experience some fatigue and some nausea, which is easily controlled.

The only way for you to know how you will affected is to try it.
DX 5/13/2016 (Friday the 13th) mRCa Stage 4b
Met Liver, Lungs, Spine
mut KRAS G12V
mut PIK3CA
MSS
5/15/2016 Tumor partially obstructive; colostomy performed
5/2016 FOLFIRI with higher dose of Irinotecan
8/2017 Signs of tumor growth, added Avastin to FOLFIRI
4/16/2018 Primary tumor invading surrounding tissue. Chemo stopped
5/2018 Started radiation.
6/2018 Radiation finished
7/2018 Start FOLFOX
1/2019 FOLFOX canceled due to neuropathy after 14 cycles.
Maintenance, 5FU and Avastin
6/2019 FOLFIRI

BUD2016
Posts: 60
Joined: Sat Sep 10, 2016 3:25 pm

Re: Deciding if I should take Irinotecan and Cyramza

Postby BUD2016 » Sun Oct 08, 2017 11:43 pm

Hi,

My mom now started Irinotecan (folfiri) + Cyramza. Please see signature for history. She progressed unfortunately on Folfox + Avastin, Folfiri + Avastin and now they switched her to Folfiri + Cyramza. She is being scanned every 2 months (MRIs and CT with contrasts). Her decease is currently limited to liver, but inoperable and treatments like ablation and cyberknife are not possible due to a number of small mets (over 10) and underlying autoimmune decease.

Everyone is very different in terms of chemo side effects. She has never developed neuropathy and had 8 treatments with Folfox/oxi and then 4 without oxi. After 9 cycles of Iri she has finally had to shave her head, since her hair felt off in patches. For some reason this one was a truly difficult one for her psychologically (losing her hair). She never had diarrhea. She suffers from constipation, but daily enemas help plus various laxatives and eating lots of plumps.

Cyramza is more advanced medication than Avastin. It was approved in combination with Folfiri in 2015 I think. We have hopes and our onc participated in initial clinical trials with it before it was approved.

I was asking earlier about Cyramza on this forum, but it seems that there are very few who have any experience with it.

Best wishes.
09/2016: Mom dx/rectal cancer
10/2016: Open surgery. T3N0/Grade 2
11/2016: PET/CT scan shows 5 liver mets in both lobes
11/2016: FOLFOX + Avastin started on her 71st birthday
KRAS gen 2 G13D mutant, BRAF Negative, MSS
03/2017: Oxi stopped after 9th tx, 5FU cntd. CT scans w/ contrast every 2 months - small shrinkage/stable
05/2017: PET/CT progression, started FOLFIRI + AVASTIN
07/2017: MRIs/CT stable
09/2017: MRIs/CT - min progression
09/2017: FOLFIRI + CYRAMZA
11/2017: left us


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