Has anyone taken a break from chemo in between their adjuvant chemo?

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Hooandtrue93
Posts: 11
Joined: Tue May 11, 2021 10:28 pm

Has anyone taken a break from chemo in between their adjuvant chemo?

Postby Hooandtrue93 » Sat Jun 05, 2021 8:39 am

My mom is feeling the effects of the FOLFOX after 4 cycles and brought up maybe taking a break after 6 cycles. Her CTDNA was positive prior to chemo and will be reassessed after the 5th cycle. Ultimately it is her treatment and her decision. I was wondering if anyone else had taken a break in the middle of their adjuvant chemo but then resumed treatment after 2-3 weeks?

I've also been looking into things that can help with side effects and keeping her in top shape during chemo (on top of the medications already prescribed). I saw that CBD oil can help and also requesting fluids when you get your port flushed helps. Any other tips would be great
28 year old, son of 62 year old mom
Stage 3B Duodenal Adenocarcinoma.
7/13 lymph nodes positive
02/22/2021: Whipple Surgery
04/08/2021: Port Surgery. CtDNA test sample taken (positive)
04/13/2021: Folfox-6 begins for 6 months

stu
Posts: 1503
Joined: Sat Aug 17, 2013 5:46 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby stu » Sun Jun 06, 2021 3:09 am

It’s rarely straightforward. A small break helped my mum considerably. Got her through it all really !
I wish your mum well !
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

boxhill
Posts: 730
Joined: Fri Apr 06, 2018 11:40 am

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby boxhill » Sun Jun 06, 2021 8:59 am

My oncologist told me that very few people get through the full 12 cycles of FOLFOX without having to lower the dosage or take breaks to let platelets rise up to treatable levels. Including in the original studies. This is, of course, different from taking a break because of severe side effects or just plain feeling lousy.

I personally tolerated FOLFOX better than many, and although I felt progressively crummier as time went on--I recall telling someone at coffee hour after church during round 8 that I had to admit that it was really wearing on me--I never felt that I wanted to pause, in fact I found the platelet pauses frustrating. I just wanted to get through it as quickly as possible.

What side effects does your mother have, and how bad are they? Some of them can be ameliorated to some degree--nausea, cold sensitivity, diarrhea, depression, even loss of appetite perhaps--but fatigue is something that I think you just have to allow yourself to feel and give yourself permission to rest as much as you need. I don't know how some people keep going to work. I can only imagine what it feels like to take care of young children who are too young to understand when every atom in your body seems to be screaming that you need to lie down on the sofa NOW. I had the luxury of just concentrating on doing chemo, without a lot of other demands on me. If she's developed low ANC, there's Neulasta. My NP recommended that I eat a rare steak during the second week of every cycle to combat my incipient anemia. (It worked!)

Another thing to consider is whether a 2 or 3 week break would actually make her feel any better. I know that when I was forced to take 2 weeks off at once for blood counts I didn't feel any different. I wouldn't count on a short break helping much, and then she probably has to go back and finish it.

She can reassess after her round 5 test, talk with her oncologist. Some people just do a shorter course for adjuvant chemo. There's research out there about it.

My best to you both.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
Stop Key
All MRIs NED

prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby prayingforccr » Sun Jun 06, 2021 9:01 am

I BARELY made it through 8 rounds of FOLFOX.

I don’t know that I could have done another.

I still have lingering neuropathy in my hands and feet which has been helped by acupuncture.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

saltygirl
Posts: 26
Joined: Sun Feb 07, 2021 4:46 pm
Facebook Username: Salty.girl

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby saltygirl » Sun Jun 06, 2021 2:24 pm

Taking extra week off is no big deal. I wouldn’t stop treatment for longer than that. I agree that she will not start feeling overall better until few months after she completed treatment. I would motivate her to complete her treatment ASAP.

Real Tar Heel
Posts: 1
Joined: Tue Feb 18, 2020 8:19 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby Real Tar Heel » Thu Jun 10, 2021 2:37 pm

I handled FOLFOX pretty well but a scheduling mishap caused me to miss a week. Now that I look back I wonder if that was a negative? Did that give the cancers time to mutate to protect themselves?
I didn't finish the Oxy but finished the 5FU. Had a recurrence within months, so the FOLFOX had probably already stopped working.
Colonoscopy discovered 1.4 cm tumor/MSS/KRAS mutation - April 2019
pT2N0
Lap resection April 2019
Oops! CT scan, 1.3 CM Liver Met discovered - May 2019
CEA 1.5
Stage IVa Oligometastatic
RFA on Liver - August 2019
FOLFOX 12- September 2019
missed a month! - November 2019
Oxaliplatin dropped Feb 2020
Diagnosed w/ diabetes, steroid possible culprit
CT scan shows nothing April 2020
Blood test for diabetes (controlled) but CEA 4.1
July 2020 CEA 9.1

Nor Cal
Posts: 25
Joined: Sun Dec 06, 2020 8:18 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby Nor Cal » Thu Jun 10, 2021 3:57 pm

Short breaks are likely due to side effects, so if she can power through I'd definitely encourage that.
Dx June 2020, stage IV, w liver mets in both lobes. M, age 50. Right-sided colon tumor. BRAF mutation. CEA 120
July 2020 - July 2021 17 cycles chemo (FOLFOXIRI x9, FOLFIRI x6, 5-FU x2)
December 2020 - February 2021 Radioembolization, Chemoembolization x2

Hooandtrue93
Posts: 11
Joined: Tue May 11, 2021 10:28 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby Hooandtrue93 » Mon Jul 05, 2021 2:46 pm

Thank you all so much for your input.

After her 5th cycle she spent that weekend in the hospital due to intense nausea, issues eating, high pule rate (117) and high blood pressure (169/90). She was severly dehydrated and her nausea was intense. Her x rays were clear/no obstruction noticed. They were able to hydrate her over the weekend and give her a new nausea medication which is working beautifully. She had slight dose reduction for her 6th cycle.

I believe she gets her scans done this week so we'll see. A lot of anxiety and im praying for the best but also preparing for the worst (been heavily researching clinical trials, methods such as radioablation and proton therapy, drugs like devimistat and Leronlimab), especially since her ctDNA was positive pre-chemo.
28 year old, son of 62 year old mom
Stage 3B Duodenal Adenocarcinoma.
7/13 lymph nodes positive
02/22/2021: Whipple Surgery
04/08/2021: Port Surgery. CtDNA test sample taken (positive)
04/13/2021: Folfox-6 begins for 6 months

Siti
Posts: 224
Joined: Thu Aug 01, 2019 10:58 am

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby Siti » Tue Jul 06, 2021 7:48 am

My husband had a break (he was hospitalised due to severe cramps and fever) and he also had a his dose lowered.

I wish your mom good results for the scan!
Wife of DH (54) DX on 5/7/19
Sigmoid | Adenocarcinoma | Grade: G3 | 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 7
6/11/19 CT Scan after 3rd cycle, all nodes have shrunk! Yay!! 20/12/19 Last round of Ox (NED)
1/2020 Maintenance: Cap + Avastin
4/2020 Maintenance: switch to Teysuno (S-1) + Avastin due to bad HFS side effects.

DanNH
Posts: 4
Joined: Mon Mar 29, 2021 5:25 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby DanNH » Tue Jul 06, 2021 12:07 pm

My wife had to switch to Folfiri during Infusion 5 due to a reaction to Oxaliplatin. She gets a bag of IV fluids from time to time at pump disconnect. The infusion office told her to come in for fluids even during the off chemo week if she felt dehydrated.
Caregiver to 61yoa wife, Stage 4 adenocarcinoma
Diagnosed Feb 2021. Mets Liver and Lungs
Needle Biopsy diffusely and strongly positive for CK20 and CDX2, and focally positive for CK7.
Chemo Folfox March 2021.
Vitamin C IV 50g and 45 min hyperbaric 02 weekly
Supplementation and modified Keto - low carb diet
Reaction to Oxaliplatin on 5th treatment.
Chemo FolFiri May 2021, 6th treatment
May 2021 Scan showed reduction to tumors, some lung tumors disappeared.

Hooandtrue93
Posts: 11
Joined: Tue May 11, 2021 10:28 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby Hooandtrue93 » Tue Jul 06, 2021 8:22 pm

DanNH wrote:My wife had to switch to Folfiri during Infusion 5 due to a reaction to Oxaliplatin. She gets a bag of IV fluids from time to time at pump disconnect. The infusion office told her to come in for fluids even during the off chemo week if she felt dehydrated.


Yeah they set it up now so my mom gets hydrated twice a week, even on weeks when she is off chemo.


Praying/keeping your wife and yourself in my thoughts (all of you reading this really).
28 year old, son of 62 year old mom
Stage 3B Duodenal Adenocarcinoma.
7/13 lymph nodes positive
02/22/2021: Whipple Surgery
04/08/2021: Port Surgery. CtDNA test sample taken (positive)
04/13/2021: Folfox-6 begins for 6 months

Hooandtrue93
Posts: 11
Joined: Tue May 11, 2021 10:28 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby Hooandtrue93 » Thu Jul 29, 2021 10:01 am

An update: my mom's ctdna cleared at the halfway point which is good (especially since her starting ctDNA was really high at 30.61 mtm/ml which is very much on the higher end post surgery). However she is going to finish the 6 months of adjuvant which I fully support.

Still nowhere out of the clear and ctdna can't pick up dormant cells that aren't growing and could grow in the future, only the irradication the micromets already growing. But I am going to celebrate this day. It's a much needed win and gives us some room to work with down the line.
28 year old, son of 62 year old mom
Stage 3B Duodenal Adenocarcinoma.
7/13 lymph nodes positive
02/22/2021: Whipple Surgery
04/08/2021: Port Surgery. CtDNA test sample taken (positive)
04/13/2021: Folfox-6 begins for 6 months

User avatar
beach sunrise
Posts: 500
Joined: Thu Mar 05, 2020 7:14 pm

Re: Has anyone taken a break from chemo in between their adjuvant chemo?

Postby beach sunrise » Thu Jul 29, 2021 10:55 pm

Very good news!
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"


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