Cisplatin & Pemetrexate OR Carboplatin & Alimta - Keytruda

Pemetrexed is the generic name for Alimta. It works by preventing the cancer cells from being able to heal themselves. Patients using it require folic acid and vitamin B12 shots.

The overall survival difference between Cisplatin and carboplatin is something like 2-3 weeks. Cisplatin being the winner there. However, Cisplatin is far more toxic than carboplatin and often a patient is switched to carbo for that reason.

I had Cisplatin. If you decide to go that route I recommend having hearing tested first as Cisplatin can cause hearing loss. Neuropathy is another side effect you would want to watch with either but Cisplatin may be the worst and seems to be the reason most patients are switched.I did not know what neuropathy was so I did not report it. Almost 14 years later I still have some in my feet. When they get cold, I feel like I'm standing on a piece of ice. Some lose the ability to feel anything in heir feet and require canes or wheelchairs. This can happen with either drug, Cisplatin being the more difficult of the two.

oh wow, thanks for the info. I do remember the Doctor who recommended the cisplatin therapy telling me hearing loss and possible need for IV antibiotics in the hospital for infections. He didn't say anything about feet because I surely would have told him I have Raynauds and asked if having Raynauds would make it more possible or vice versa.

When you say 2-3 weeks survival, are you talking like if we have months to live? Guess I am not getting this 'survival rate' thing as it seems like over half die before 5 year mark.

Saw pulmo yesterday for fluid on lungs followup. Gasping for breath just talking but oxygen was 99. He put me on Trelegy and agreed I was too weak to have a port put in. Sure, I smoked but NEVER needed any kind of inhaler before. Hope this goes away. Seems like my surgeon is a huge liar saying I would be back to normal and everything was fine. (If I don't look good, he doesn't look good, I guess...). Pulmonologist said I may never get better. like what?? I did all this for nothing. I'm too weak for chemo/port and totally disabled now. Day before lobectomy I had been workign 16 hr days doing hard labor non-stop. Would have rather lived 4 months eating/drinking/swimming than 3 months dying on a couch unable to breathe or even eat and sitting in clothes covered in body fluids and animal feces. and haven't even felt like having a box of wine or fifith of whiskey for a temporary escape. I don't trust any of them now. thanks for the info.

@julie67, I'm sorry to hear about your troubles. We've all been there. Chemotherapy of any type definitely takes a lot out of you, and it's important to rest while your body is recovering. Most people take months or years to recover. Show yourself some grace, as they say here in the South.

None of us are oncologists on this site, at least not that I know of. The best we can offer are our experiences and the experiences of others. It doesn't mean you will have the same experiences. As our doctors always tell us, "Every body is different."

The important thing is to know what type of lung cancer you have. The specific type determines the treatment. I had Carboplatin and Alimta simultaneously with radiation after my robotic surgery, and the primary side effect was tiredness. I received Vitamin B-12 shots before and after and took Folic Acid during chemo. That was over six years ago. I have the EGFR Exon 19 mutation, so I'm not a candidate for Keytruda and can't talk about what it's like to be on that.

Other things can cause shortness of breath. For me it was an undiagnosed heart condition. The cardiologist put me on lasix and within a couple weeks I was breathing much easier.

You have a better understanding than you know. When I mention that it increased survival by 2-3 week that meant that the average patient on Cisplatin lived 2-3 weeks longer than the average patient on carboplatin.

I send hope your breathing issues are swiftly resolved.

thanks, I am not sure I'm gonna live through this now. I was at Urgent Care AGAIN yesterday--2 sundays in a row. Well, I kept feeling this 'thing' in one of my sutures on my back. I can't see it by using a mirror. Yesterday mornign I felt it and thought 'that's not a scab like i thought since all the others are healed.' so i pulled on it. It felt like a STITCH left in! So then I freaked, googled it ..saw it can cause more scarring etc like that matters now lol..so I went to our OTHER hospital's urgent care....thinnk i am done w/ deaconess now!..and the NP wasn't sure WHAT it was! She said could be a subcutaneious stitch that didn't dissolve or tissue...ugh...so she just cut it off and gave me antibiotic creme since she said it is red and inflamed. Well, now i am freaking out. I thought all my sutures were glued. I went to surgoen last week to get the one stitch out of chest tube cut and another one out of my back so I did have at least one in my back. How do i find out what this is??? I don't ever want to see the surgeon again so i don't know how they find out if a stitch that was supposed to be removed is under there causing that lump and redness or what? i am so sorry guys. I am here alone and already crying before 6 am again. Holidays and i can't even get out of here. Watching the animal feces pile up. losing weight i see from no appetite. i don't think i am gonna live thru this
'

thank you for that. The more I hear from you guys, the more I think this whole thing for me is soooo screwed up. So no, my biomarkers haven't come back yet as someone just asked so how can both oncologists be recommending keytruda and already asking for approval from my insurance since they do not have those tests back?! i have now lost faith in the only 2 hospital systems we have here.

months or years to recover. hmm.. i don't see the point for me then. 4 weeks and i;ve already lost so much from just the lobecctomy. i mean thousands of dollars of damages because i can't do anything. lost the entire month of august.

so 6 yrs for you! how long were you tired? I don't even know how to ask the questions. i mean, like months or yrs after chemo stopped? are you in remission...not sure i even know what that is. thanks for the help. i do appreciate it. it makes me think of what questions are in my head and stuff i haven't thought of yet. julei

@julie67, there are different stages of recovery. I was only noticeably tired for 2 days after the first round of chemo and 3-4 days after the fourth round.

Two months after chemo, I still felt a little slow and stiff, but I wouldn't have even thought it was chemo-related until a physical therapist told me she could tell I'd had chemo because my soft tissue was a bit "crunchy." Her first thought was that I had a poor diet. Once she learned I was following the Mediterranean diet with plenty of fruits and veggies and that I was drinking enough water, chemo was her only thought.

Yes, I'm currently in remission and have been for most of the last six years -- except when I wasn't! Honestly, I don't think about it. If or when the cancer shows up again, I'll deal with it at that time. Otherwise, life is too short to worry about things that haven't happened yet.

Was your PT related to cancer or chemo? Nobody has ever mentioned I might need PT! Nobody has told me anything except infection or hearing loss!

What is crunchy tissue and does it go away; what do they do about it? what problems does it cause? first hearing of this!!

Does remission mean the cancer is all killed (gone) or it has stopped spreading or what does this mean exactly? When you weren't in remission, do you get another round of chemo or what happens ? confused on remission except when you weren't 😉 I am mad because 2 of my doctors keep saying 'cured' to me for every treatment they propose.

thank you so much!

@julie67, I'm sad to hear that you are continuing to struggle with this list of things. You did the right thing by seeking care when any surgical site appears red and/or puffy. It's not unusual to have some complication, and I'm glad that you've received some antibiotic cream.
You are under a great deal of stress. The diagnosis and treatment are hard for anyone to deal with.
In my case, I was diagnosed stage IV right from the start. It was devastating, but I continued to work and powered through (likely in serious denial) for two years. When the reality finally set in, I was a puddle, not able to get through much of anything without crying. I needed help to get my mind back on track, to focus on looking forward, and looking ahead to the possibilities of brighter better days. It's not easy, but I knew that I couldn't continue to remain in that dark place. Please don't take this as a criticism, it's shared as a concern for your well-being and future happiness. Have you sought any help for your mental health in the past? A psychologist or psychiatrist that specializes in cancer care may be helpful now, do you agree?

Thanks Lisa, yes, in a very dark place. Yesterday I was well, i was making a plan. I have absolutely nobody now! The one friend I did have from 37 yrs ago even blocked me on FB when I told him I had cancer. Am going to my primary care in an hour for the back. I realize now it's what I was complaining about in the hospital as well after surgery--to the right of my spine where that stitch is. I can feel something under the skin.

Was going to tell him I need to talk to someone!! Not a coounselor right now but what to do! I am not sure I want chemo. I want to know the probability of what will happen....it goes to my brain, what happens? It goes to liver , what happens? Etc. I want to know what to expect w/ no chemo so I can plan accordingly. But I know he'll just tell me to go talk to the oncologist as that would be the only person who would know the probabilites, etc. So scrweed again.

Nurse navigator LOL called from Anthem this morn wanting to know if i needed anything! AGAIN.. lol told her it would be nice to have some kind of food if I felt like eating since I have no money--was using food pantries before surgery but can't stand in line now or lift and can't stand long to cook. Need something already cooked or microwavable. She gave me our Swirca again. Nope. Gave me Meals on Wheels. Nope, no help. I am officialy out of help from anyone. I am not gonna sit here and live my last months in this literal dump now ---even told the nurse navigator i had sh#t all over my feet. Did not care. I wish i had never had this surgery. I am wondering why so many had it...if their story is like mine that they would be 'cured' since it was only in the lung. Need to ask. It's bothering me. ok, off to my pribary which will be another joke and waste of time. Right now I just want this whatever out of my back. It hurst and it's all i can think about now. thank you again!!!