CA-19 numbers continuing downward

i find it interesting the way they are doing your treatments...my patient has them 3 weeks on then 1 week off... he's on abraxane/gemzar and gets a steroid before every dose...

Don’t know why the difference…. could be differences in patients. Female at 90# that lost 20# and anemic vs male at mush higher weight. Have to trust your oncologist to make these decisions.

that is sooo true. i hope things sort themselves out for you quickly... i know with my friend its been a rollercoaster and my hubby is SOOOO over it... its starting to affect HIS health as well... we need our home back lol...

Each chemo protocol varies in how it is administered. Of the two first-line treatments, Folfirinox which is prescribed to those whose physical health is good and the patient is less than 70 years old is a 14 day cycle with oxaliplatin, Leucovorin and Irinotecan administered in approximately 6 hours followed by getting a portable pump to infuse 5-Fluorouricil (5-FU) over 46 hours.

The other first line chemo is Gemzar/Abraxane (Gemcitabine plus nab-Paclitaxel). This is given to patients generally over age 70 or if younger and health is frail or significant co-morbidities that would impact treatment and patient health. Its cycle is 28 days with weeks 1,2 and 3 receiving the two drugs followed by a week as a resting cycle before it repeats.

Folfirinox is used in curative setting but when a patient may have difficulty in tolerating some of its components, the concentrations and frequency can be adjusted. This is known as metronomic dosing and more oncologists whose specialty is pancreatic cancer have familiarity with the metronomic dosing technique. Basically, less chemo is given but it is administered more frequently to achieve therapeutic benefit.

I wonder if @altc321 and I have the same oncologist. My Gem/Abrax/Cis is also every 2 weeks instead of the 3-out-of-4 cycles regimen. I'm thankful though to have one less 5-hour round trip every month!

There is something to the life/reproduction/death time of cell cycles in the way these regimens are structured, but I couldn't tell you exactly what it is. One of my PAs told me then when an interim blood test (10 days after chemo) showed drastically lower RBC counts, hemoglobin, etc... that there was a typical nadir of 10-11 days after chemo, and things recover a bit by day 14 and my regularly scheduled tests/infusions. That leads me to think the 3-of-4 schedule is designed to really beat things up before giving you a chance to recover.

But when I was discussing maintenance therapy options with a different PA/NP, they included reducing or eliminating the Abraxane and/or Cisplatin or both. I also asked about keeping the full dose of all drugs but getting infused every three weeks instead of every two, and their response was that all the data they had was based on biweekly cycles. So who knows...

My dad's mesothelioma was treated with immunotherapy drugs Opdivo and Yervoy with 3 weeks between one and 6 weeks between the other, but I have seen the same drugs used on different cancers with a totally different schedule.

CA-19 numbers are down to 59 this month...but his quality of life sucks...he's so weak he can barely walk and he's aged 20 yrs by his looks....they admitted him to hospital yesterday because he needs more care than i can give him atm due to his repeated falls AND considering while we were at his oncology appt yesterday i had literally just found out that i have ovarian cancer that has spread to my liver...so now the journey begins with me...i meet with a doc today to start the whole referral/trying to get medicaid/ etc process... so we'll see...i'll be honest, i'm scared...i posted on the ovarian cancer support group hoping for info... i know the more informed i am going in today maybe the faster i can make stuff happen