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What's usually done here?


joanie55

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I've been through my first line chemo (Taxol & Carboplatin) and finished since November, 05. I've also been taking Avastin since the beginning.

As of my last MRI they saw growth on a large met on my sacrum and slight growth on a met on my spine.

I'm almost finished radiation to both spots.

Is the usual protocol to be put on chemo again. That's what my docs suggesting and I do trust him, but I just want to have all my questions ready for him next Friday.

They also have stopped the Avastin because of the new growths.

Besides this and some "not having anything to do with cancer stuff" I've had a fabulous 14 months. Need to have a lot more than that though. What to do?

Thanks much,

Joan

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I honesstly don't know. It stinks that you have this to face now, too. I love how positive you are about the last 14 months. Here's hoping the next 14 months will be good ones as well!

We have a Dr that we love and trust, too--Mom would follow him to the ends of the earth. At any rate, I'm sure some of the wise folks here on the board will chime in and give you some real info. They are just so good at that!

Prayers for finding a great plan to help you out.

:) Kelly

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Hi Joan,

I was originally on gemcitibyne and carboplatin with good results. However after 10 cycles the doctor took me off because my blood counts just were too often a problem. He put me on Alimta - which did not work, after 3 cycles. Next step was Taxotera. This apparently can be given 1x every 3 weeks with one week off or 1x each of 3 weeks than a week off. The advantage of the weekly infusion is no or little side effects.

Unfortunately, I was taken off for a few weeks to have radiation to my spine and radio surgery. I had the radio surgey Thursday, and I have 2 more days of radiation. So I go back on chemo the following Monday.

I have to say, except for a few aches due to spine mets, I have felt well. I think throughout my chemo I have only had a little nausea a few times. About the only problem I had at all was withdrawal from decadron back a year ago.

My doctor did also suggest Tarceva as an option for treatment, but I declined that. I just wasn't ready to have my face and head with the kind of sore and itching rash that most people develop. Since that discussion, I did also speak with his nurse and she encouraged me to think some more about it - suggesting they work to treat the symptoms. Anyway, I may try that if the Taxotera doesn't work. I'm truly hoping it does though!

Good luck. Let me know what you are given. (Avastin wasn't an option for me because I had brain mets.)

Mary

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Lucie started with Carboplatin/Taxotere, which was very effective. She had a period of months before the tumors grew again and she was put on a different chemo, Navelbine, which was also effective for a while.

I think your doctor is on the right track. It depends on the individual and the chemo. If you are still having growth, it is definitely a good idea to have more chemo. In Lucie's case, the onc thought something else should be tried. She is now back on Carboplatin and Taxol, with Avastin, and that is effective for her. Best to you. Don

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My doctor had mentioned a few different chemo's, but I find it really interesting that sometimes they go back to the original and sometimes not, depending on I have no idea. I did do well on the first round, so I don't know why he wouldn't do that again. Well, I'll see what he suggests next Friday.

Thanks so much for this valuable imput.

Joan

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Thanks John. I actually did discuss clinical trials with my doc. He said they open and close so fast that we have to see what's open when I go in next week and I guess make a quick decision. Oh boy!!

I will check out that site though. You never know whats available in other places.

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My wife's dx was because of pain in the sacrum. In fact the cancer had eaten a hole through the bone. The radiation by itself pretty much took care of the tumor and she didn't have anymore pain there and she could sit down at long last. The Chemo is just to mop up what's left circulating. Has the doctor done a CEA blood test. SOme doctors don't believe in it but it's good moral support if the count is low of decreasing. SHe tried Taxol and Carbo but was allergic to Taxol (system had built up a resistance from a prvious 1 time use) Now on Gemzar and Carbo.

Some clinical trials stay open for along while, i.e. Tarceva and Avastin trials are at multi centers in many states. Make sure you don't start Tarceva by itself because that would disqualify you. www.luncanceralliance.org had a good article about Clinical Trials in their Education Series last week.

Good Luck - Chuck

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Joanie, I have heard that oncologists will sometimes put people back on an earlier regime if they had not had it for a year or longer.

Typical second line chemos are:

1.alimta

2.taxotere

3.tarceva

4.gemzar

5.tarceva in combination with any of the others

6. avastin in combination with the above

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Tony had 8 cycles of taxol/carboplatin. (Taxol reactions usually respond to steroids and benedryl given before treatment and a very slow drip.) The reason that he was taken off of this treatment was due to the carbo reaction that can occur at about the 7-9th treatment. It was still working for his cancer, but Doc isn't sure if he could use a platin based drug at all because of the developed reaction. They put him on Taxotere/Gemzar for 12 cycles. It worked quite well. Beats the crap out of blood counts and he started needing procrit & neulasta around the fourth treatment. (It all becomes a blur.) He then developed a fluid retention reaction to long term use of Taxotere. He's been off the chemo since mid-May (for the first time since diagnosis). Doc figures to do another PET in August - Sept. and will probably restart chemo with Tarceva. I told him I wanted to up the odds of response to Tarceva by combining it with Celebrex, but that treatment approach is still in trials. (There are ways around that however.) There are still plenty of drugs around after first line treatment, so don't worry. We found that the second line really zapped the cancer. Just our experience, hope the info helps.

Best regards,

Welthy

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Gosh Joanie.....missed this somehow and I am sorry about that. I don't know how to answer your question, but I sure am hoping MSK comes up with a superb new plan of action for you. You've done well and we all sure hope to see that continue. Be sure to let us know what the plan is as soon as it is in place.

Love,

Kasey

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I'm sorry Joanie, I hope your onc has come up with a new plan of attack that you are both comfortable with.

Keith always followed his radiations with chemo, but only reverted back to a previously tried one when all other options were exhausted and after 2+ years had passed since being on it originally.

Have you asked your onc about Tarceva. I've been reading a bit lately that Tarceva seems to be having good results when following Avastin when the Avastin stops being effective.

I will keep you in my prayers

Carleen

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when my father had his recurrence they placed him on a different form of chemo. The recurrence was in the same spot so they could not radiate any further and the previous chemo they would not work since it returned in the same spot. They placed him on Altima and when that did not work, on Tarceva, which kept him stable until his death.

My thoughts and prayers are with you and your family.

God Bless.

Cathy

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Hi Joanie,

I am thinking of you and whatever choices you and your doc decide on, I will pray it works for you.

Keep a positive attitude and NEVER GIVE UP!!! You were a fighter from day 1... I just know whatever is decided it will work for you.

Maryanne :wink:

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