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Thread: Should I go for this chemo therapy?

  1. #1
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    Should I go for this chemo therapy?

    Greetings to every member of this family!! My father has been diagnosed with stage four esophageal cancer at GE Junction. He is 75 years old and is quite week (42 Kgs) now. Doctors has prescribed Palliative Chemotherapy for him with injections Carboplatin AUC 5 and Paclitaxel 175mg/m3. I've heard about severe side-effects of Chimo and really don't want to go for this. If someone can please share their experience and suggest what I should do at this time. Is there any alternative available? I am very new to all this so please help.

    Thank you!!
    Sushant Kumar Dubey

  2. #2
    Moderator Top User HighlanderCFH's Avatar
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    Hello Sushant,

    Welcome to the forum with regrets that your father is going through something like this.

    I'm basically from the prostate cancer forum, but you should be getting advice from others who have knowledge and/or experience with this type of cancer. Things tend to slow down a bit over the weekends, but there should be a lot of help coming your way as the new week begins.

    Sadly, it sounds like your father may be nearing the end stages of this terrible disease and it could be that the pallative chemo might make him feel more comfortable and keep his quality of life as good as possible.

    But let's see what others -- with more knowledge in this area -- have to say.

    I just wanted to drop in and say hi and that others will be chiming in with advice for you in the next day or two.

    Wishing the best for your father,
    Chuck
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  3. #3
    Administrator Top User Didee's Avatar
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    Sometimes paliative chemo can help ease symptoms. Maybe get a second opinion. What does he want to do as his wishes are what should be done. My best wishes to you.
    Aussie, age 61
    1987 CIN 111. Cervix lasered, no further problems.

    Years of pain, bleeding, women's plumbing problems. TV ultrasound, tests, eventual hysterectomy 2007, fibroids in lining of Uterus.

    Dx Peripheral T Cell Lymphoma stage 2B bulky, aggressive Dec/09.
    6 chop14 and Neulasta.
    Clean PET April/10, 18 rads 36gy mop up. All done May 2010
    Iffy scan Nov. 2011. Scan Feb 2012 .still in remission.Still NED Nov 2012.
    Discharged Nov 2014.

    May/2012. U/sound, thyroid scan, FNB. Benign adenoma.

    Relapse Apr 2016. AITL. Some chemos then on to allo transplant. Onc says long remission was good. Still very fixable.

    SCT Aug 2016

  4. #4
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    Thank you for responding Highlander. Let's see if others have some more experience and can suggest anything.

  5. #5
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    Thank you Didee!! I'll try to get a second opinion on this too. It it help with his symptoms and he starts eating will less difficulty...this should good but I've heard that chemo has very severe side effect and sometime it can case brain stroke or heart failure. This makes me puzzled on whether or not we should go for it. My father is not aware of the criticality of his disease and chemotherapy....and frankly I don't want to share with him because he'll be very tensed.

  6. #6
    Administrator Top User Didee's Avatar
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    I have moved this to the other forum and have deleted the duplicate post you have there. Replying in different areas can cause great confusion.
    Aussie, age 61
    1987 CIN 111. Cervix lasered, no further problems.

    Years of pain, bleeding, women's plumbing problems. TV ultrasound, tests, eventual hysterectomy 2007, fibroids in lining of Uterus.

    Dx Peripheral T Cell Lymphoma stage 2B bulky, aggressive Dec/09.
    6 chop14 and Neulasta.
    Clean PET April/10, 18 rads 36gy mop up. All done May 2010
    Iffy scan Nov. 2011. Scan Feb 2012 .still in remission.Still NED Nov 2012.
    Discharged Nov 2014.

    May/2012. U/sound, thyroid scan, FNB. Benign adenoma.

    Relapse Apr 2016. AITL. Some chemos then on to allo transplant. Onc says long remission was good. Still very fixable.

    SCT Aug 2016

  7. #7
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
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    7,232
    Quote Originally Posted by xlsushant View Post
    Thank you for responding Highlander. Let's see if others have some more experience and can suggest anything.
    You're welcome. Yes, others will be jumping in a bit on Sunday and probably many more on Monday as the new week begins.

    In the meantime, Di's suggestion of getting a second opinion is something to consider.

    Take care,
    Chuck
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  8. #8
    Newbie Top User BobInBonita's Avatar
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    1,790
    Quote Originally Posted by xlsushant View Post
    Thank you Didee!! I'll try to get a second opinion on this too. It it help with his symptoms and he starts eating will less difficulty...this should good but I've heard that chemo has very severe side effect and sometime it can case brain stroke or heart failure. This makes me puzzled on whether or not we should go for it. My father is not aware of the criticality of his disease and chemotherapy....and frankly I don't want to share with him because he'll be very tensed.
    I'm really sorry to hear about the late stage of your fathers disease. One of the most difficult choices a patient makes is the decision that the quality of his remaining life is more important than the quantity. It sounds like you have accepted that he has a fatal condition, but that he is not aware of the seriousness.

    Every patient is different,and I don't know the particular circumstances of your father's situation, but if he is mentally able, shouldn't he be able to make this important decision about his life? Yes, hearing the news will cause a variety of emotions, but it will also allow him to say his goodbyes and come to acceptance of what lays ahead.

    It is also important to have a frank discussion with his Drs about the chemo they are proposing. What do they expect will be gained? Both of the drugs you mention can have severe side effects, but it depends on the patient and their strength going in as well as the dosages used. I believe the most probable and noticeable side effects are nausea and fatigue, although his blood counts and ability to fight infection will probably be affected also. A question you might ask the Drs is "If you were in this condition, would you want chemo or would you just want comfort care?"

    Has he expressed in the past what his thoughts and wishes for death are?

    Best of luck to both of you as you face this difficult decision.
    7/12 DX stage 3 pan can (adenocarcinoma) @ 65 - borderline resectable
    8/12 - 10/12 Chemo (GTX) & Stereotactic Radiation
    12/12 Whipple - R0 margins, 2/29 nodes pos.
    1/13 - 5/16 Vaccine clinical trial - randomized to control group - vaccine showed no benefit
    2/13 - 8/13 Gemzar for 6 months
    Quarterly scans - no evidence of disease to 10/14 - spot on lung being watched - possible infection 2 months on antibiotics
    3/15 - spot larger - probable met - surgery planned
    4/15 - PET prior to surg - recurrence & lung mets - Surgery cancelled - EUS w/ FNA showed adenocarcinoma - Stage 4
    5/15 - 9/15 Folfirinox @ reduced dosage - Stopped treatment after 11 infusions due to neuropathy
    10/15 - 8/16 maintenance 5-fu every other week
    8/16 - stable disease on both CT and PET/CT - chemo holiday while other treatments explored
    9/16 - lung biopsy confirms pan can met,
    10/16 -NanoKnife to pancreatic bed -PET after Nano showed new met in hilar lymph nodes - SBRT to both lung & lymph
    4/17 - PET/CT showed significant disease progression, multiple lung mets, pancreatic bed tumor has grown
    5/17 - Started hospice care - striving for acceptance

    Stay busy and live life to the best of your ability.

  9. #9
    Palliative chemotherapy is used to help the patient feel better. If this can ease his pain and other symptoms, I think that would be a good thing. My chemo treatments helped me feel better and did not make me feel sick.
    Diagnosed with stage 2c papillary serous cystadenoma borderline malignancy of the ovary in 2009. Hysterectomy, omenectomy, appendectomy, debulking.
    - 2010 - laparoscopy showed inoperable recurrence, so started chemo.
    - Frontline chemo - carboplatin and cyclophosphamide, six cycles
    - Additional chemo regimens: Avastin - ten cycles; Weekly Topotecan - 4 cycles.
    - Spring 2012 developed pleural nodules. Topotecan plus Avastin - 1year.
    - April, 2014, had surgery to remove Aspergillus infection from right lung.
    - September, 2015, started on Megace because my tumors are PR positive. Stopped Megace after three months.
    - September, 2016, hospitalized for shortness of breath and back pain.
    - September, 2016, respiratory failure reversed with prednisone. Maintaining on 50 mg Prednisone per day and supplemental O2.
    - October, 2016 left hospital with no supplemental oxygen. Feeling great! Will start tapering off the prednisone Oct. 10.

  10. #10
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    Quote Originally Posted by xlsushant View Post
    Greetings to every member of this family!! My father has been diagnosed with stage four esophageal cancer at GE Junction. He is 75 years old and is quite week (42 Kgs) now. Doctors has prescribed Palliative Chemotherapy for him with injections Carboplatin AUC 5 and Paclitaxel 175mg/m3. I've heard about severe side-effects of Chimo and really don't want to go for this. If someone can please share their experience and suggest what I should do at this time. Is there any alternative available? I am very new to all this so please help.

    Thank you!!
    Sushant Kumar Dubey
    My husband was diagnosed Stage IV esophageal cancer in early March. We were told this diagnosis would likely end his life in 6 months to 2 years. My husband wanted to fight and they began a chemo protocol of
    epirubicin, cisplatin and fluorouracil. He had the treatment for 5 sessions over 15 weeks, took a 5 week break after a pet scan showed no further metobolic activity and then did another 5 round course. His cat scan shows no mass or tumor and no enlarged lymph nodes. My answer to you is YES your father should try chemo if he still has the strength to fight. Are there bad days from the treatment? Yes, but we found that doing treatment every 3 weeks rather than every 2 gave us many more good days than bad. I don't know what the future holds for us, but right now he's off treatment again and enjoying life. Every day is a gift. BTW my husband is 68 years old. It is your father's choice, but certainly find someone to explain everything to him so he can make an informed choice. Good luck to you and I will pray your father has the same outcome and has time to enjoy life as well and prepare for the end. And very sorry you are going through this

 

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