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Starting chemo tomorrow


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I went with my Dad to his appointment last week and talked about the treatment options with the doctor. There was very little choice actually - he has had the surgery to remove the right middle lobe of his lung where the tumor was located, so it's chemo or no chemo. He decided to go with the chemo.

They will be using Gencitabine (Gemzar) and Cisplatin (Platinol). The first day with the combo, following week with just gemzar, and 15 days off. (I think I've got that straight.)

I didn't think to ask the doctor at the time, but does anyone know why they choose the drugs that they do? Do they have certain chemo drugs for the different types of lung cancer or the stage you are in or your overall health and what they think you can handle....?

I am so nervous about this, with all of the possible side-effects and just the unknown. My Dad is also diabetic and wears an insulin pump full-time. I'm worried about any complications from this as well.

I still can't believe this is really happening. :cry:

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I don't have all the answers to your questions. I do think that overall health is a large factor in how aggressively they will treat a patient. The combo your Dad will be getting seems to be very aggressive. Looks like his Oncologist is all over this in a good way.

I hope he does great with his treatment. Make sure he stays on top of the anti-nausea meds and is well hydrated to help minimize the side-effects. A couple of B-6 vitamins a day may help to reduce any peripheral neuropathy. The first treatment is always the most frightening because of the "unknown" -- it will get better.

Warmest wishes for success!


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Hi Betts, Carboplatin/Cisplatin + gemzar seems to be a very common 1st line chemo....I asked Dr. West about this in the past. He said that he uses this for many of his patients. My mom is on the same cycle with Carboplatin/Gemzar and has been doing extremely well. She was a little tired the very first week, but has had an amazing amount of energy since then and is doing all kinds of activities she has been unable to do in months. I wish the best for your dad. Shelley

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Hi, Betty:

The oncologist must be confident that in spite of the diabetes your dad will be able to handle this chemo regimen with little difficulty. Another positive sign is that he's able to start chemo so soon after the two surgeries. Some apprehension before the first cycle is normal. Your dad probably feels it too, as I did, but we guys often mask those feelings. I may not have masked mine as well as I thought, since our 35-year-old son gave me a big hug before I left for my first taxol/carbo/avastin session last October -- sort of a surprise, since he's not normally the hugging type!

You or your dad should keep a chronology of treatments and side effects so you'll notice any patterns that may be developing. Some side effects may decrease with each cycle while others build up, and everyone reacts differently. Some are common and not particularly worrisome, while others (like neuropathy) need to be nipped in the bud fast. There may also be symptoms that seem to be a side effect, but which are actually a flare-up of a pre-existing condition that occurs because of the body's weakened immune system and reduced circulation during chemo. This all becomes a blur unless you have good records to refer to.

Keep us posted on how it's going. Best wishes and Aloha,


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Hi Betts, They couldn't get it all in surgery, or he just had small margins?

Are you going with Dad to chemo? If so, be sure to watch him carefully for any signs of allergic reaction like face flushing or problems breathing when they start the chemo drips. The nurses are supposed to watch, but sometimes they are distracted.

I had very fast and very bad reaction to Taxol product - stopped breathing almost immediately - but luckily nurse was right there and stopped drip, another nurse and two oncs came running and got me breathing again.

So just be aware that allergic reactions are possible and be on the look out for your Dad. Hope this helps. Barb

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Yes Ann, some very good advice and I am paying attention to all of it. There is a big difference between hearing it from people who have experienced it and just reading about it in a booklet.

Blaze, they did get all of the tumor out, but the lining around the lung and at least one lymph node was also affected so the chemo is to try to make sure they get anything that might be left behind. My brother will be with him tomorrow and I'll let him know to keep a close eye on things when they get started.

Thanks for the info on the neuropathy - that's something that diabetics have to worry about even without chemo. I'll also tell him to be sure to drink lots of water and keep a record of side effects and when they occur.

Ned, my Dad has been upbeat through this whole process. He just wants to get this started and over with and not have to deal with any more cancer, but I know he has to be worried. He's not really the hugging type either, but that has changed a little bit since this all happened.

Thanks again to everyone for your help!

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Hi Betts, I think this is very scary time for everyone.

He just has to get through the chemo safely to mop-up any left over cells floating around. I think I read that the stronger he stays during treatment, the better the expected outcome.

Did you find out what kind of lc he had? Have you read any of Dr. West's posts at www.onctalk.com

I know in some cases he is suggesting no or very limited followup treatment for certain BAC situations....

I got got the chemo and radiation because of 0.1 mm margins which looking back could have been overkill. Still here though 6.5 years out.

Prayers for good results. Barb :)

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Hi Barb,

What I read on the lab report about the tumor was that it was a well differentiated adenocarcinoma with papillary features and that it had invaded the visceral pleura. I'm not familiar with the term BAC...yet. And thank you for the link, I know I've checked it out before, but I've been reading so many things from so many sites that I can't remember what I read where!

The doctor described this as adjuvant chemotherapy, to do like you said, mop-up any left over cells floating around.

It was an all day process, but it went well. (I ended up going too - it was a family affair.) He was feeling fine until this morning and now the nausea is making an appearance. My mom said he took the medication the doctor prescribed to help with that and he's sleeping now. He's still in good spirits and thinking positive! And drinking lots of water.:)

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