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Thread: New Care Taker Questions Gemzar/Abraxane

  1. #1
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    New Care Taker Questions Gemzar/Abraxane

    I apologize in advance if this is the wrong place to post this question.

    My sister is being treated stage 4 pancreatic cancer with metastasis to the liver. I will be relieving our mother for a about tens days to look after her. My sister will be starting a new protocol (for her) of Gemzar/ Abraxane on Tuesday. Could anyone please give me some idea of what to expect with this regimen in terms of side effects, how quickly will they begin,and the duration of them? I believe she will be infused once per week for three weeks , then one week off and repeat. Previously with her initial chemo regimen (Folfirinox) she would experience side effects approximately 3-4 days after infusion. Any information or sharing of experiences would be greatly appreciated.

    Thank you.

  2. #2
    Super Moderator Top User DebbieC's Avatar
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    Hi Mas,

    You posted in exactly the right place...welcome. I'm very sorry to hear about your sister...you'll find yourself in good company here with people who have a large range of experiences with, well, just about anything pancreatic cancer related.

    My dad was on Gemcitabine, which is essentially Gemzar. For him, his side effects didn't start until many, many weeks into treatment. It seems from hearing others on this forum, the side effects of this particular drug aren't too severe. That being said, it is unpredictable what will happen from person to person. My best advice to you for this particular drug is to just be up on the anti-nauseau meds that she will have. They worked wonders for my dad. At the first sign of nauseau, give her a pill right away! Don't wait or it'll be too late. Also, be aware of her temp always. Infections are common it seems, so just be on high alert.

    As for Abraxane, I don't have any insight on that as my dad hasn't had it...yet. However, there are a few here that have and I'm sure they will be chiming in soon enough. In the meantime, there is a post at the top of this forum specifically about Abraxane. If you haven't had the chance to read it yet, it is long, but
    there is some good info in there that you might find useful. Here is the direct link....http://www.cancerforums.net/threads/...haring-of-Hope

    Hope that helps a bit. Pop back in with any questions that you have!

    Debbie
    March 21, 2011 - Dad diagnosed. Pancreatic Adenocarcinoma on head of pancreas.
    April 2011 - Gemcitabine and radiation for a total of 12 weeks.
    October 14, 2011 - Successful Whipple procedure. Cancer free! Best 5 months of my life!!!
    March 2, 2012 - CT scan and discovery of possible mets to both lungs.
    March 23, 2012 - Biopsy confirmed recurrence.
    May 2, 2012 - Folfiri regimen started. Stopped after 2 treatments due to infection.
    June 2, 2012 - Switched to Xeloda
    Sept. 21, 2012 - No more chemo...treatment not working anymore. Now we wait and pray.
    October 6, 2012 - My dad is now at peace in Heaven, watching over us until we meet again.

    ♥ Forever in my heart! Miss you every day more than words can say! ♥

  3. #3
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    Hi. I am currently on gemcitabine/abraxane. I have one more treatment in my first round of nine. My schedule was how how you stated...three consecutive weeks then a week off. After 18 treatment of folfiri I found this protocol much easier to tolerate. I have minimum premeds and other than a loss of appetite for a few days and fatigue for a few days I am able to function quite well. My weight is stable and have not had neuropathy which many struggle with due to abraxane. My hair did come out rabidly this time, and I am quite bald. Not sure how it is working. I am having scans so I will keep you posted if that would help. I am 16 months into this cancer and my diagnosis is like your sister's. I have been fortunate so far with holding the cancer in check. Low white blood cells and platelets are common with this protocol, and your sister may have to hold off a week after a few treatments if this happens. If she was on folfirinox, she will probably be familiar with the routine. Good luck, and this should be easier! Let me know if there is anything else I can help you with.

  4. #4
    Top User Queensville's Avatar
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    Hi,

    We have found Gatoraid helpful to keep hydrated. Husband is now using liquid magnesium and liquid B complex to help with the Chemo induced peripheral neuropathy. Constipation can be real nasty so make sure you talk with your doctors about constipation relief and definately consider staying away or reducing red meat intake until she finds out how she tolerates the new chemo. There are two types of constipation meds, one that stimulates movement, the other which softens. Make sure you understand which is which and have them in the house - you don't want to get caught on the weekend without knowing how to handle it. Also have a script of basic painkillers ready incase this happens.

    Also have a good ear thermometer ready because if there is a temperature, then there is a trip to the hopsital. Tape the protocol temperature on the ear thermometer case so you don't have to dig in the paperwork to find it when you need it. Our Oncologist said a temp of over 101.5 degrees meant a trip to the hospital. We kept the temperature in the house at 76 degrees because he always seemed to be cold.

    There are lots of more tips throughout the forum. Hope this helps.

    Queensville
    July 22 2011 Hubby (64) Diagnosed PanCan. Sept2011- Feb 2012: Abraxane/Gemcitabine. Feb-May 2012:Gemcitabine only. June-Sept 2012 5FU. Sept 4-no more chemo - Just living life. Multiple stents. Jan 2013/18 month mark. Mets everywhere. Looking for a bumper sticker that says 'Stay at safe distance - Driver suffering caregiver burnout'. Hospice Thurs Feb 28 2013. March 12 2013 he went off to his new adventure where we will one day meet again. It was 20 months from date of diagnosis until now.

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    Thank you all for your posts. Will continue to read the
    boards for further support and updates.

  6. #6
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    Hi Mas

    I hope all is going well. As others mentioned, our experience was similar:
    - delayed onset prior to serious side effects kicking in (a number of cycles)
    - cold: dad was regularly wearing a down jacket indoors
    - hair loss: this will happen fairly fast
    - nausea: dad wasn't so bad, but with ever treatment had anti nausea meds and steroids
    - peripheral neuropathy: after 10+ treatments this start o get bad. Difficulty walking (walking stick) and just towards the end it got so bad he collapsed a few times, once on mum and this was a drama. But in our case he had in total, over 7 months a treatment. This reversed once he stopped the meds. Even though it may sound bad, luckily in my dads case it was manageable, it will affect people differently but is also reversible.

    Euphoria - in our regime, dad steroids with the chemo drugs. Aim being to reduce side effects. This worked really well with very little nausea as well. But he would experience next day as being great but day 2 he would be completely without energy(rebound off the high of the steroids).

    Pls do share and let us know how the treatment goes.

  7. #7
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    Hi Mas, my father has been too on Gemcitabine/Abraxane (6 cycles), It has worked very good with him and side effects have not been very hard;

    Fatigue, specially 2 days after treatment and everyday less until next.
    Cold, always.
    Hands and feet sometimes very cold and sometimes very hot and swollen.
    Sight, he has worse sight.
    Nausea: My father hasn't had because he had antinausea meds before quimio.
    Fever, very little but you must monitor it.
    Insomnia, sometimes.

    For my daddy these side effects have been slight, I wish the best for your sister,

    Ira

  8. #8
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    Hi Martin,
    Please let us know how your Dad is progressing. We wish him healing and health. Elaine

  9. #9
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    Wanted to let you know I was on folfiri for 18 treatments and tomorrow will receive my 9th dose of gemcitabine/abraxane. The folfiri did a great job shrinking cancer, but I am happy to say my recent scans have shown the gemcitabine/abraxane is doing a good job too. My pancreas mass(tail) is stable, but the mets to the liver shrunk a lot and no other mets are visible. I am very happy as it has been 16 1/2 months since diagnosis. CA19-9 has gone up a bit, but nothing new is showing up. I hope my results give others hope. This protocol is also more tolerable than folfirinox for many people. There is hope for some quality of life with precious time even at Stage 4!

  10. #10
    Super Moderator Top User DebbieC's Avatar
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    Teacher1 ~ I am so happy to hear any good news that you have to share! I really am! I hope you know that I am constantly keeping you in my thoughts and in my prayers and I only hope for the very best for you!

    I know your story gives many people hope...including me!

    Deb
    March 21, 2011 - Dad diagnosed. Pancreatic Adenocarcinoma on head of pancreas.
    April 2011 - Gemcitabine and radiation for a total of 12 weeks.
    October 14, 2011 - Successful Whipple procedure. Cancer free! Best 5 months of my life!!!
    March 2, 2012 - CT scan and discovery of possible mets to both lungs.
    March 23, 2012 - Biopsy confirmed recurrence.
    May 2, 2012 - Folfiri regimen started. Stopped after 2 treatments due to infection.
    June 2, 2012 - Switched to Xeloda
    Sept. 21, 2012 - No more chemo...treatment not working anymore. Now we wait and pray.
    October 6, 2012 - My dad is now at peace in Heaven, watching over us until we meet again.

    ♥ Forever in my heart! Miss you every day more than words can say! ♥

  11. #11
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    Hello, hope you are ok and continuing with the good job.
    My father just passed the first session of Gem + abraxane. Two questions .....
    A) having temperature is something to be carafull with or it's just another side effect that will go away
    B) did you do anything in particular to keep the platelets high
    Many thanks,,,,, best wishes!

  12. #12
    Regular User bbake1's Avatar
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    I have been on gemcitabine since Feb (2 weeks on - 1 week off) and my platelets have been an issue at times. I was told there is nothing dietary you can do or anything to take to increase your platelets. There was one time that I was feeling really good, ate good, and thought all was going well, but the blood lab before chemo showed a really low count to where they delayed chemo for two days. Went back and I was in the "ok" range for them for chemo to continue. I was surprised on how much it did change in two days with no change in what I was doing or given anything for increasing platelets. I still occasionally have low platelets, but not to where they have refused to do chemo. I try to keep my diet stable (which I like anyway - I'm not good with food changes lately), which may be boring, but it may be one way to figure out why my platelets are so low at times.
    12/06/11 - Diag w/Stage IV PC on head of pancreas. Liver and lymph mets
    06/01/12 - Months of Gemzar chemo. Scan shows 50% smaller in size of liver tumors. Panc tumor shows 10% smaller in size.
    10/22/12 - Scan shows spots on lungs. Moving to MM-398 trial. Bad side effects.
    12/14/12 - One year mark. Scan shows no appreciable change.
    03/06/13 - 15 month mark. Scan not good. Now on Xeloda pills.

  13. #13
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    I just had gemcitabine/abraxane Tuesday. I now only get it every other week. I regularly have problems with white blood cells and once had low platelets that prevented chemo. The white blood cells can be treated with neupogen or neulasta, but there is nothing you can eat that helps. The platelets also just have to come back on there own as far as I know. Frequently just holding chemo a few days gives the platelets a chance to come back up. As far as a temp. goes, my nurses and docs want to hear right away if I start to run a temp. I also have an antibiotic at home to take if my temp goes to 100.1 while awaiting their instructions. I have read that some people run low grade temps, but I would let the doctor know! I agree with bbake to keep a steady diet even when food is not so appealing. Also get up and move around, but allow for naps so the body can heal.

 
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