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When to say enough to chemo?

Posted by alisonsullivan203 @alisonsullivan203, Jan 27 8:40am

My 81 year-old mom has been receiving chemo (gem/abrax) since September. Three weeks on, one week off. In December she started having skin issues, swelling, extreme fatigue, muscle aches, and shortness of breath. She was hospitalized last weekend with pleural effusion caused by heart failure. They’ve only given her a diuretic. She’s miserable. She’s got an unresectible locally advanced tumor on the head of her pancreas. It reduced in the fall, but with extra breaks off chemo due to side effects, it has grown. When do we say enough to chemo treatments? She’s supposed to have one more round, then recovery, then SBRT in March. Would love to hear how others have decided and what the outcomes have been.

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mcoplien | @mcoplien | Jan 28 8:37am

My husband is 68 and just started the gem / abrax chemo in December. 3 weeks in a row was too much, too many side effects, they were going to reduce the abrax but instead now he has it every other week and the side effects are not as bad. His numbers are looking better. CA 19-9 went from 14000 to 860 after 2 rounds. We have been told he will be on this as long as it is working, then there is something else to try. They did DNA / RNA testing and there does seem to be one more chemo out there for his mutation, it is a common one KRAS.
I was wondering what is SBRT? thanks Kim

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alisonsullivan203 | @alisonsullivan203 | Jan 28 9:46am
In reply to @mcoplien "My husband is 68 and just started the gem / abrax chemo in December. 3 weeks..." + (show)
Profile picture for mcoplien @mcoplien

My husband is 68 and just started the gem / abrax chemo in December. 3 weeks in a row was too much, too many side effects, they were going to reduce the abrax but instead now he has it every other week and the side effects are not as bad. His numbers are looking better. CA 19-9 went from 14000 to 860 after 2 rounds. We have been told he will be on this as long as it is working, then there is something else to try. They did DNA / RNA testing and there does seem to be one more chemo out there for his mutation, it is a common one KRAS.
I was wondering what is SBRT? thanks Kim

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@mcoplien Thanks - I’m thinking that if she continues on chemo she needs to do a week on/week off schedule instead of 3 weeks in a row. SBRT is short burst radiation therapy. We’ll have it done at Henry Ford Hospital, which is closer for us. It uses live MRI to guide short bursts of radiation directly to the tumor - it shuts off when you breathe or move your body at all so it doesn’t also send radiation to other organs.

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carrie40 | @carrie40 | Jan 28 10:18am

Glad there's a new plan. As an 85-year old, 91# "mom" on gem/abrax (every 2 weeks, reduced (65% of one of them) I am doing great. Especially for me, as I quit the Floflorinox 3 years ago but survived until things got worse again (peritoneal carcinomatosis). My marker has reduced from over 1000 to 190 after about 3 months, and I only have tiredness on the 3rd day (after the steroids wear off). Best wishes--sorry I'm not precise about some of the treatment. Chemo brain or old age--not sure which! Courage, Carrie

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56pan | @56pan | Jan 29 10:33am
In reply to @alisonsullivan203 "@mcoplien Thanks - I’m thinking that if she continues on chemo she needs to do a..." + (show)
Profile picture for alisonsullivan203 @alisonsullivan203

@mcoplien Thanks - I’m thinking that if she continues on chemo she needs to do a week on/week off schedule instead of 3 weeks in a row. SBRT is short burst radiation therapy. We’ll have it done at Henry Ford Hospital, which is closer for us. It uses live MRI to guide short bursts of radiation directly to the tumor - it shuts off when you breathe or move your body at all so it doesn’t also send radiation to other organs.

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@alisonsullivan203 Not a big thing, but SBRT is Stereotactic Body Radiation Therapy. Supposed to be slightly more effective than IMRT, Intensity Modulateed Radiation Therapy, in prostate cancer. Don't know any difference in effectiveness on Pancreatic Cancer and I did do a search. I'm getting IMRT for the tumor on the left muscle of my left eye.

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