My mom (74/F) was diagnosed with pancreatic cancer a couple months ago. She has started chemo and is fighting hard. Her quality of life is not bad, all things considered, but she is having troublesome diarrhea, mostly in the evenings. Does anyone have any tips on dealing with this symptom? She is already taking Creon (pancreatic enzymes), and has tried Immodium without much success.
Thanks for any insight. God bless.
Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.
Have pancreatic cancer as well. Had the whipple surgery. Started chemo had serious diarrhea so bad. So dehydrated ended up in hospital for a week.
Dr. Stopped the one drug of four chemo drugs and after a one month break from chemo. Diarrhea free.
Best wishes, God bless.
I had Whipple in Feb. of 2019. It was followed by 6 month of Folfirinox. After a few sessions of chemo, the diarrhea became a problem and Dr. dropped on drug. Made a big difference.
Best wishes to your mother on her journey.
My husband also had diarrhea that Immodium didn’t help. The doctor added Lomotil . Between the two meds it was manageable.
I too had bad diarrhea when taking folfirinox treatment. Doctor cut down on the cistoplastin (?) that was in my take home IV bag. Still didn't help much and it dropped my potassium level.
Irinitecan (spelling?) is chemo drug that causes the diarrhea. My oncology team gives something to prevent diarrhea as a pre-med. Its in a syringe that is white/yellow color and tastes weird like almonds or something.
The oxyplatin causes neuropathy and cold sensitivity. I haven’t had Whipple so I’m pre- surgery taking the Floforinox. I’ve managed the D with Immodium – but yes D messes with magnesium and I think Potassium levels.
My oxyplatin was reduced for bad neuropathy. Reach out to your oncology team.
I experienced diarrhea from the Irinotecan component of Folfirinox which targets fast dividing cells which the GI tract has. Immodium was not effective for me. My team wrote Rx’s for several anti-diarrheal medications depending on what the insurance company formulary was covering at the time. The anti-diarrheals that were effective for me were Loperamide, Lomax, Lomatil and the generic diphenoxylate atropine. I did not wait until the onset of symptoms to take any of them. I took it proactively starting about 30 hours before administration of chemo to have a consistent therapeutic level in the circulation.
I didn’t want to reduce or eliminate the effectiveness of the oxaliplatin so dealt with it by stimulating circulation in the feet doing foot massaging, warm-water soaks and found walking on warm beach sand was very therapeutic. To lessen the discomfort, I was prescribed 200 mg of gabapentin. A biosimilar medication is Cymbalta. I did 24 cycles of Folfirinox over 24 months. I didn’t experience any improvement in neuropathy until 2.5 years after Folfirinox was completed. At that point there was a slow, steady improvement and it resolved at 7.5 years after finishing treatment.
Long after I went through Folfirinox and neuropathic symptoms, I began reading anecdotal reports of clinics and patients using icing therapy on the extremities to reduce neuropathy. The theory behind it is restricting the blood flow through the capillaries in the hands and feet fo the Oxaliplatin is not coming into contact with tissues and nerves in those areas.There are a few abstracts and articles documenting the technique and it’s effectiveness-
Updating here: if Oncology team gives your mom magnesium in an IV – look out! This gave me immediate diarrhea. We switched to slow mag pills to address low magnesium instead.
When I was on Folfirinox with Oxaliplatin, anything cold was intolerable, even touching metal. Cold (below 62°F) would cause blisters in my mouth and throat. When I was able to get to warm climate, then I could do barefoot sand walks as excercise for the feet and hand neuropathy. Helped slightly. When chemo stopped vigorous aerobic excercise eliminated almost all my neuropathy. I could see an immediate improvement a few hours after a good workout. For me it was swimming, vigorous swimming.
Ask your team about taking Gabapentin for the neuropathy. I still have it and the oxplantin for a long time. As far as cold touching. I asked my husband or daughter to help or I used a kitchen towel.
Thank you all so much for your kind replies. This is all so helpful. I'm going through them with my mom and we have a lot of new drugs to ask the oncologist about. Appreciate your help so much.
Merry Christmas & Happy Holidays to you all. Wishing everyone good health for the new year.