Last chemo treatment put me in hospital

Rare to once again increase the Oxaliplatin. I'm surprised at this. Has there been any thought to eliminating it altogether and just staying with the 5FU? Or maybe the more typical switch to Folfiri... putting in the Irinotecan for the Oxaliplatin?

Gary

That will certainly be brought up before another treatment, Gary. You know a great deal more than I, I’ll mention your comments. Sure can’t stay a week in the hospital following ever treatment. Thanks for your reply

Zoom call starting in 1 minute (9am Eastern). Pop on if you'd like... here's the link...
https://us06web.zoom.us/j/4550284795?pwd=UjBHQ0J2V1pOc21SOExTR2N1UXNpQT09

I'm sorry to hear of the adverse events you experienced with the up titration of you oxaliplatin dosage. While, I'm not an oncologist I am trained in clinical pathology & laboratory medicine. Given the symptoms you've described, it would appear that you suffered an acute/chronic hypersensitivity reaction to your last up-titration of you oxaliplatin dosage.

This may occur within hours of the infusion and is characterized by an autoimmune-like or idiosyncratic immune-mediated hemolytic anemia and/or thrombocytopenia due to repeated oxaliplatin infusions. Patients may also experience episodes of hypotension and other cardiac symptoms that require suppotive care and rarely, episodes of chronic productive coughing. If you are thrombocytopenic and have reduced clotting capacity you may also experience episodes of hemoptysis (coughing up bloody sputum).

I've had a similar experiences requiring hospitalization while undergoing FOLFOX chemo for stage 4 ESCC. I assume that your oncologist and the other members of your treatment team were/are actively monitoring your CBCs for evidence of neutropenia, anemia and thrombocytopenia. As I'm sure you are aware, neutopenia (low neutophils) can markedly lower you resistance to infections and thrombocytopenia (low platelets) can render you more susceptible to bleeding. Higher doses of oxplatin may also be associated with increased cough. These oxaliplatin related side effects may explain your episode of hypotension and pulmonary issues of cough and hemoptysis. After the supportive care they've provided render you stable with regard to your blood pressure, neutrophil counts and restoration of exceptable platelet levels, they may switch you to a FOLFIRI chemo regimen.

In my experience, FOFIRI, a second line therapy for EC, is usually more tolerable than FOLFOX as regards development/worsening of peripheral neuropathy, neutropenia and thrombocytopenia. Thus far, it seems to be as effective as FOLFOX with respect to the maintenence of my sustained good clinical response and disease control.

I wish you well in your journey with our unwelcome fellow traveler.

I will discuss what you outlined in your detailed message which certainly seems to nail down exactly what I’ve been going through. I’ve stabilized in terms of vitals and once the chronic coughing ( with blood stained sputum) has subsided I should be discharged by Tuesday .

I have an oncology appointment Wednesday which was to be for Herceptin and Keytruda infusion but could become a bloodwork check and another consultation to discuss what occurred and what changes should be made to prevent future acute reactions. I will keep in mind your recommendations which I greatly appreciate.

Just want to thank you again, David for your seemingly spot on analysis of my experience. It has comforted me as the best the doctors could do is state that they believe the onset of my symptoms was likely due to the last treatment but didn’t explain with nearly the details you provided. Thank you again. It goes to show the value of such a fine patient forum as mayoclinic connect

Going home later today ( Tuesday. Oxygen saturation being low 80’s yesterday w/o supplemental oxygen, they say I need O2 to go home. On the O2 I’m low 90’s. This is upsetting to me but no choice. I was kept bedridden for 5 days which didn’t help. As I’m helpless as I am now if I am better in a few days but still need oxygen I won’t be able to work in my lab/ shop with the oxygen due to fire regulation- devastating. Before last Thursday my O2 was 96-97 and I could do anything physically. Now I feel like I’m in my Now deceased Mothers 88 yr old body.
However, I’m while the infection is cleared up, I still have fluid in both lungs, inflammation, and coughing up pink stained mucus, so when this clears up in time and with the steroids and oxygen assist, and increasing activity, the need for oxygen should hopefully diminish quickly ( I hope) this depends on whether there was permanent damage caused by this event. I did notice a 1-2% saturation improvement over the past 24 hours even with more congestion and coughing.
Time will tell.

Keep fighting friend. We are with you. You go where you look. Keep that positive outlook and it will come through for you. God's blessings.

First night back home with my shiny new oxygen tank. The portable unit my wife brought to the hospital for me to go home with ran out of battery 5 minutes before we got home( it’s an hour + to hospital and same back plus a pharmacy stop). I had to walk into the house w/o oxygen at that critical time, which caused some distress but the home unit was up and running immediately and was it was good to be home. First night was not uncomfortable just a few minor issues. Today I have a immunotherapy appointment and will discuss my chemo reaction and hospitalization, review the last PET scan and what mods will be made to prevent this from happening again.

I have no clue what your speaking capabilities are at this point... I've talked with hundreds of us EC patients... I know what it is to have diminished lung capacity at certain times. But who cares... pop on our Zoom calls and just listen in... both you and your wife. Much love...

Gary