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What to expect from Gemcitibine chemo/radiation?

Pancreatic Cancer | Last Active: Jul 11, 2023 | Replies (18)
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@jk77

Hi, ken240. Sorry to ask you a q? that should be addressed to my onc., but so far I get very little time with him.

My cancer (diagnosis in Feb. 2023; chemo began 4-4-23) hasn't been staged bc there's still some ambiguity about the nodules on my lungs (i.e., are they metastatic?). I've finished six rounds of Folfirinox, will have at least another two, and will learn, probably next week, what comes next (radiation, or surgery, or radiation plus surgery).

I too have five bad days from Fol., with days 1 and 2 the worst and days 3, 4, and 5 gradually becoming tolerable. Do you know why there's a lag between infusion day and the really bad days? For me, the lag is always four days -- chemo on Tuesday, feel lousy on Sat. and Sun.

Thanks for taking the time to read this, and best wishes to you.

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Replies to "Hi, ken240. Sorry to ask you a q? that should be addressed to my onc., but..."
ken240 | @ken240 | Jul 6, 2023

Hi,
Hope you're doing ok. I will try to give you an answer to your question based on my experience, but it can be frustrating because everyone has different experiences. The thing that delays my bad days is the pre-meds that they give me before treatment. I get Zofran for nausea and Decadron (sp?), a powerful steroid that makes feel better than I actually am, until it wears off. These are the pre-meds that I presently get with the Gemzar Abraxane chemo. It was similar, but different brands, that I received with the Folferinox. This, I think, explains my delay of the bad days. Additionally, I have found side effects to be cumulative, where bad days might stretch out a little longer, the more treatments you get. I had dosage lessened to guard against that. I hope is helpful. Best wishes.

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markymarkfl | @markymarkfl | Jul 8, 2023

@jk77 ,
Are you counting Day 1 as the first infusion day, and then taking home a pump with 46 hours of 5FU (flurouracil) that you return on Day 3?

If so, your feeling lousy on Day 4 might just be the culmination of Day 1 pre-meds wearing off plus the 5FU, plus two nights of lousy sleep with that pump around your neck?

Also, dehydration is common with chemo, and makes one feel lousy. Maybe you could inquire about getting one more infusion on Day 3 before they disconnect your pump? It seems like a liter of saline (for hydration) plus some Palonsentron (Aloxi) might get you through the next two days. Aloxi is similar to Zofran, but remains active a good while longer. (I'm getting Aloxi instead of Zofran in my pre-meds now with the Gem/Brax/cis). I avoid the dexamethasone as much as possible because of its impact on my blood sugar and sleep quality.

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