radiotherapy and chemotherapy together

wammer

I am writing in repsonse to an early posting. My mum is due to start radiotherapy for stage IIIb lung cancer on the 28th. She is to have 4 weeks of this. She will also start chemo while on the radio. This is a new procedure apparantly where she is having it done and i just wanted to ask if anyone else has had experience of both treatments done together and anything in particular to be worried about or to look out for.

Also i am worried as she is having such aggressive therapy that the side effects will be worse. Can anyone suggest any complementary medicines of therapies that could reduce the side effects.

Many Thanks

Tracie[/quote]

mikes · Senior User Joined: 25 Jul 2005 Posts: 143

It is fairly common to receive chemotherapy and radiation therapy concurrently.

The side effects can be compounded. The main concern is the blood counts depending what area the radiation is applied. If the radiation is being applied to the sternum, spine, pelvis, or ribs the red bloods count could be adversly affected. Most types of chemo also have the potential to reduce red blood counts.

Ask the doctor if Procrit might be appropriate as a defence to the loss of red blood cells. If so, it is much preferred to transfusions.

Melatonin is given in some clinics to reduce the adverse side effects of chemo by enhancing the immune system. Melatonin must be avoided if your mum is taking Procardia or Prednisone or Dexamethasone.

wammer

Thanks for your eply Mike. She cannot take Melatonin as she is on prednisolone but i will ask about the other.

Does anyone know of any complementary medicines or therapies that may help with the side effects?

Trace

gdpawel · Posted: Thu Nov 24, 2005 10:50 pm Post subject: Anti-angiogenic Therapies

Giving low doses of several drugs every day by mouth. There would be no needles and the side effects are expected to be mild. Unlike standard chemotherapy, which is given in high doses to kill as many cancer cells as possible, the lower-dose regimen is meant to attack the blood vessels that feed the tumor. Tumors create their own supply lines by secreting substances that stimulate the formation of new blood vessels and researchers suspect that frequent low doses of certain drugs may disrupt the growth of those new vessels, starving the tumor.

The treatment includes small daily doses of standard chemotherapy drugs and two other drugs that have been found to inhibit the formation of new blood vessels, called angiogenesis. One is Celebrex and the other is Thalidomide. It is offered only to people who have no other options, who have advanced tumors that standard treatment cannot cure or those for whom standard chemotherapy has quit working.

Women with advanced breast or ovarian cancer are being given smaller, more frequent doses of chemotherapy to reduce side effects. It is hoped that low-dose treatment may help other cancer patients, not just those who are considered terminal. It may work just as well or even better, maybe through this ability to cause an anti-angiogenesis effect.

This approach to treatment is based on something that can frequently occur in people, when a tumor becomes resistant to chemotherapy and high doses stop working. It is believed that angiogenesis plays a role. Angiogenesis is essential to the survival of many tumors. Many chemotherapy drugs, in addition to killing tumor cells, also fight angiogenesis. But, if these medicines stop angiogenesis, chemotherapy should work better than it does. Blood vessel cells are less likely than tumor cells to become resistant to chemotherapy, so if cancer cells become drug resistant, these medicines should still be able to shrink tumors by destroying their blood supply.

The reason chemotherapy was not stopping angiogenesis was that chemotherapy is usually given in big doses, with breaks of several weeks between doses to let the body recover. During the breaks, the tumor's blood vessels could grow back. By giving chemotherapy more often, at lower doses, it might prevent the regrowth of blood vessels and kill the tumor or at least slow its growth.

It is especially important to study low-dose therapies now because they are being used increasingly in clinics. Doses, timing and combinations all need to be worked out. Doctors need to find out whether the treatments can make patients live longer and whether tumors will eventually outsmart the drugs and find ways to survive even without angiogenesis.

For further information about clinical trials, refer to the National Cancer Institute's website: http://cancertrials.nci.nih.gov

Word of caution in receiving chemotherapy and radiation treatments at the same time: it doubles the toxic side effects.

Leucovorin is a fast acting and more potent form of folic acid. It is used as a rescue after dose-intense therapy to lessen and counteract the effects of toxicity and other folic acid antagonists. It may help. And then again, maybe not.

MyDadStageIV · Regular Joined: 17 Nov 2005 Posts: 16

My father did both Radiaton and Chemo at the same time. He did take a shot every single dayright before the Radiation to help prevent problems with his throat. He was getting radiation directly to his throat though, so it is a little different. He actually had two different cancers at the same time - Thorasic and Stage IV Lung Cancer. So, I don't know if they think this would be a problem in your case. Chemo itself can cause sores in the mouth and throat his was just exasperated because he was receiving Radiation as well.

He also used Magic Mouthwash and another numbing mouthwash to help with those problems.

The nausea and vomiting were harsh because of combining the two. Basically, we were advised that all the side effects would be compounded. My father was put on several anti-nausea meds. Phenergan is a must I say if they experience nausea and then my Dad used Zofran (1/2 the week) and then Compazine (the other half the week for delayed nausea to Chemo). He was on anti-nausea all the time after his ontake of vomiting and nausea. He was also given an anti-nausea med while getting the chemo.

He received IV fluids two times a week for the dehydration (helps with nausea too). He took Aranesp when his red blood cells went low. And he took Neulasta when his white blood cells declined. He took several vitamins/minerals on the side as well per the doctor and she strongly recommend CoQ10 (Co-enzyme Q-10 to boost the immune system).

My suggestion is to be as proactive as possible. When my Dad first got sick, we just considered it part of what they said the side effects would be. But when we told the doctor she immediately jumped on it and made sure that the nausea was kept at bay with all the meds. She also made sure he had something to help with the throat because she warned of the chance of needing a feeding tube-but thankfully he never did! Don't hesitate to have them tell the doctor any symptom/discomfort they are having.

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