Anyone on Gemcitabine with Abraxane? How long? Effective?

@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and get home feeling OK, relax on the weekend, then crash and have to take Monday off work.

I did reduce the decadron in my pre-meds by about 1/3 several months ago because of its impact on my blood sugar. That and a long drive home might be suppressing my insomnia. I do have dexamethasone tablets at home as a backup to Zofran. I rarely take them, but if so, only in the morning because of the insomnia.

@sprinter345 and @199 -- You are true marathon champions. Have your oncologists discussed switching treatments or reducing/eliminating any of your chemo meds?

I've heard the Gem/Abrax (+/- cisplatin) is usually only good for 6-9 months before it either becomes intolerable (neuropathy) or ineffective (cancer develops resistance). My docs have said they have an answer for every side effect but neuropathy, which I accept as a tradeoff for the other positives of treatment.

My CA19-9 leveled off around 40 for about 8 weeks, and two oncologists both started discussing "maintenance therapies" for me, suggesting the Abraxane/cisplatin had done all they were going to do. This would mean reducing/eliminating one/other/both and likely going to nothing but Gem. And then, my CA19-9 this week dropped to 33 -- two points inside the normal range! (Previous week's scans still report "stable disease" and Signatera detects no ctDNA.)

I don't think this regimen has run out of gas yet. I fear if I back off of anything it will give the cancer a chance to regroup and spread. 19 treatments haven't killed me yet. I was ruled out as a candidate for HIPEC, and I might be a candidate for some trials in the distant future, but I don't see anything on the horizon with more promise than what I'm currently on.

Would love and appreciate your insights on this.

Did your tail tumor size decrease significantly? Did they find it in the lungs because they were looking for it or did you have symptoms?
I’m always afraid it’s going somewhere and we won’t realize unless he has other symptoms. It had metastasized to the liver when he started.

@sprinter345 -- Thank you for that! Is the pamrevulab approved yet, or just part of a clinical trial?

@gamaryanne -- It's hard to follow all the radiology reports because of changes in terminology and landmarks, and nothing has a definitive, positive biopsy, so everything is just based on imaging, but there are suspicious lesions or nodules or masses or deposits at the original surgical site (head of pancreas); tail of pancreas; central mesentery; peritoneal wall; liver; spleen; paracolic gutters, and other parts of the anatomy I've never heard of!

My mom started chemo about 6 weeks ago. The Dr. says it is to give her a better quality of life and slow the growth of her cancer. The doctor warned us that eventually the chemo would stop working. Does anyone know how long the chemo can keep a person alive? She is stage 4 and she is having scans tomorrow at Mayo Clinic to see if the chemo is even working. She is feeling pretty good , just weak and tired. Pain is under control. Her CA19-9 is 118,800 and has been the exact same number for two weeks. I can only think that at least it stayed the same. The previous number was 50,000. I’m so nervous for the news we will find out tomorrow.

Last week I finished my 38th chemo with Gemcitabine & Abraxane for stage 4 inoperable pancreatic cancer started in tail & went to lungs. I started end of July 2022. My CA 19-9 is within normal limits at 18. My CT shows improvement. The worse pains I have had are bone pain and neuropathy from the chemo. I am bald & due have fatigue, but I am still here 🙂 Just had my dose of Abraxane and Decadron reduced, and the schedule changed from 2 weeks on & one off to one on & one off. Will see how that goes. I get Decadron & Aloxi prior to the Abraxane, then normal saline flush & gemcitabine. Would love to have a break soon but will see what my oncologist says. Only taking Percocet & Tramadol for pain so far. Lately I have been taking one of each in the morning, mid-afternoon & 2 in the evening either together or spaced depending on the severity of the pain.

@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and get home feeling OK, relax on the weekend, then crash and have to take Monday off work.

I did reduce the decadron in my pre-meds by about 1/3 several months ago because of its impact on my blood sugar. That and a long drive home might be suppressing my insomnia. I do have dexamethasone tablets at home as a backup to Zofran. I rarely take them, but if so, only in the morning because of the insomnia.

@sprinter345 and @199 -- You are true marathon champions. Have your oncologists discussed switching treatments or reducing/eliminating any of your chemo meds?

I've heard the Gem/Abrax (+/- cisplatin) is usually only good for 6-9 months before it either becomes intolerable (neuropathy) or ineffective (cancer develops resistance). My docs have said they have an answer for every side effect but neuropathy, which I accept as a tradeoff for the other positives of treatment.

My CA19-9 leveled off around 40 for about 8 weeks, and two oncologists both started discussing "maintenance therapies" for me, suggesting the Abraxane/cisplatin had done all they were going to do. This would mean reducing/eliminating one/other/both and likely going to nothing but Gem. And then, my CA19-9 this week dropped to 33 -- two points inside the normal range! (Previous week's scans still report "stable disease" and Signatera detects no ctDNA.)

I don't think this regimen has run out of gas yet. I fear if I back off of anything it will give the cancer a chance to regroup and spread. 19 treatments haven't killed me yet. I was ruled out as a candidate for HIPEC, and I might be a candidate for some trials in the distant future, but I don't see anything on the horizon with more promise than what I'm currently on.

Would love and appreciate your insights on this.

@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and get home feeling OK, relax on the weekend, then crash and have to take Monday off work.

I did reduce the decadron in my pre-meds by about 1/3 several months ago because of its impact on my blood sugar. That and a long drive home might be suppressing my insomnia. I do have dexamethasone tablets at home as a backup to Zofran. I rarely take them, but if so, only in the morning because of the insomnia.

@sprinter345 and @199 -- You are true marathon champions. Have your oncologists discussed switching treatments or reducing/eliminating any of your chemo meds?

I've heard the Gem/Abrax (+/- cisplatin) is usually only good for 6-9 months before it either becomes intolerable (neuropathy) or ineffective (cancer develops resistance). My docs have said they have an answer for every side effect but neuropathy, which I accept as a tradeoff for the other positives of treatment.

My CA19-9 leveled off around 40 for about 8 weeks, and two oncologists both started discussing "maintenance therapies" for me, suggesting the Abraxane/cisplatin had done all they were going to do. This would mean reducing/eliminating one/other/both and likely going to nothing but Gem. And then, my CA19-9 this week dropped to 33 -- two points inside the normal range! (Previous week's scans still report "stable disease" and Signatera detects no ctDNA.)

I don't think this regimen has run out of gas yet. I fear if I back off of anything it will give the cancer a chance to regroup and spread. 19 treatments haven't killed me yet. I was ruled out as a candidate for HIPEC, and I might be a candidate for some trials in the distant future, but I don't see anything on the horizon with more promise than what I'm currently on.

Would love and appreciate your insights on this.

My mom started chemo about 6 weeks ago. The Dr. says it is to give her a better quality of life and slow the growth of her cancer. The doctor warned us that eventually the chemo would stop working. Does anyone know how long the chemo can keep a person alive? She is stage 4 and she is having scans tomorrow at Mayo Clinic to see if the chemo is even working. She is feeling pretty good , just weak and tired. Pain is under control. Her CA19-9 is 118,800 and has been the exact same number for two weeks. I can only think that at least it stayed the same. The previous number was 50,000. I’m so nervous for the news we will find out tomorrow.

My mom started chemo about 6 weeks ago. The Dr. says it is to give her a better quality of life and slow the growth of her cancer. The doctor warned us that eventually the chemo would stop working. Does anyone know how long the chemo can keep a person alive? She is stage 4 and she is having scans tomorrow at Mayo Clinic to see if the chemo is even working. She is feeling pretty good , just weak and tired. Pain is under control. Her CA19-9 is 118,800 and has been the exact same number for two weeks. I can only think that at least it stayed the same. The previous number was 50,000. I’m so nervous for the news we will find out tomorrow.

I am on Gem/Abrax currently, 3 weeks on, 1 off. I, too, receive Decadron as a pre-med with Aloxi or Zofran. I was thinking about asking my oncologist to reduce the Decadron dose because I think it causes insomnia. May I ask why your dose was reduced?