Treatment plan ?

[poggie]

We met with the oncologists at the University of Chicago yesterday to discuss my mother in laws treatment options. She is has been diagnosed with Stage IIIB NSCLC. She has a tumor in her right lung and one small lymph node near her neck (she had a mastectomy on the same side in '89 and had a lot of lymph nodes ~mostly under her arm~ removed then. Since the needle biopsy of the node was possitive, she is no longer a canidate for surgery.

The doctors purposed several treatment plan options.

After hearing their presentation (some times it can sound like a sales pitch), she decided to go with a clinical trial that they are doing at U of C.

This trial includes chemo and radioation as well as a new medication called OSI-774.

The plan is that she will receive 7 weeks of radiation Mon-Fri. During this same time, she will take the OSI-774 pill for 49 days. She will also get 4 doses of Cisplatin on Mondays of weeks 1,2,5 and 6. She will be given 10 doses of Etoposide Chemo for 5 days in week 1 and week 5.

After this phase is done, she will start phase II. Phase II includes 3 doses of Docetaxel Chemo with 21 days inbetween each dose. At this time, she will also continue taking OSI-774 daily but the dose may be increased or decreased. After she finishes the last dose of chemo, she will be evaluated with another CT.

In addition to all of this, they will be giving her a salt water solution in her central line to prevent kidney problems from the cisplatin, Decadron and Zofran prior to Cisplatin to prevent nausea and Decadron prior to the Docetaxel.

As I'm sure that you can tell from this post, this is all new to us.

Now that I've typed this all out, it sounds like the first week (tenatively she should start Dec 15) is going to be HORRIBLE. She will be getting two chemo meds and radiation. They said that she will have a horrible sore throat from the radiation but she will have to keep swallowing and force herself to eat and stay hydrated. Not the way that we planned to spend Christmas for sure but we will get through this!

I guess, I'm looking for any advice/suggestions from others that have had any of this.

I almost forgot~~~OSI-774 is a medication similar to one already approved by the FDA but I forgot the name. It is supposed to stop cancer growth.

On a possitive note, she would not be a canidate for this trial if there was evidence that the cancer had spread to involve other organs in the body..

If you've made it this far, THANK YOU!

Mother in law ~~very active 71 year old non-smoker, breast cancer survivor in '89 (mastectomy but no chemo or radiation was needed)

[beckyg]

It does sound rough, but at least in my experience, it took a while for the radiation sore throat to begin. I am considerably younger than your mom, so that may have had something to do with it, but it still normally takes a while for the radiation to build up enough to start causing trouble.

Becky

[MO_Sugar]

I didn't start with throat pain for at least the first 3 weeks of radiation. After that it took 3 months before I could REALLY eat again but I made it through. Be sure she drinks LOTS of water and by that I mean at LEAST 2 liters a day. It helps alot!!!!!

God Bless and prayers will be said for a successful trial!

MO

[kimblanchard]

There are methods of preventing and/or lessening the radiation-induced esophagitis that your Oncology treatment team can provide for you.

******************************************************

You'll also want to meet with the Clinical Nutritionist working with your

Oncology treatment team ASAP to work out a diet that provides a balance of nutrients, calories and H20 to prevent the onset of catabolic wasting.

HTH

[john]

Ask about Ethyol (amofistine (sp?)). She may be restricted from being given this since she is going on a trial

Info on OSI-774. BTW OSI-774 is Tarceva. It makes it hard keeping track of thing when every drug has three or more names

It is like Iressa but I have read that it is stronger

http://www.pslgroup.com/dg/1e9fc6.htm

[mhutch1366]

Hi Poggie,

The treatment your motherinlaw is having, the first part, sounds much like the treatment I received. I am glad they thought ahead to premedicate for nausea. I would like to add:

Cisplatin is a very toxic drug. It can cause problems with hearing. After my first treatment I complained, and my oncologist prescribed pretreatment with Ethyol or amifosdine, to protect kidneys/inner-middle ear from damage. It did indeed reduce the damage to my hearing.

Second thing: There's a 'mouthwash' the doctor can prescribe for you, my doctor called it Mary's Magic Mouthwash, was great for sores in the mouth and the raw esophagus. Still, things will taste funny and it might be hard to swallow.

Lastly: Your mil may have trouble with acid stomach or reflux esophagitis. I was given prescription ( can't think of it now, by makers of nexium but now OTC) for a year, helped enormously with that.

PS. There is a medicine called megace which can be prescribed to stimulate appetite if eating gets to be a real problem.

And always, with the platinum chemos, drink lots and lots and lots of water. At least a couple liters a day if you can. I got used to it, liked it RT because if it was always cold I got chilled.

And ... just FYI, I had only cisplatin/etoposide, and when they removed the tumor over three years ago (13# all told) it was all DEAD. It was a pancoast tumor, which describes growth I think, not type, it was NSCLC.

Good luck and God bless,

MaryAnn

[Cary]

I think there have been others here that have used aloe vera, I know my father used it for his radiation he received to his Mediastinum. It's a antioxidant though, so I would check with your rad onc first, just to make sure it is safe to use.

Cary

Aloe vera as a powerful antioxidant

Antioxidants are essential for a healthy metabolism and to protect against free radicals. These form when a molecule loses an electron as a result of the normal metabolism which occurs as food and oxygen are turned into energy. Large numbers of these highly-charged molecular fragments can weaken the immune system which fights infection and resists degenerative changes.

Triggers include growing older, viral infections, high intakes of animal fat and or alcohol, stress, smoking, pollution and other toxins. Effects include ageing, wrinkled skin and an increased risk of arthritis, cancer and infections.

Aloe vera contains powerful naturally occurring antioxidants in the form of vitamins B complex, C and E, plus beta-carotene which is converted by the body into vitamin A. Dietary nutrients in Aloe vera also include potassium, calcium, magnesium, zinc, manganese, chromium and sodium and all are essential for maintaining a healthy metabolism.

ALOE VERA SCREENS OUT RADIATION

Aloe Vera gel protects against skin damage from X rays, according to researchers at Hoshi University in Japan publishing in the journal Yakugaku Zasshi. They found that aloe was an extremely effective antioxidant, mopping up the free radicals caused by radiation, and that it protected two of the body's healing substances, superoxide dismutase (an antioxidant enzyme) and glutathione (an amino acid which stimulates the immune system)

[john]

I don't know about aloe vera, but Drs do prescribe synthetic anti-oxidants such as ethyol and there is another one messa?

This is made by Medimmune and I am sure it costs a pretty penny.

Not sure why?

[MO_Sugar]

Ethyol is the ONLY drug I took during chemo or radiation that made me sicker than a dog, lol. We tried it twice and I threw up with in 1/2 hour of each shot and continued to throw up all day. Needless to say, twice was enough on THAT one, lol. Now another lady geting treated at the same time had NO problems at all so it can certainly affect everyone different. Mr. Dr. did have me stop all anti oxidants during treatment so be sure to speak with yours on what they recommend.

God Bless,

MO

[beckyg]

I wasn't offered Ethyol and was too new at this game to know about it myself. Now, suffering as I have from severe radiation pneumonitis, I wish it had been something I at least tried--it might have made me sick, but it might have protected my lung some. I would advise anyone doing concurrent chemo and chest radiation to at least ask about it--not being able to breathe is by far the worst part of my cancer experience.

Becky

[karen335]

I was given Ethyol twice and like MO, made me sick. My gums bled, I thought my head was going to explode, light headed and very disoriented. It was awful. I told my onc and she took me off of it. It apparently works for some but not for me. It is used mostly for people getting radiation for the head and neck. It is a fairly new drug. I didn't know it was a synthetic or an antioxident. Good luck to anyone using it.

God Bless

Karen

[awpoint]

Our Radiation Oncologist insisted on Aloe vera during treatment. I guess each Dr has a different idea.

I put some in a very small bottle that would fit in shirt pocket and husband took a swig immediately before and after treatment.

He also took at least 4 drinks a day.

You do have to look around to find one that tastes decent.

Anne

[Tami]

Wow! This board really is a wealth of information.

I had chemo and radiation together it was yucky. I was so tired. I was also getting a mix of two cocktails for my chemo. One of them being Cisplatin. i didn't know it could cause hearing problems.... It's been over a year since my chemo and over that time I've developed a hearing problem in my right ear. It feels like my ear is always plugged, my PCP told me it is problably due to a middle ear infection (eustation tube could be blocked) but I just can't hear very well in that ear. I wonder.....

It took a while for my throat to get raw. even then it wasn't sore as much as swollen so much I couldn't seem to swallow. but it took several weeks for that to happen and they gave me several meds to help. Staying hydrated helped-for two weeks the only things I could eat were popcicles. It sure felt good!!! I sort of felt like I was in that old Rudolf the rednosed reindeer cartoon. Remember when mrs. Santa keeps telling Santa to "eat" "eaaaat!" "EAT!!!!" well that's what the docs kept telling me. Hang in there!