Bill

//////////// B : The " increased opacity within the right lower lung field " can appear on CXR as a result of various conditions such as infection, inflammation and fluid accumulation. Good luck. B

////////////// R : Can't hurt to try but IMO the Celebrex is most likely only providing a modest anti-inflammatory effect at tumor sites vs. actual tumor shrinkage. This anti-inflammatory effect would result in some apparent additional tumor shrinkage being visualized on scans ( vs. Tarceva alone ). The higher dosage requirement suggests this, as well. Good luck. B

//////////// Kelly : Oxycontin is a proprietary name for sustain-released oxycodone. Your mother must be taking both the sustain-released plus the immediate-release ( oxy IR ) for breakthrough pain with the sustained-release formulation labeled as Oxycontin and the immediate-release formulation labeled as oxycodone. If this is not the case, you need to clarify this with the prescribing doctor(s) in order to check for possible double dosing. Bill

/////////// Agree ... Alimta is much more toxic than initially promoted. IMO if anyone receiving Alimta were to develop severe and persistent fatigue with SOB I'd urge you to get a CXR ASAP in order to R/O fibrosing alveolitis. B

Laurie : Sounds typical. All of the schedule 2 opiates, in therapeutic doses, cause a wide variety of mental and physical adverse effects. One suggestion is if this becomes a big problem ask the prescribing doc to try another comparably dosed schedule 2 opiate. For instance, oxycodone or morphine. Even though they all have the potential to cause the same or similar adverse effects many patients who switch around discover that they tolerate one opiate better than the others. Bill

Amanda : My wife experienced a severe adverse reaction after receiving one round of Alimta. She was cheerful, active, walking, talking, cooking, etc. for the first two days following the tx. Then on the evening of the third day she experienced a sudden onset of extreme fatigue and extreme SOB. The cause was determined to be a diffuse alveolitis that was unresponsive to tx with massive doses of corticosteroids and ( prophylactic ) antibiotics. About 50% of the previously healthy tissue in her left lung was irreversibly damaged and appeared " whited-out " / opaque on CXR and CT scan. Previously healthy tissue remaining in her right lung was completely " whited-out ". I have no regrets about her receiving Alimta but had I known about the potential for this adverse reaction I would have asked the med onc to reserve Alimta for last chance salvage tx as there were still a couple of more established chemo tx drugs for NSCLC that hadn't been tried yet. In fact, the immediate tx plan at that time was to try Alimta and Taxotere in no particular order. At the last minute the med onc decided to go with Alimta first. Good luck. Bill

Betty, It sounds like you may have radiation recall. My sister-in-law Etsuko had spine radiation in addition to the same chemo drugs that you mention. My brother Bill ( Etsuko's husband ) tried Aquaphor but it did not help. Bill ended up preparing a Lidex based cream compound that he applied 3 times daily to the inflammed area that gave Etsuko some temporary relief. Hopefully your burn area will clear up but if its radiation recall the inflammed area may stay that way for a long time. The chemo drugs in your system will keep inflamming the radiated area. Etsuko's burn area never cleared up. Gemzar is one of the worst chemo drugs in causing radiation recall. Carol ESC 7/28/47 - 6/19/06

Adela, Thanks for the thought. I will tell Bill. He has always kept pretty much to himself and submerged himself in work up until Etsuko's cancer diagnosis when it all came to a screeching halt. He is a clinical pharmacist and eventually will return to work but he is in no hurry to step back into a medical setting after over 2 years of medical chaos and tragedy. Etsuko's down hill slide the last month of her life was heart breaking to all of us. Carol ESC 7/28/47 - 6/19/06

Pretty harsh and quick krecovery that you expect. My brother not only witnessed his beloved wife pass on June 19 but he signed the morphine drip directive that ended her life. A true double whammy that he must deal with. Carol

Several states are conducting pilot programs whereby unused drugs and medical supplies, that meet certain packaging requirements, can be donated and redispensed to indigent patients. In some cases the program specifically targets cancer patients ( see KY & NE cancer drug repository program ). BTW, at least in California, it is no longer flatly illegal for a pharmacy that's dispensed an RX to take it back. The pharmacy, at it's discretion, can take back an RX but isn't required to do so. B

Before you reveal your identity to any of these PAPs I'd urge you to review your income, assets and available medical coverage. Then, review the eligibility requirements for the relevant pharmaceutical companies. Some companies have very generous eligibility requirements but some companies want extensive personal financial info and have strict limitations. Most, if not all, will want a copy of your most recent Fed tax return. Also, some companies are starting to charge a mandatory co-pay on participating drugs. B

IMO, it's best to avoid on-line pharmacies that don't require a valid RX. This is particularly important when purchasing scheduled drugs. Also, stay out of Mexico. Major U.S. drug chains are safe as are most independent pharmacies. FDA oversight, unannounced state inspections and threat of civil / criminal liability keeps them honest. There are several on-line sites for drug identification. If you receive an unfamiliar drug, proprietary or generic, that is of concern you can always ask the pharmacist to show you the stock bottle and / or provide related information. A good example of a widely used generic line with a shady sounding name is Dr. Reddy's, but they're big and legit. http://www.drreddys.com/ JMO B

Grace, Most definitely and in this case you can color it GREEN !!!!!!! Carol

Randy , TY for the advice. My brother Bill is going through a difficult period right now but he is strong and will recover. Some of you that have been through this know that these tragedies can be made worse and complicated when unfortunate issues can surafce and more vulture$ than angel$ circle overhead. Carol ( Bill's sister )

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