Preparing For Chemo

[Leslie]

Hi all--

It looks like my dad is going to begin chemo on Friday. He was diagnosed with Ademocarcinoma Stage IIIB last week. The treatment plan is Taxol/Carboplaxin and Avastin---six three week cycles.

My question: What should we do to prepare him for his treatment? I have searched on the web and a few sites have mentioned the importance of going to the dentist ahead of time because of the risk of infection in the mouth. True? Several sites have also recommended fruit smoothies as a good way to get in calories with minimal digestive side-effects. Any thoughts on what he should eat/not eat the day of chemo and afterwards? Any other recommendations from folks who have already been down this road?

Additionally, we would like to understand how long this type of treatment usually takes to administer and the typical side effects?

Thanks in advance for your help.

Leslie

[wendyr]

Hi Leslie: Glad your Dad has a treatment plan in place. Maurice had carboplatin & paclitaxol last year as a first line treatment. About 3 days after chemo he felt very tired and achy. Never any nausea or vomitting. His hair started to come out after the 3rd treatment. Red blood counts were a problem which was taken care of with aranesp shots & he got shots of neupogen 24 hours after each chemo for white counts. He is presently on Avastin & Tarceva & if you haven't already been advised he should not take any any nsaids because of the risk of bleeding. Tylenol is ok for pain, but definitely no nsaids. His primary side effect of the Avastin has been severe joint, bone & body pain. He too was told to get his dental work done before starting on the Avastin, which he did (just one small cavity) Hope this info helps. Good Luck & God Bless

wendyr

[Don Wood]

My wife had the same chemo her last year and it was very effective. It will take a full day to administer the three chemos, plus nausea medicine and some other items that go with the package. We always took snacks with us and something to read (also they had a TV to watch) and I went out for lunch to bring back sandwiches. Fruit smoothies are a good thing -- easy to digest, very tasty and full of calories. Don

[raneyf]

I just finished this chemo and found it not too hard at all. I did have a bit of nausea and vomitting one treatment because my doctor didn't pre-med with Zofran. I also found that whatever I ate during the chemo treatment and later that day through when I went to bed would make me nauseous to think about or eat any time in the future. Even right now, if I think about one of those foods, it makes me feel sick. So, my advice would be to feed him stuff he won't miss during the day of treatment, at least the first time. He might not have the same problem, but just in case.

Also, the Avastin will get shorter each cycle until you get it in 30 minutes. This will shorten your days up eventually, but the first treatment will be a long day.

Have him wear comfortable clothes, and if he does not have a port, make sure he drinks a lot of water before he gets there and keeps his hands and arms warm. That will help with getting the iv started.

That's all I can think of for now. I was really scared of the chemo before I went, but it was nowhere near as bad as I thought in reality. Good Luck!

Raney

[recce101]

Hi, Leslie -- good question, good answers!

You've probably read my profile before, so I'll try not to repeat much of that or what others have said so well. For the Taxol/Carboplatin/Avastin combo my IV premeds were Benadryl, Aloxi, and Decadron. The day following chemo I went back for a Neulasta injection. This was my general pattern for all 6 of those cycles:

The Benadryl was toward the beginning of the all-day session, and it's the only thing that ever gave me any sort of effect during the infusion itself. Our head chemo nurse is a terrific gal (originally from Canada) who's been doing this kind of work for 20 years, and she's seen it all. My first day she said "Okay, Ned, this is the Benadryl -- you'll get drowsy and slur your words." I kind of shrugged it off, and she asked me some small-talk question that required an audible response, and we both cracked up. The rest of the room got a kick out of it, as they'd been newbies too not long ago. Some used the Benadryl as a prelude to a nice long nap, but I tried to shake it off as soon as possible so I could get to my reading or the portable DVD player that my son had surprised me with. Some drowsiness persisted through the rest of the day and evening.

The next day I always felt great and arrived back at the chemo clinic for my Neulasta injection in fine spirits. That evening the Decadron wore off as the Neulasta was taking effect and it was "good night" without question by 10pm. The third and fourth days were usually the worst for fatigue and muscle aches but ideal for some serious napping. Toward the end of the first week my energy level started to improve and the various weird side effects would make their presence known in a somewhat random manner. By the end of the third week I was feeling much better, but then it was time for the next fun day at the clinic.

I had been advised not to eat acid foods such as pineapple on infusion day since that added to some patients' nausea, but I found that restriction to be unnecessary. I never had the slightest tendency toward nausea, and I adopted the chemo patient's mantra "eat what you want when you want."

The chemo was continuous throughout the day, but we were free to move around within the general area. The IV pump gadgets are on rolling stands and have battery backup, so there is no problem unplugging from the wall and going to the restroom or walking over to chat with someone. I found the restroom trips to be rather frequent because there's lots of saline solution accompanying the drugs and, well, I'm at that age...

Some of the chemo clinics here have taken great care to make their infusion room a cheerful, pleasant place, and I hope yours is similar. Though I'm afraid you won't have our view -- corner suite, wrap-around windows, panoramic view of Central Oahu and the Waianae Mountains to the right, Pearl Harbor to the left. Aloha,

Ned

[fillise]

Hi Leslie,

Mo mom is on the Carbo/Taxol regime. She hasn't had any nausea. Ned's description sounds pretty much like her experience. Feels fine the day of and the day after and pretty tired and achy on days 3 & 4. Most of her aches, she thinks, come from the Neulasta shot the day after. Her hair started falling out two weeks after her first treatment and was pretty well all gone a few days later.

She will have her fourth treatment on Wednesday and overall the chemo hasn't been as bad as she expected. After her third treatment she had mild problems with mouth sores which seemed easily handled by avoiding acidic foods.

It is an all day process, so comfy cloths and reading material or a protable DVD or IPOD will he helpful. Mom tends to sleep after the Benadryl so she just sticks with taking a book or a couple of magazines.

Good luck to your Dad on Friday. Be sure to let us know how he does.

Susan

[Leslie]

Wendy, Don, Raney, Ned, and Susan--

Thank you so much for your excellent information. We get the results of the PET scan and brain MRI tomorrow--and if all goes well (a major if, I know...) chemo begins tomorrow.

Ned--I can't say that the view from UCLA will compare--but at least the weather will be nice...

I wish I wasn't here--but I am so happy to have found you.

Leslie

[Adrian]

just want to echo my sister's thanks to you all...

Les, a minor correction, chemo starts on Friday--you really are ready to get this party going!

luv, A

anyways, here's to hoping tomorrow's PET/CT results come back boring.

[ernrol]

Leslie,

I had about the same type of cancer as your dad. My treatment was similar. I had Tarceva instead of Avastin. I had heard so many negative things about chemo, that I was determined to make it a fun event. I planned for my first day of chemo. I went out and bought a DVD player and some funny movies. The day of my chemo I packed a nice lunch, took my DVD player and off I went. I also brought my own supply of water. I spent 4 ½ hours watching funny movies interrupted by a pleasant lunch. I had chemo once a week for 3 weeks then one week off. I had chemo for about 4 months and then went into remission. I continue the Tarceva to this day.

I can honestly say that I looked forward to every chemo session. Drinking plenty of water is a must with chemo. I tried to drink an 8oz glass of water for each hour that I am awake. I took some supplements, but don’t know for sure if they helped. I was able to maintain my weight with my diet. In fact I added a few pounds. I never got sick or lost my hair. If you have questions let me know.

Stay positive,

Ernie

[Judy-OK]

Hello Leslie and Adrian and my best to you dad. Sounds like he has the family behind him and that is worth more than mere wors can imply. I had the carbo/taxol but unlike enrol who said the benadryl knocked him out ... it wired me up BUT the liquid ativan they had in my chemo cocktail hit me with the slurred speech and not really caring what else was going on around me. Chemos of today or so much more "user friendly" than they were years ago and each one of us responds differently. The most important things is the intake of lots and lots of liquid ... water being the best thing for our bodies.. he must stay hydrated and my onoclogist told me to eat whatever appealed to me; hence, I manage to put on about 25 pounds. Let us know how his treatment goes.