change of plans

carolyn · Regular Joined: 23 Jun 2009 Posts: 18

Just an update--my mom 87 with lung cancer was going to take Tarceva. Well,,,,,the dr. has advised her to start IV chemo---Carboplatin, Taxel, and Zometa...I am not so sure about this...I have heard so many things about the side affects. I can't imagine my mon going thru that. But she made her own decision. At stage 4, I just I not sure about this, at her age and frail condition....Any experiences or comments would be appreciated. Thanks carolyn
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carolynf

pbj11 · Site Admin Joined: 12 May 2007 Posts: 2841

Hi Carolyn,

Carbo/Taxol (sometimes with Avastin) is the typical first line of treatment and can work very well to reduce the cancer. The Zometa is given for bone strength to help prevent any more bone mets.

It's a fairly tough regimen for someone who is elderly and frail, in my opinion. Are they planning on doing it every three weeks? It could be that they will scale back the dosage to make it more tolerable for her. Ask the doc what his/her plans are for dosing. Although everyone responds differently to the side effects, it did take my husband down for almost a week each cycle and he generally did very well handling the chemo.

It's all about buying time and you need to weigh the advantages of quality vs. quantity. There are members here who have opted to not take treatment and done pretty well. It also depends on how widespread the cancer is though and how many tumors there are.

You and your Mom are between a rock and a hard place. I'm sorry that more hard decisions are in the offing and pray that God will give guidance on what will ultimately be best for her.

Feel free to keep asking questions.

Hugs,
PBJ
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Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

onecoyote · Senior User Joined: 15 Jul 2008 Posts: 153

Hi Carolyn,
You have never said what type of NSCLC your mom has, adenocarcinoma or squamous cell? If it is squamous, I would definitely pass this by Dr. West because Avastin and squamous cell are a disaster in the making. Even the FDA does not approve the use in squamous due to bleeding issues. Dr. West advised my husband to tell his onc that he did not want Avastin used.
Also, let me reiterate what PBJ said about the carbo/taxol being" fairly tough regimen for someone who is elderly and frail". My husband is only 66 but had lost 23% of his overall weight and he was knocked down by the first infusion of this doublet. Had he been in good physical shape he probably would have done fine. I know I have read a few answers over in Dr. West's site concerning Tarceva and the elderly and I think all the docs there would use that instead.
Wishing your mom the best outcome,
Charlene
_________________
Husband Danny, age 66,
diagnosed squamous cell June 6, 2008,
Right pneumonectomy performed with no adjuvant chemo or radiation on Sept. 2008
Metastatic lung cancer in the ribs, scapula and right kidney raised it's ugly head May 2009.
Renal cell carcinoma diagnosed May 2009
One round carbo/taxol, too weak to continue
Cancer racing like a freight train
Held my husband's hand when he passed away September 29, 2009

pbj11 · Site Admin Joined: 12 May 2007 Posts: 2841

She didn't say it included Avastin. That was my comment on typical first line therapies. Heck, even with adeno, my husband couldn't take Avastin because he had a tendency to cough up blood. Too dangerous.

Sorry for injecting that into the conversation and muddying things up. Embarassed

My husband was 68 when he had this regimen (8 cycles) and fit as a fiddle, except for massive amounts of lung cancer! It made him feel pretty darn yucky and he had ants in the pants. We used a med to calm him down a bit during these times (can't remember the name, but it was like Xanax). Sorry -- widow-brain. I'd put him in the car and take rides to try to relax him a bit. I hear nausea can be bad with this too, but he never had a problem with nausea.

PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

onecoyote · Senior User Joined: 15 Jul 2008 Posts: 153

Ooops, sorry Carolyn and PBJ about the inclusion of Avastin. At least you know that I read your post PBJ Wink

_________________
Husband Danny, age 66,
diagnosed squamous cell June 6, 2008,
Right pneumonectomy performed with no adjuvant chemo or radiation on Sept. 2008
Metastatic lung cancer in the ribs, scapula and right kidney raised it's ugly head May 2009.
Renal cell carcinoma diagnosed May 2009
One round carbo/taxol, too weak to continue
Cancer racing like a freight train
Held my husband's hand when he passed away September 29, 2009

carolyn · Regular Joined: 23 Jun 2009 Posts: 18

Thanks so much for all the info---moms cancer is nsclc carcinoma. We started treatment today carbo/taxol &zometa---so far so- good, not really sure what to expect. When do the side affects kick in? She said she felt fine just a little tired. The pet scan show tumor in lung 7.8 X 6.1 cm, Is this considered large? Also in lymph nodes in neck 4.1 X 3.2 mass,, also a few other enlarged nodes. Lymph nodes also affected under left arm. You guys are so wonderful with your comments and prayers. You have helped me tremendously thru this nightmare so far..
thank you so much. Carolyn
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carolynf

onecoyote · Senior User Joined: 15 Jul 2008 Posts: 153

Carolyn,
Just so you know there are three types of NSCLC. Squamous cell, adenocarcinoma and large cell. Your mom has one of these if the doctor said it was NSCLC. Adeno is the most prevalant nowadays, large cell is the faster growing and squamous tends( I use this term loosely) to grow slower.
Good luck with treatment,
Charlene
_________________
Husband Danny, age 66,
diagnosed squamous cell June 6, 2008,
Right pneumonectomy performed with no adjuvant chemo or radiation on Sept. 2008
Metastatic lung cancer in the ribs, scapula and right kidney raised it's ugly head May 2009.
Renal cell carcinoma diagnosed May 2009
One round carbo/taxol, too weak to continue
Cancer racing like a freight train
Held my husband's hand when he passed away September 29, 2009

pbj11 · Site Admin Joined: 12 May 2007 Posts: 2841

Hi again,

I agree with the above. It's probably adenocarcinoma. The size of the masses strikes me as fairly large.

It will hit her probably on Sunday. You usually get a couple of day grace period before the stuff starts killing of the bad cells. It kills off good cells too, so that's why it's not a walk in the park. Make sure she is taking the anti-nausea meds NOW and have her continue for at least 5 days after it hits to be sure. If they don't work, call the doc and get a different prescription. The Zometa may add to the aches as it seems to have that effect in some people. Think of a bad case of the flu. At least that's what the books say. We just said "yucky."

Also, make sure she stays super hydrated so there are no other complications. People who DO stay hydrated seem to get through it a little easier. The first time may be scary for both of you, but it WILL pass and she'll start feeling more like herself by next Friday.

God bless and good luck. We're here if you have questions.

Hugs,
PBJ

Charlene -- you mean you don't always read my posts? LOL Wink

I think of you often and hope you are as well as can be expected. It's a very lonely and emotional time. Big hugs for you too!
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

maryaz · Posted: Fri Jul 17, 2009 11:32 pm Post subject: Re: change of plans

Carolyn, I wish your Mom good luck with the treatments. My husband had the Carboplatin, Taxel before he had an allergic reaction to one of them. He was fairly healthy and so not good comparison. He was having radiation every day of the week and was more knocked down over the radiation. The meds kept his nausea pretty good. He got tired.

I will pray for you both. I posted in the other topic about Tarceva and had not seen this one. I did the same thing last time I was here posting. I will have to start at the top next time. I always start at the bottom where I leave off.
_________________
Mary

Husband is 67 year old Male
NSCLC - Squamous Cell Carcinoma
Chemo and Radiation Treatments together
Allergic reactions to Taxol and Taxotere.
The Story: http://www.cancerforums.net/about9079.html

carolyn · Regular Joined: 23 Jun 2009 Posts: 18

Thanks for all the input. The cancer is adenocarcinoma. Hopefully all will go well this weekend. We are starting the anti-nauseau meds today. Monday she is getting an injection for her bones, I believe that is what they told us. This shot will probably make her ache and have flu like symptoms they say. Well it looks like a very unpleasant road ahead but hopefully she will get better and we will be able to go on a little road trip... Again you guys are great. Thanks, Carolyn
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carolynf

onecoyote · Senior User Joined: 15 Jul 2008 Posts: 153

Carolyn,
Considering that my husband's condition at the time of his first chemo was comparable to your mom's condition, I will relate what happened to him. He got the joint aches similar to the flu. I rubbed his legs constantly which helped as did warm, frequent baths. He had pretty bad diarrhea for about 5 days and lost his appetite. This landed him back in the hospital with dehydration. So as PBJ said, stay super hydrated, try anything you can get into your mom, especially Gatorade, Pedialyte or water.
Best wishes for an uneventful course of therapy,
Charlene
_________________
Husband Danny, age 66,
diagnosed squamous cell June 6, 2008,
Right pneumonectomy performed with no adjuvant chemo or radiation on Sept. 2008
Metastatic lung cancer in the ribs, scapula and right kidney raised it's ugly head May 2009.
Renal cell carcinoma diagnosed May 2009
One round carbo/taxol, too weak to continue
Cancer racing like a freight train
Held my husband's hand when he passed away September 29, 2009

dcomputer · Regular Joined: 18 Jul 2009 Posts: 10 Location: New Jersey

I would also consider this level one treatment but I had little in side effects except loss of hair. I am yound so there will be some differences but I am also off of that treatment now since it was worthless.

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