Abraxane gemzar at age 82

Oh I am so sorry to hear this . My husband advanced to this same position after a year of treatment -everything they offered but it was not meant to be . They offered more after the metastases but thinking thru the offer he decided no . He was 79 . It’s a tough decision , not made lightly but ultimately it is your decision. Gather those you love for a big hug and listen and hopefully they listen to you .

Gemcitabine plus Abraxane can sometimes shrink pancreatic cancer and relieve symptoms caused by the cancer, but it can also cause fatigue, low blood counts, infection risk, nausea, appetite loss, neuropathy and weakness.

If you are already in significant discomfort, I think the important question isn't simply, “Can I tolerate chemotherapy?” It is, “What is the realistic chance this treatment will make me feel better or give me meaningful additional time, and how likely is it to make me feel worse?”

I would ask your oncologist very directly:

“For someone in my condition, what are the realistic chances that this treatment will shrink the cancer and improve how I feel? How much additional time might it give me, and what would you recommend if maintaining my quality of life is my highest priority?”

You could also ask whether starting with a reduced dose or modified schedule would be reasonable. Another possibility is agreeing with your oncologist to try treatment for a short period and reassessing. Starting chemotherapy doesn't mean you are committed to continuing it if the side effects become unacceptable or it isn't helping.

I would also consider getting a second opinion from a pancreatic cancer specialist before making an irreversible decision, particularly if you haven't already done so. Being told that a cancer is incurable doesn't necessarily mean there are no treatments capable of controlling it for a meaningful period of time.

@dianethemom Hi and welcome to Mayo Connect. I understand your concern about more discomfort. Maybe the treatment will help with it. What discomfort are you currently experiencing and what additional discomfort are you concerned about with the abraxane gemzar? It is a balancing act of risk versus reward. They are the toughest decisions to make on a cancer journey. My heart goes out to you.

@mcharlesfrancis
He said I could try the chemo and see what happens but I don’t feel at all well enough for the infusions and I do t want to get all the side effects before I quit. I’ve been through chemo before and it was extremely difficult. I took gemcetibine and capceibine pills but adding the abraxane with its side effects of neuropathy and fatigue which I already have is not exciting. In addition I am in a lot of pain and oncologist doesn’t deal with that. All dr said was that it was a “gentler” chemo than the last time and I would take it forever until it didn’t work and then die anyway. Think Hospice is the best bet now.

@tomrennie dr said treatment might shrink the tumors for a while but not forever and I would have to be on chemo until it doesn’t help or I want to stop. Am in constant pain and discomfort now. I also have neuropathy and fatigue already. Don’t think I want the side effects to prolong the inevitable. Looking for what to expect from abraxane and gemzar from those who have taken it

I did 6 months of gem/brax as a first treatment for acinar cell carcinoma of pancreas. It was unsuccessful, and yes, it did cause neuropathy and fatigue. I then had 5 SBRT radiation treatments and had a 50% shrinkage of tumor which made me eligible for the Whipple surgery. I was 77 when this started. I am now 8 months post Whipple and all clear, for now, per CT scan of last week. If you have not already done so, a 2nd opinion would be a good idea. It is ultimately your decision, but I always like to make informed decisions. Prayers for you.
Kathryn

I am sad to read of your situation and hope very much that things can improve.

I had abraxane, and gemzar as my first treatment for pancreatic cancer. I was pretty sick when i started as the tumor had blocked my bile duct and I had a external drain for the bile.
I had no bad side effects from the chemo which i think also included a steroid first, to help keep things ok. I would be fine for two days or so, then crash for two days, then back to normal. The crash was basically extreme fatigue, so i spent those two days in bed, mostly asleep. No nausea, no vomiting. My strength improved enough so that i was out hiking before my Whipple
I had my chemo both pre and post my Whipple which was inJuly, 2018.

I wish you the very best, and if you try the chemo that your experience is like mine was.

@grandmahiker this is encouraging to hear. My 85 yr. Old healthy husband had the Whipple first. Tumor was adhered to portal and another vein, so the surgeon could not get a clean margin, plus he had 2 of 12 lymnodes testing positive. Next was 15 rounds of radiation along with Xeldon chemo. Now he has August to heal and get ready for 4 months of the chemo cocktail you were on.
He had no problems with the other stuff, so the oncologist says he’ll probably do well with this other poison.
How long ago was your “adventure with cancer?” How are you doing now?
Are you on Creon?

God, this sucks!

@jerryc131
I think the adventure never ends. It has been 8 years. The first ones were the hardest, i dreaded every scan and blood test. But it waned and now i feel like my reaction to a negative change would more likely be indignation: a recurrence after all this time more ofan insult than anything else.
I was 76 when it all started, had my Whipple on my 77th birthday. I believe the margins were clear and no positive nodes.
Have no complaints now except for the GI changes that seem to come with that surgery: very bad smelling gas and poop, and still the occasional abdominal cramp. The latter have eased over the years but not gone away. And somewhere someone said that post Whipple gas can clear an aisle in Walmart in 30 seconds. And emptying the bowels does require more attention to planning ones morning.
I use Creon, have since almost the beginning. Have never retested to see if it still is necessary.
Dont know what else to tell you - please ask if you want any other info.
My best energy to your husband.

I am a month from 77 and was diagnosed last September with stage 2B pancreatic cancer. Began gemzar and abraxane in early November, my infusion scheduled complicated by C. diff brought on by too many IV antibiotics given to fight an infection that a GI procedure caused. Finished the 6 infusions, 7 weeks off to prepare for surgery which was a Robotic Whipple. It removed the Pylorus, the Duodenum, gall bladder and of course the cancer which was not on an artery, just on the head of the Pancreas. 6 weeks later the same infusion regimen was accomplished with the final chemo today. My CA-Antigen has gone from about 2,000 to this mornings reading of 28. I rang the bell gladly with hope of moving forward. CT will give more info on August 21st. Any input appreciated, or any questions. I ended up with 5 occurences of C. diff, and then had a fecal implant, which to this point has been successful.