Hi
I thought it might be interesting to tell you exactly what drugs they are going to use for this round of Chemotherapy and what side effects you need to watch out for with each drug. First though let me describe the room where you get the treatment. Imagine a big open room filled with about 50 leather chairs that resemble barber shop chairs. They recline and spin around like the old barber shop chairs did. Beside each stool there is a long metal pole that looks like a broom stick with hooks on the end of it, on a base with wheels. This pole is where they hang the bags of drugs from (For intravenous delivery) The bags have plastics tubes that attach directly to the port in your body. The pole is on wheels in case you need to get up and go to the bathroom or go see a doctor while they are giving you the treatment.
So these chairs are all lined up in rows, some facing each other, some facing a window but they are scattered all over. You go in and sit in your chair and the nurse brings over your drugs. Some of the drugs can be dumped into at the same time but some need to go in all by themselves. The port is set up to allow them to put 2 drugs in at once. Basically I will be sitting there for about 5-6 hours getting my drugs. Because the drugs are room temperature they feel very cold going into your body so they have warm blankets that you can use and they tell you to bring your own blanket or whatever will keep you warm. You also need to bring snacks and drinks because you will be there all day.
After they have all the drugs in you, they have to keep you there for an hour or so to watch you because one of the drugs I am taking requires that. There have been some instances where people have had a very bad reaction to it and they need to keep you under observation in case you need to go to the ER. Anyway, that is how it works. I will try and get a picture of the room next week when I start.
So here are the drugs they are going to give me and the side effects of each one. I will be getting the first 3 drugs for sure. The doctor is waiting to get the results of a test back before he decides between #4 OR #5. It will not be BOTH. I took Avastin during my first round of Chemo and I did not experience any of the bad symptoms..just nausea and general weakness.
1. CPT-11 (Irinotecan)-
a. Common side effects occurring in greater than 30% of the people who take it
§ Diarrhea; two types early and late forms.
§ Early diarrhea: Occurring within 24 hours of receiving drug, accompanied by symptoms runny nose, increased salivation, watery eyes, sweating, flushing, abdominal cramping. (This can occur while the drug is being administered. If so, alert your healthcare professional promptly. Medication can be given to stop and/or lessen this early side effect).
§ Late diarrhea: Occurring greater than 24 hours of receiving drug, usually peaks at about 11 days after treatment. Because of concerns of dehydration and electrolyte imbalances with diarrhea it is important to be in contact with health care professionals for monitoring, and for medication and diet modifications advice.
§ Nausea and vomiting.
§ Weakness.
§ Low white blood cell count. (This can put you at increased risk for infection)
§ Low red blood cell count (anemia).
§ Hair loss
§ Poor appetite
§ Fever
§ Weight Loss
b. Less common side effects occurring in about 10-29% of the people who take it
§ Constipation
§ Shortness of breath
§ Insomnia (see sleep problems)
§ Cough
§ Headache
§ Dehydration
§ Chills (see flu-like symptoms)
§ Skin rash (see skin reaction)
§ Flatulence (see abdominal pain)
§ Flushing of face during infusion
§ Mouth sores
§ Heartburn
§ Swelling of feet and ankles
2. Leucovorin
§ Allergic reaction: rash, itching, facial flushing. Rarely severe
§ Nausea and vomiting Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling of facial features, hives (possible allergic reaction).
3. 5-FU—Fluorouracil
a. Common side effects occurring in greater than 30% of the people who take it
§ Diarrhea.
§ Nausea and possible occasional vomiting.
§ Mouth sores.
§ Poor appetite.
§ Watery eyes, sensitivity to light (photophobia) (see eye problems).
§ Taste changes, metallic taste in mouth during infusion.
§ Discoloration along vein through which the medication is given.
§ Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
b. Less common side effects occurring in about 10-29% of the people who take it
§ Skin reactions: Dry, cracking, peeling skin. Darkening of the skin (hyperpigmentation), darkening of the skin where previous radiation treatment has been given (radiation recall).
§ Hair thinning.
§ Nail changes - discoloration, loss of nails (rare)(see skin reactions).
§ Hand -foot syndrome (Palmar-plantar erythrodysesthesia or PPE) -skin rash, swelling, redness, pain and/or peeling of the skin on the palms of hands and soles of feet. Usually mild, starting 5-6 weeks after start of treatment. May require reductions in the dose of the medication
4. Avastin—Bevacizumab
a. Common side effects occurring in greater than 30% of the people who take it
§ Generalized Weakness
§ Pain
§ Abdominal pain
§ Nausea & vomiting
§ Poor appetite
§ Constipation
§ Upper respiratory infection
§ Low white blood cell count. (This can put you at increased risk for infection.)
§ Proteinuria (see kidney problems)
§ Nose bleed (see bleeding problems)
§ Diarrhea
§ Hair loss
§ Mouth sores
§ Headache
b. Less common side effects occurring in about 10-29% of the people who take it
§ Shortness of breath
§ Dizziness
§ High blood pressure
§ Weight loss
§ Muscle aches and pains
c. These are rare but serious complications of Avastin therapy
§ Gastrointestinal perforation/ wound healing complications
§ Hemorrhage (severe bleeding)
§ Hypertensive crisis (severe high blood pressure)
§ Nephrotic Syndrome - a condition marked by very high levels of protein in the urine (proteinuria), low levels of protein in the blood, swelling, especially around the eyes, feet and hands. This syndrome is caused by damage to the glomeruli (tiny blood vessels in the kidney that filter waste and excess water from the blood and send them to the bladder as urine).
§ Congestive heart failure in patients who have received prior treatment with anthracycline based chemotherapy, or radiation therapy to the chest wall.
5. Erbitux
a. Common side effects occurring in greater than 30% of the people who take it
§ Rash (acne-like)
§ Generalized weakness, malaise
§ Fever
b. Less common side effects occurring in about 10-29% of the people who take it
§ Nausea and vomiting
§ Diarrhea
§ Constipation
§ Poor appetite
§ Headache
§ Abdominal pain
§ Nail disorder - inflammation of the skin surrounding a fingernail or toenail
§ Mouth sores
§ Swelling
§ Difficulty sleeping
§ Itching
§ Low red blood cell count (Anemia)
§ Cough
If you notice, nausea, diarrhea or constipation and generally feeling like crap in the stomach and bowels area, are the most common and likely problems. That is because we are trying to treat colon cancer (which has spread to the liver) so most of the target areas for the drugs they choose are fast growing cells in the digestive tract (from mouth to butt if you will). So it is logical to expect that this is the area where I could experience most of my side effects. And based on my experiences the first time, I expect to feel nauseous most of the time with bowel movement problems (either too many or too few) most of the time and generally feeling run down and crappy ALL the time. But its not anything I can't handle and I have things to help in all those areas so I will get through it.
So there you have it…this is the outlook for the next 6 months or so. If you want to learn more about these drugs and what they can do for you or TO you there are a lot of sites out there but one that I like is
www.chemorders.com. Just do a search for any of these drugs or for colon cancer in general and you will get a ton of information
Peace!
John
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