Question on Chemo: How often? At Mayo or locally administered?

Hi, I also was diagnosed with Stage 1b pancreatic cancer, following a distal pancreatectomy on July 29. I am on a modified Folferinox treatment every 2 weeks for 6 months. I have had 2 out of 12 treatments so far. My oncologist told me that, for my situation, the treatment plan was standard. I hope this is a little helpful.

A treatment cycle can vary based on the chemo regimen being used. Folfirinox is a two week cycle where on day one you get three components and go home with a portable pump for infusion of 5-FU over 46 hours. Cycle 2 begins on the 15th after the prior cycle.

Gemzar + Abraxane may be a where you receive the drug every 7th day for three weeks and the fourth week is a rest period before it repeats.

Speak with your oncologist about doing the treatment at a local facility. One word of caution- make sure the clinic you have in mind has experience in treating pancreatic cancer patients. Someone I was mentoring insisted on being treated locally. She was not tolerating the chemo well, the clinic administering the chemo did not do any dose reductions and issues arose. Upon investigation it was learned that with pancreatic cancer being rare compared to the others, no one had experience treating with Folfirinox. The patient eventually went back to the original medical center where the surgery was performed for all future treatments.

During my treatments that started with Gemzar and then was switched to Folfirinox, I chose to be treated at the medical center where I had my Whipple surgery. It had a pancreas program and treated a higher volume of pancreas patients so I was more comfortable knowing there was a higher level of expertise. It required a round trip train/subway commute of 4.5 hours but I didn’t mind it. I was used to doing that commute daily as I worked across the street from where the hospital clinic was located.

Hi @tomswife, a second opinion is not always necessary, especially if the medical condition is not complex and the treatment is standard. However, if you wish to get a second opinion, you should. Most physicians are not insulted when a patient asks for a referral for a second opinion. It affords them the benefit of consulting with an expanded team of experts. The goal is the patient and treatment outcomes.

@annebauer19 @chemobile @colorafo19 @terryabk @marvinjsturing may have persaonl experiences with getting second opinions to share with you.

You may be interested in these related discussions:
- How do I get a Second Opinion (cancer)? https://connect.mayoclinic.org/discussion/second-opinion-8/
– Getting a second opinion on treatment (for pancreatic cancer) from Mayo https://connect.mayoclinic.org/discussion/getting-a-second-opinion-on-treatment-from-mayo/

Sounds about right. Most important talk to your oncologist. But these are the standard treatments. I started with Folfirinox and the pump. I had to have my dosage adjusted because of side effects. I have had my second recurrence and just had a big dose of radiation. My cancer was in the tail of my pancreas

My husbands is also in the tail, metastasized to liver.
Was yours metastasized?

I am considering a second opinion. I was diagnosed Jan of 2020. I had surgery to remove the tail of my pancreas. Because I developed an infection I had to go back in the hospital for 5 days. Once I started to heal I had my port placed and started chemo. Fast Forward to last summer I had a recurrence so more chemo. This went on for a year. Finally stopped . Two months later my PET showed a second recurrence. I just had radiation yesterday (oct 13). I feel ok but very fatigued. I am also looking for clinical trials and so far none that I will qualify for.
I feel like there is something more to do. My biggest problem is if I go outside of my insurance I am going to have to pay. I have an HMO.

My husbands is also in the tail, metastasized to liver.
Was yours metastasized?

@cathyras, if you would like to inquire about a second opinion at Mayo Clinic, here's how to get started: http://mayocl.in/1mtmR63

You may also appreciate connecting with other members in this discussion about pancreatic clinic trials:
- Is anyone participating in a clinical trial for pancreatic cancer? https://connect.mayoclinic.org/discussion/clinical-trials-1/

My husbands is also in the tail, metastasized to liver.
Was yours metastasized?