Questions about gemcitabine

didi02453 · New User Joined: 02 May 2006 Posts: 3

My dear friend has Stage IV pancreatic cancer, with mets to the liver. He is starting gemcitabine next week.

I'm reading that on average, life expectancy is 4-6 months - but his doctor is telling him that he may live a year or two.

I'm reading that the side effects can be daunting -- his doctor is telling him that the chemo will make him feel *better.* This is not like some cancers, where you go through the hell of chemo in hopes of an end to the cancer -- this is all about just feeling as good as possible for whatever time you have.

I am so worried about him. I will really appreciate hearing from some folks who have actually taken gemcitabine - because I will trust you much more than the oncologist OR the research studies!

Thanks

Didi

missumom · Experienced user Joined: 05 Jan 2006 Posts: 65

Hi Didi,

My mom was diagnosed with cancer in the pancreas, gallbladder and liver in September 2005. A couple of days after being admitted, she became jaundice. She was hopeful to all the procedures being suggested by her doctors. We were informed that pancreatic cancer is very painful because there are tons of nerves in the area. The doctors said that my mom's life expectancy is between one week to a year. When the doctor told her that chemotherapy (Gemcitabine) was the last chance to prolong her life (possibly shrink the mass and stop it from spreading), she opted for it. She was able to decide for herself and the family respected her rights.

After her first dose of chemo, she was vomitting for 48 hours straight. She couldn't eat nor drink, and her usual pain intensified that she needed additional morphine doses. Her second chemo was postponed because she was too weak at the time, but she gathered up her strength and took on the second chemo. She didn't vomit, but was nauseous. The second chemo also intensified her pain which required an increase of morphine. A couple of days after the second chemo, my mom started experiencing chest tightness (angina). She was given blood thinners for the angina which caused internal bleeding. She became semi-comatose and passed away in a little less than a month after being diagnosed.

There are a lot of questions in my mind that I choose to just put aside because they would never bring my mom back. Firstly, I would liked to have tried other pain relievers before putting her on morphine because it weakened her tremendously and at times, just made her so groggy you couldn't even have a conversation with her. If we didn't let her have chemo, would she have lived a little longer because in my opinion, the chemo just worsened her condition. It made her weak, intensified her pain and caused other side effects that just quickened her death.

After my mom's death, I realized that there was no way of saving her, but in my opinion, the chemo just took the quality of life that she had left away from her -- but it was her choice to go through it and I can't regret her decision.

This is just my opinion and as I have learned, every cancer patient is different in their own way. There are many people who have very positive outcomes with chemo and I hope that your friend will be one of them.

cedar · Regular Joined: 01 Apr 2006 Posts: 17 Location: Canada

When my dad was diagnosed he was given the same drug as well,but was told it was strictly to relieve symptoms(he was not told about any tumour shrinkage etc) My dad only made it to two chemo treatments, they were extremely well tolerated, but unfortunately made absolutely no difference(perhaps relieved some pain?) He never made it to treatment number three, I know he thought the chemo was 'helping' and because he had no adverse symptoms, we certainly supported his wishes. But like missumom above posted, no two pancreatic cancer patients, and treatments are alike, even though the feelings we go through are similar! Perhaps your friend will benefit from chemo, and if no direct benefit, hopefully will not have severe side effects. I know my dad wanted everything done, he even had surgery which also, in hindsight didn't help much. But I think it gave him comfort and hope to know the medical community spared nothing in treating him. But at the same time none of his treatments made things 'worse'. Hope some of this helps, very difficult time for all of you.

Dee Clarkin · New User Joined: 05 May 2006 Posts: 2

Hi, My dad was diagnosed with Pancrectic cancer 4 weeks ago. We firstly thought it hadn't spread past the pancreas but now know it has spread to three places in his liver. He has lost a huge amount of weight, and has numerous side effects, the worst being his chronic hiccups. Does any know any way of helping these?

He was in hospital for 3 weeks, and got out yesterday. They put in a stenth to bypass the bile ducts and they bypassed his stomach, so it doesn't get infected by the cancer. The Stenth has got rid of his Jandice, and he is a little stronger now. If we could just help him with the hiccups, I feel he would be much more comfortable.

His doctor has told him that Chemo will start in 3 weeks, so we're all hoping this might prolong his life.

I feel a bit better from writing this down and also hearing that people are going through the same thing.

Please keep me posted about the Chemo.

Thanks.

Dee
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Dee

cedar · Regular Joined: 01 Apr 2006 Posts: 17 Location: Canada

I'm so sorry to hear about your dad's diagnosis. I hope the gemzar does indeed help your dad, and I hope he has minimal to no side effects. Unfortunately, my reading does tell me(as was the case with my dad) that by the time of diagnosis most pancreatic cancer has metastisized. I'm glad your dad has a 'stent' hopefully he can start gaining a bit of weight back. Regarding hiccups, what does the Dr. suggest? I'm thinking it has something to do with gastric/acid reflux type symptoms related to excess bile? But the stent should be helping with that a bit. My dad also had an operation,a ileostomy, which the bowels/intestine was rerouted and he ended up with a 'bag'. Unfortunately, his life was not prolonged, but we were told ahead of time the chemo and the 'bag' would make him more comfortable, there was really nothing more they could do for him. He did take comfort from his family so perhaps your dad will appreciate you and your family being with him as much as possible. I think, now that I think back, my dad was scared and expressed it by wanting all of us(we're a big family) around him all the time. So the only 'advice' I can give you is take your cue from him and support him and where he needs an advocate re medical decisions support him there as well. Come to this forum if you need support, the people here are available and want to help. Take care

Dee Clarkin · New User Joined: 05 May 2006 Posts: 2

Thanks so much for your resonse. Unfortunately the doctors have told us that there's instead a pill he can take for the hiccups and as he is out of hospital there's no one to administer an injection. He a little better this evening and I'm hoping he will have a good nights sleep.

How old was your dad?

Mine is 65. A very young 65 though..
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Dee

cedar · Regular Joined: 01 Apr 2006 Posts: 17 Location: Canada

Hi Dee, you don't have to tell me 65 is young. My dad was a very healthy 85(!) year old. Other than diabetes(which has also been implicated in pancreatic cancer) he was robust. Possibly your dad's age will help him, my dad also dropped a huge amount of weight in an extremely short period of time. By the time my dad was 'properly' diagnosed, the cancer had spread to the liver, gall bladder, lining of abdomen, and he also had a hole in his bowels. He was in bad shape, he was originally diagnosed with an 'infection' which they never found which infection, because it was pancreatic cancer. Then he had an 'abscessed gall bladder' etc etc none of which he actually had or he had them as a result of the spread of the undiagnosed cancer. So perhaps your dad, what with his age and somewhat better diagnosis will live alot longer and with fewer complications. When my dad first went into hospital for 'infection' to the time of his passing was 5 months. So it was very fast, once the actual diagnosis was made he unfortunately lived 6 weeks. But don't be discouraged, my dad was a fighter and never gave up even at 85. And your dad is at home which is wonderful. Take care of yourself and him, and I hope you can work out the hiccup meds.

didi02453 · New User Joined: 02 May 2006 Posts: 3

Chemo was supposed to start today (Gemcitabine). But my friend became very weak last Thursday - so weak that we actually had to 911 him, he could not make it to the car. Once back in the hospital, they found two clots in his lungs (his symptoms began with deep vein thrombosis - caused by the pancreatic cancer, although we did not know that at the time - about six weeks ago), and fluid around his heart. The following night he had a "mild" heart attack from more clots near his heart. He went home tonight, feeling a bit stronger - but they are postponing the chemo for a week.

The whole chemo thing scares me to death -- his body is already *so* compromised. I'm trying to sound positive with him "Hey, the oncologist says this may give you more energy!" -- but I'm just not feeling positive at all.

I'm also very worried about the clotting -- he was already on a powerful anticoagulant (Lovonox) prior to last week, and still formed at least four clots. He's on that same med now - but I worry that another clot will cause a massive coronary this time, or that he will throw a clot to the brain and just stroke out.

So we will see if he makes it to chemo next Monday. He is very trusting in his doctors, and believes that the chemo will make him feel *better,* not worse. I hope he's right.

Didi

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