Questions reference drugs.

[snappy]

Again, not sure where to put my questions. Actually, I am wondering why I am asking questions but don't see too many others asking. Was I suppose to be reading something in particular to find these answers. Surely other people have questions. This has me a little puzzled.

I want to know what ablation technique or Chemo Ablation is.

Also, what is avastin. I see that mentioned quite a bit.

There is one other that looks more like something used later. Tarceva

I know I found a page that listed many chemo drugs but I am only asking about these because they keep getting mentioned in posts that I am reading. I have assumed that they are more 'regular' drugs that are used at different times.

Thanks again.

[RandyW]

ablation refers to Radiation ablation, This is a link to answer all your questions about this subject. It is rather lond and pretty basic in terminology, not a lot of scientific mumbo jumbo... Click on Link to be redirected;

http://www.radiologyinfo.org/en/info.cf ... ung&bhcp=1

Chemotherapy ablation is when Chemo is added to radiation for treatment purposes. Standard Radiation ablation plus Chemo is Chemo ablation basically.

tarceva is a Type of Chemo that is taken orally at home. This is maintenance chemo that is used usually when other chemos have not worked. The Chemo drug iressa was a predecessor to Tarceva. However iressa failed for many and was only found to give the BEST RESULTS in oriental women who smoked. Tarceva has a great success rate for a period of time and that is what we fight for is Time......

Hugs and Prayers Randy

[Connie B]

Chemotherapy Drugs

Avastin ®

Avastin®

Generic name: Bevacizumab

Chemocare.com uses generic names in all descriptions of drugs. Avastin is the trade name for Bevacizumab. In some cases, health care professionals may use the trade name Avastin when referring to the generic drug name Bevacizumab.

Drug type: Avastin is classified as a "monoclonal antibody" and "anti-angiogenesis" drug. (For more detail, see "How this drug works" section below.)

What Avastin is used for:

Treatment of metastatic colon or rectal cancer, used as part of a combination chemotherapy regimen.

Treatment for non-squamous, non-small cell lung cancer as part of a combination chemotherapy regimen.

Note: If avastin has been approved for one use, physicians may elect to use avastin for other problems if they believe it may be helpful.

How Avastin is given:

Avastin is given through an infusion into a vein (intravenous, IV). The first dose is given over 90 minutes. The infusion time can eventually be shortened to 30 minutes if well-tolerated.

The amount of avastin that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side effects of Avastin:

Important things to remember about the side effects of avastin:

Most people do not experience all of the side effects listed.

Side effects are often predictable in terms of their onset and duration.

Side effects are almost always reversible and will go away after treatment is complete.

There are many options to help minimize or prevent side effects.

There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

There is no data as to the frequency of adverse reactions that may be attributed to avastin alone. (In clinical studies avastin was used in combination with other chemotherapy medications).

The following side effects are common (occurring in greater than 30%) for patients taking avastin:

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

These side effects are less common side effects (occurring in about 10-29%) of patients receiving avastin:

Shortness of breath

Dizziness

High blood pressure

Weight loss

Muscle aches and pains

These are rare but serious complications of avastin therapy.

Gastrointestinal perforation/ fistula formation/ 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.

Delayed effects:

Based on animal studies, avastin may disrupt normal menstrual cycles and impair fertility by several effects. Some parameters do not recover completely, or recover very slowly following discontinuation of the drug.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

Fever of 100.5º F (38º C) or higher, chills (possible signs of infection)

Severe bleeding

Shortness of breath, difficulty breathing

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

Swelling of the feet or ankles. Sudden weight gain.

Abdominal pain

Nausea (interferes with ability to eat and unrelieved with prescribed medication).

Vomiting (vomiting more than 4-5 times in a 24 hour period).

Diarrhea (4-6 episodes in a 24-hour period).

Constipation unrelieved by laxative use.

Coughing up blood.

Black or tarry stools, or blood in your stools.

Blood in the urine.

Mouth sores (painful redness, swelling or ulcers).

Swelling, redness and/or pain in one leg or arm and not the other.

Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.

Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decreased amount of urine, or dizziness.

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

Before starting avastin treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.

Do not receive any kind of immunization or vaccination without your doctor's approval while taking avastin .

Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).

For both men and women: Do not conceive a child (get pregnant) while taking avastin . Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

Do not breast feed while taking avastin.

Self-care tips:

Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.

This medication causes little nausea. But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.

Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by avastin.

Wash your hands often.

You may be at risk of infection report fever or any other signs of infection immediately to your health care provider.

To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.

Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.

Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.

In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.

Get plenty of rest.

Maintain good nutrition.

If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

You will be checked regularly by your health care professional while you are taking avastin, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How Avastin works:

Monoclonal antibodies are a relatively new type of "targeted" cancer therapy. Antibodies are part of the immune system. Normally, the body creates antibodies in response to an antigen (such as a protein in a germ) entering the body. The antibodies attach to the antigen in order to mark it for destruction by the body's immune system. In the laboratory, scientists analyze specific antigens on the surface of cancer cells (target) to determine a protein to match the antigen. Then, using animal and human proteins, scientists work to create a special antibody that will attach to the target antigen. Antibodies will attach to matching antigens like a key fits a lock. This technology allows treatment to target specific cells, causing less toxicity to healthy cells. Monoclonal antibody therapy can be done only for cancers in which antigens (and the respective antibodies) have been identified.

Avastin works by interfering with the process of angiogenesis by targeting and inhibiting human vascular endothelial growth factor (VEGF). VEGF is a cytokine (a small protein released by cells that have specific effects on the behavior of cells) which when it interacts with its receptors in the cell leads to new blood vessel formation or angiogenesis.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

[john]

Tarceva is not really a chemo drug. It is a targeted therapy type of drug.

It targets a receptor called Epidermal growth factor.

It is one of the first fairly successful targeted therapies. Iressa was one of the first attempts at a targeted therapy and Tarceva was developed by another company after Iressa.

Tarceva seems to work better than Iressa.

Tarceva works best when a person's cancer has a certain type of genetic mutation. There is a test for this.

[snappy]

Thanks for the replies. I was just asking in general.

Connie; the reason I asked about the Avastin was because I saw where so many had it included in their chemo treatment.

I had read someone I sort of know was getting a chemo ablation and I wanted to know what that was because I know she is not doing well.

I kept reading about the Tarceva.

Thanks,

[cat127]

Snappy - your husband's history says that his biopsy showed squamous cell NSCLC? Well then I doubt he will ever receive Avastin, as it is labeled for use in only non-squamous cell form of lung cancer. The clinical trials showed an increase risk of bleeds that appeared more prominent in the squamous cell NSCLC patients (32% severe or fatal bleeds in squamous cell histology vs 2.3% when predonimant squamous cell histology was excluded). In fact, Avastin has a black box warning about fatal hemorrhage. My sister has mixed histology (adeno-squamous) and that also precluded her from being a candidate for Avastin. Just an FYI.

[Connie B]

"snappy"]Thanks for the replies. I was just asking in general.

Connie; the reason I asked about the Avastin was because I saw where so many had it included in their chemo treatment.

I had read someone I sort of know was getting a chemo ablation and I wanted to know what that was because I know she is not doing well.

I kept reading about the Tarceva.

Thanks,

I didn't question you as to why you asked about Avastin, I just shared the information with you because you asked about it. No need to explain yourself for asking. I was just giving you an answer to your question.

Although I DID ask why your husband was taking pain medication? And what kind of pain is he having?

[snappy]

Connie; You did ask about the pain med. I forgot.

It is Hydrocod/Apap 5/500 Tab. The night before last was the first time he used the medicine.

This whole cancer thing is very mindboggling to me. It has come on so quick and so much to learn that I am not surprised if I miss anything.

This pain med was prescribed by the Pulmonary Dr back in October. It was to have on hand. He just had pains that came and went. Still never used it until this week. He was dealing wtih the infection and the 4000 mg anti's and also questioning and checking on his heart back then. No one sure at that time just what the pains were.

Joe said the medicine really helped with the pain. He also said it didn't cause any drowsiness. I am interested in your comments about any of this. I am knew at this and we have no better than Joe & I doing this. Any guidance ix appreciated.

[Welthy]

Snappy,

Cat127 got to the Avastin answer first. My husband also could never have Avastin, even with Adeno, because he had bloody sputum when he would cough. The risk of bleeding was too high for him as well as for people with Squamous Cell.

Welthy

[john]

Radio Frequency Ablation zaps just the tumor. There are questions whether the margins are big enough using this technology.

There has to be enough margin around the tumor to ensure everything is treated or a recurrence will be likely.

RFA is good probably only for people with poor lung function who can not have a wedge resection or lobectomy.

Also during a lobectomy many lymph nodes are commonly removed. With RFA I am not sure if this can be done. Removing the lymph nodes I believe increases ones changes of keeping the cancer away.

[Adrian]

yes radio frequency ablation uses radio waves to heat up tumors and essentially burn them out from the inside. It's a local treatment---like radiation. If you have metastatic cancer, then RFA only makes sense if some particular tumor is causing pain or threatening to do damage (e.g. compromise the spine).

Avastin: As mentioned above, its not for people with squamous type. Its a recent non-chemo therapy which in the most simplistic terms, functions by blocking the formation of the blood vessels support tumor growth.

Others also mentioned Tarceva and have described it correctly. It has "third line approval' which means that its one of the few cancer therapies that the FDA has determined is a proven option to use after two prior lines of treatments have been tried and failed. For some people, Tarceva is the golden ticket and has given them profound tumor shrinkage and prolonged periods of progression free survival (e.g. periods of time where the cancer is not getting any worse). As noted by Randy, women, with adeno type cancer who are of Asian descent and have never smoked (i.e. less than 100 cigarettes in a lifetime) are the sub-group most likely to have the most dramatic results with Tarceva. But there are some non-smoking asian women who get no results from Tarceva and some people who don't fit under that classification who have benfitted quite a bit: including squamous type sufferers.

I'd alos like to point you over to www.onctalk.com where you can learn everything you could realistically want to know and interface with a set of doctorsd who can answer any questions you might have (spearheaded by the incredible Dr. West.)