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Question RE: Change In Symptoms While On Chemo


Bill

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I would appreciate any input on the topic of change(s) in symptoms while on chemo. In my case, I'm particularly interested in hearing about changes in LUNG / RESPIRATORY symptoms. Did key symptoms that were present prior to starting chemo get steadily better, get worse then better, get worse, get better then worse, no change, etc. during the course of chemotherapy ? If you can tie change(s) in symptoms with approximately how far into chemo ( i.e. how many cycles, etc. ) that would be of interest also.

Thanks much.

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Bill,

It's a little hard to determine. I had been short of breath (SOB) with exertion before diagnosis but then I had surgery to get a biopsy and do pleuradesis (sp?) to keep my lung inflated and that meant having a chest tube for a week in the hospital. After that, I was even more SOB. Gradually over time my SOB got better although during the point in each chemo cycle when I felt the worst with side effects, I would have increased SOB and then it would get better untill the next chemo treatment. I really, really tried to keep doing some physical activity (except on the worst chemo days) and I think that helped too.

Hope this makes some sense,

Jane

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My wife just completed her second cycle of chemo a week ago. The medical oncologist tells us that it's still too early to check progress with a Pet Scan, etc. Sounds like he wants at least 3 chemo cycles in before ordering such diagnostic tests. So, the oncologists ( medical and radiation ) are relying heavily on my wife's description and impression of her symptoms and how she feels for guidance. If you've been reading my posts you know that my wife's complaint of hip pain led to the testing and examination that revealed mets to her hips. There was no plan to check her hips. In fact, to the best of my knowledge, her hips were never even X-rayed prior to this. She has had two ( 2 ) known respiratory symptoms since before chemo began to the present. Periodically coughing up blood-tinged sputum and an involuntary gasp ( supposedly caused by the tumor hitting the diaphragm. There appears to have been a net improvement in these two symptoms with these two chemo cycles complete but I got to tell you it's not clear cut to me. Some days one or both of the the symptoms are bad enough that it makes you wonder if there is any net improvement at all and, instead, the symptom(s) are suddenly worsening. Next day these same symptoms may be much better. IMO monitoring symptoms as a guide is very difficult and confusing, especially when the oncologists are counting on an accurate description.

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Thanks for the replies but it looks as though my question may have been misunderstood. I assume that most of you had one or more respiratory-related symptoms BEFORE starting chemotherapy. I am interested in hearing whether or not you noticed an improvement, worsening, no change, etc. in those pre-treatment respiratory symptoms as the course of chemo progressed. I'm not asking about chemo side effects. At least in my wife's case the chemo side effects appear to be distinct and separate from her pre-treatment respiratory symptoms.

Thanks again for the replies.

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Hi Bill

My mom has copd and emphezema (sic), and i think im learning that they are one in the same. Anyway she quit smoking 5 yrs ago, had 5 bypass surgery 10/02 and after that time her breathing got horrible, since that time, she has been using duoneb every four hours, and believe me her life revolved around those 4 hours. she literally had to have the treatment in order to walk to her car.to do anything, and even then it was still bad, she had a horid pulmonary doc who has since been replaced (we see new doc tomorrow), she was never able to get in to see him even when in march she started coughing up blood she could not get in for 4 months. crazy. finally after 2 trips to ER and numerous doctor visits to GP and ENT doc, who all said allergies allergies allergies, she was dx with lung cancer. she was admiited to hospital on friday to wait till monday for tests to determine "spot". They immediatly started her on prednisone, and oxygen, and i will say within 5 -7 days she was forgetting her breathing treatments. Today 6 weeks later she does maybe 2 a day morning and night. She can walk thru the grocery store, walk to her car just about anything. she is finding out everyday she can do more and more as her breathing is great. well not great, but compared to where she was its great.Im not sure if its the chemo or the prednisone or a combination of both that has made it better. Her quality of life before was horrible, mom said many times she didnt want to continue living like this, there had to be something they could do for her breathing(back to not being able to get in to see doc) she was miserable, and like overnight she finds out she has cancer but her breathing changed dramatically. Dont know if I have helped you any at all, but figured i could related my experience with my mom and hopefully it weould be of some help to you. Also Mom has alot of sweeling in her left foot, from her heart surgery, and her foot has not been swollen since prednisone and also she takes coumadin/warifan and her blood has NEVER been right and since the start of prednisone if has not been wrong. Strange, i feel sure all these changes have to do with the steriod, but since chemo started 2 days after the prenisone started, which is doing what. Plus i have not heard of chemo doing these things.

God bless and let me know if i can be of help, i am research obsessed these days

Kim

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Hi -

I had no symptoms or breathing problems prior to diagnosis (cancer found by accident). After surgery I had a little breathing difficulty then it got better. I started chemo and radiaition and about three weeks into treatment I noticed breathing was worse. My lung has since collapsed 20% and I am having shortness of breath now (of course). But yes, once treatment started I did note difficulty breathing and shortness of breath, that I had not experienced before.

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Justakid

I started chemo and radiaition and about three weeks into treatment I noticed breathing was worse. My lung has since collapsed 20% and I am having shortness of breath now (of course). But yes, once treatment started I did note difficulty breathing and shortness of breath, that I had not experienced before.

/////////////////

My wife completed chemo cycle #2 about 10 days ago. She has had two (2) respiratory symptoms from the beginning ( blood-tinged sputum and involuntary gasp ). Gasp is net better and the sputum is net worse. IMO not very encouraging as I'm more concerned about the sputum. BTW, she has never complained of shortness of breath or difficulty breathing even though they seem to be common complaints.

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Bill

I recently developed the "involuntary gasp" that you speak of. I had never heard of it before. I think it might be the same thing. It's like a sound that comes out like babies make at the end of a cry? Is that what you mean? Anyway, I was told this might be an indication of worsening SOB. I see you were given a different explanation. Hmmm.

I sure wonder what it DOES mean.

I pray that your wife responds well to the treatment. The other thing I want to add is this:

Cancer by its very nature seems to give symptoms that are worse on some days and seemingly disappear on the next only to return again. I have had NO treatment, and I find that to be the case. So, some of what your wife is experiencing, may have little or nothing to do with whether or not the chemo is working.

love and fortitude

elaine

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Hello Bill, I think the reason for the confusion is that cancer symptoms and chemo side effects are so often indistinguishable. The classic example of this phenomenon is fatigue - it exists before chemo, but chemo makes it worse in most people. And anemia is only part of the cause. Similarly with shortness of breath and cough.

Health care providers only wish we knew why one day is good and the next day is bad. You will have to wait for the immediate chemo side effects to diminish before you can sort out whether the cancer symptoms have improved. And, of course, some chemo s/e last quite a while after the treatment is over.

In the end, only scans can tell whether the disease is improving with treatment. Symptoms are not a very good guide when someone is actively undergoing treatment. But I'm glad the docs are asking her about symptoms; symptom management is essential. Don't let them ignore her symptoms and side effects; they can be treated.

It sounds like your wife has a good advocate in you, and that is a blessing. Best wishes, Teresa

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Elaine

I recently developed the "involuntary gasp" that you speak of. I had never heard of it before. I think it might be the same thing. It's like a sound that comes out like babies make at the end of a cry? Is that what you mean? Anyway, I was told this might be an indication of worsening SOB. I see you were given a different explanation. Hmmm.

I sure wonder what it DOES mean.

///////////////

Elaine :

Your description is the same as my wife's. Her doctors told us that this gasp is caused when a lung tumor ( on the outer edge of the lung ) intermittently rubs against the diaphragm.

Best of luck to you.

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