Question on Chemo: How often? At Mayo or locally administered?

Posted by mikewdby @mikewdby, Jun 20 10:43am

I know I am putting the proverbial cart in front of the horse here, but I have a question regarding Cemo treatment,… Are most treatments given daily, weekly, etc? Would they all be given at the Mayo Clinic (which would mean traveling an hour each way) or can the treatments be sent to a local clinic?

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A treatment cycle can vary based on the chemo regimen being used. Folfirinox is a two week cycle where on day one you get three components and go home with a portable pump for infusion of 5-FU over 46 hours. Cycle 2 begins on the 15th after the prior cycle.

Gemzar + Abraxane may be a where you receive the drug every 7th day for three weeks and the fourth week is a rest period before it repeats.

Speak with your oncologist about doing the treatment at a local facility. One word of caution- make sure the clinic you have in mind has experience in treating pancreatic cancer patients. Someone I was mentoring insisted on being treated locally. She was not tolerating the chemo well, the clinic administering the chemo did not do any dose reductions and issues arose. Upon investigation it was learned that with pancreatic cancer being rare compared to the others, no one had experience treating with Folfirinox. The patient eventually went back to the original medical center where the surgery was performed for all future treatments.

During my treatments that started with Gemzar and then was switched to Folfirinox, I chose to be treated at the medical center where I had my Whipple surgery. It had a pancreas program and treated a higher volume of pancreas patients so I was more comfortable knowing there was a higher level of expertise. It required a round trip train/subway commute of 4.5 hours but I didn’t mind it. I was used to doing that commute daily as I worked across the street from where the hospital clinic was located.

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@stageivsurvivor

A treatment cycle can vary based on the chemo regimen being used. Folfirinox is a two week cycle where on day one you get three components and go home with a portable pump for infusion of 5-FU over 46 hours. Cycle 2 begins on the 15th after the prior cycle.

Gemzar + Abraxane may be a where you receive the drug every 7th day for three weeks and the fourth week is a rest period before it repeats.

Speak with your oncologist about doing the treatment at a local facility. One word of caution- make sure the clinic you have in mind has experience in treating pancreatic cancer patients. Someone I was mentoring insisted on being treated locally. She was not tolerating the chemo well, the clinic administering the chemo did not do any dose reductions and issues arose. Upon investigation it was learned that with pancreatic cancer being rare compared to the others, no one had experience treating with Folfirinox. The patient eventually went back to the original medical center where the surgery was performed for all future treatments.

During my treatments that started with Gemzar and then was switched to Folfirinox, I chose to be treated at the medical center where I had my Whipple surgery. It had a pancreas program and treated a higher volume of pancreas patients so I was more comfortable knowing there was a higher level of expertise. It required a round trip train/subway commute of 4.5 hours but I didn’t mind it. I was used to doing that commute daily as I worked across the street from where the hospital clinic was located.

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My wife's gemcitibine/abraxane was 2 weekly treatments then the 3rd week off. Within the first line treatment regimens, the oncologist has some discretion on cycle and dosing

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Welcome @mikewdby. While you may be putting the cart before the horse, I admire your getting informed and asking questions.

@stageivsurvivor is right. How often you get chemo depends on different factors like your cancer type and which chemo regimen or combination you may receive. And as @beachdog points out, even the schedule for 2 patients with the same cancer getting the same drug combination may differ depending on the individual medical history and status of the specific patient.

As for where your chemo is administered, you may have options available to you. As a Mayo Clinic patient, you can choose to get treatment at Mayo Clinic. Or you may prefer to return to your home state and get chemo at a hospital more local to you. Your Mayo Clinic team will work with your local oncologist.

Do you have far to travel to Mayo Clinic?

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Thank you very sincerely for responding.

We live here in Woodbury, MN for the summer / fall; returning to Ft. Myers, FL sometime late October / early November. Although the drive is only an hour to Rochester from Woodbury, of course my concern would be once we would get to Florida (Jacksonville is a 5 and 1/2 drive).

Here is hoping my EUS scheduled for Thursday, June 22 just defines a cyst that was discovered during a CT and subsequent MRI for diverticulitis. My CA-19 was a ‘16’. But I am a worrywart. It even must have shown on my face when one of the GI Doctors said – “…don’t worry you’re at Mayo…”

Thanks again.

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