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Anyone had success with gemcitabine and capecitabine (GemCap) chemo?

Posted by reme51 @reme51, Dec 16, 2025

I was diagnosed in Aug, 2025 with adenocarcinoma of the pancreas. Oct 17 I had a distal pancreatectomy with app 70% of pancreas removed. My CT Scan on 12/16 was good, no metastasis, no changes in area of pancreas or lymph nodes tho my CA19-9 has increased to 232.
My doctor is suggesting I start the Gemcitabine-Capecitabine chemo. Has anyone had success with this chemo, especially for pancreatic cancer?

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reme51 | @reme51 | 4 days ago
In reply to @val64 "@reme51 I actually decided to go on GemCap, even though it is not normally used for..." + (show)
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@reme51

I actually decided to go on GemCap, even though it is not normally used for the type of cancer I have (endometrial), because I have a DPYD mutation. I have one bad copy (which they call HapB3) and one good copy. I assume you do too, because if you had two bad copies, they wouldn't let you take Cap at all. I'm a geneticist and have a lot of data on my tumor, so I realized that my tumor has actually lost the good copy, so I figured it might be more sensitive to GemCap than my normal cells would be.

The normal doses for a person my size would be ~1350 mg Cap twice daily, and 1600 mg Gem at each infusion. I started at 800 mg Cap (2x daily) and 1000 mg Gem (I approved the reduced dose of Cap, but my oncologist snuck in the reduced dose of Gem, and I've been trying to get her to increase it.) I just started my third cycle, and I'm up to 1250 mg Cap and 1300 mg Gem.

People with one bad copy of DPYD sometimes have bad side effects from Cap or 5-FU and sometimes don't. I'm not really having any troublesome side effects. I'm being careful about using moisturizer on my hands and feet, and I can see how there might be trouble if I didn't. I've had a couple brief episodes of diarrhea, but I think it was only when the meal I had before taking Cap wasn't substantial enough.

If I were you, I'd go ahead and start the GemCap with the reduced Cap dose. I feel quite good on this drug combo. (This is my 7th different type of chemotherapy, and it is one of the two best in terms of how I feel.)

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@val64
I did start with a reduced dose and felt fine until 2 days later. The nausea can be controlled but not the gout! I have serious family history of gout and both Gem and Cap cause a gout flare up. Plus Creon, which I stopped taking. Crawling to the bathroom is not pleasant...You didn't mention gout, so I truly hope you'll never experience it.
Do have any knowledge of others with gout that are on chemotherapy? I take colchicine but can't take allopurinol.

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val64 | @val64 | 3 days ago
In reply to @reme51 "@val64 I did start with a reduced dose and felt fine until 2 days later. The..." + (show)
Profile picture for reme51 @reme51

@val64
I did start with a reduced dose and felt fine until 2 days later. The nausea can be controlled but not the gout! I have serious family history of gout and both Gem and Cap cause a gout flare up. Plus Creon, which I stopped taking. Crawling to the bathroom is not pleasant...You didn't mention gout, so I truly hope you'll never experience it.
Do have any knowledge of others with gout that are on chemotherapy? I take colchicine but can't take allopurinol.

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@reme51

That sounds awful! I'm sorry you're going through that. Hopefully your doctor can figure out an appropriate treatment without horrible side effects.

I have never had gout, and I don't have that now or any nausea. I did make a mistake and took a fairly long walk right after my second Gem infusion of this cycle (when I had already been on the increased Cap dose for a week), and I woke up the next day with the soles of my feet sort of burning, as if there was a blister, although there wasn't. This must be "hand and foot syndrome". My feet felt better the next day, but now I'm cautious about walking more than 4-5 blocks slowly to avoid a repeat performance. I also went back to 1100 mg Cap per dose, which I think is probably the dose for me.

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