Topic: XELODA with OXALIPLATIN Chemo TX

Looking for those who have received chemo using CAPECITABINE and OXALIPLATIN (XELODA & ELOXATIN). We await Xeloda meds and it is my understanding that the regimen will be:
Cycle: Day 1-Infusion of Oxaliplatin;
         Day 1-Also begin 14 days of Xeloda,
         Then the "cycle" repeats.

Husband had Whipple 06/23/10, followed by two other chemo treatments. First was Gemzar with 5FU Infusion  but 5FU was discontinued. Cancer recured in surgical bed and is protected by transverse colon. Next he had CISPLATIN/GEMZAR for 6 cycles, completed 12/9/11. CAT following showed tumors slightly increased. And then yesterday (1/6/12), he required removal of fluid from within the peritoneum... 6 liters!

Seeking imput from those using this same combination. I have printed out side affects to expect for each, but if you have any "tricks in the bag," experience or advice to offer, I do welcome it!!!  Thanks.

Re: XELODA with OXALIPLATIN Chemo TX

Hi,

2 things, which you may have  known already.
1. AVOID cold drinks,use of ice cubes;touch of cold materials and housewares like cups.etc.
2. Felling fatigue is normal unless interfere with daily activities like dinning or reading a book or taking a walk .

Xeloda is a prodrug of 5Fu which your husband had before;except taken by mouth.
Oxaliplatin is the third generation of cisplatin (newer with supposed less side effects);but since your husband was on cisplatin before;please REMIND  the chemo nurse on the FIRST treatment of oxaliplatin to watch out for anaphylactic reactions(such as difficult in breathing,shortness of breath,rash,itching  and hypotension,it can occur within minutes of staring the oxaliplatin the FIRST time of treatment.) and make sure drugs as epinephrine,solu-medrol,antihistamine like benadryl injection are available ON HAND just in case.

the only other  things you have to watch which may not be on the patient  information list you got  are ,

1.Make sure the time of oxaliplatin infusion will  be around  2hours but  NOt longer than 6 hrs  to avoid acute toxicities.
2.Use of an injection port to avoid severe tissue irritation  as comparing to each time of sticking a vein and increasing the chance of extravasation .
3. If the patient is on Lanoxin(digoxin) for heart problem;talk to the doctor to adjust the dose of digoxin if needed.
4.drug interactions with filgrastim,G-csf etc may occur and you should discuss with the oncologist.
God bless

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: XELODA with OXALIPLATIN Chemo TX

To: PCL1029 MODERATOR...

Thank you so much for your reply!  I was not aware of the possible infusion reactions since he was on Cisplatin before.  If he does NOT have a reaction the FIRST time with Oxaliplatin, then am I understanding correctly that he may not thereafter????______

We were rushed the other day at the doctor's office  when all this unfolded on us. We unexpectely had to hurry away to our hospital and have his fluid removed as they were "working him in" their schedule. So I really didn't get to absorb and ask as much as I would have but I will. EACH time we hear more chemo is required it's difficult and receiving unfamiliar drugs at first make you uneasy.  SO I try to keep informed because when we go home from treatments... he's all mine! 

Your information is GREATLY appreciated and needed! I will discuss it with his oncologist and also be sure the chemo nurse is aware of it.  Take care and God Bless - AppreciateHelp

Re: XELODA with OXALIPLATIN Chemo TX

AppreciateHelp:

I was on a slightly different cocktail. Gemzar and Oxaliplatin. PCL is correct with the neuropathy warnings. Wear warm socks, gloves and a scarf if necessary. I wear fur lined boots every day because the neuropthy in my feet is the worst side effect. And the hands will have sensitivity to cold, as will the throat. So avoid cold and ice until the side effects subside. The length of time that takes depends on the individual. When I had my first treatment the side effects lasted about 4 days. I had treatment every 14 days. The side effects slowly lasted longer. By treatment #6 I had tingling and burning in my toes that did not go away. So they had to take me off oxy. It is still working, however, as my tumor is still shrinking. And thankfully, my hands and throat are not too bd. Every once in a while I get a slight tingling in my hands and every once in a while really cold drinks bother me a little.
The other side effects I encountered were: Pretty severe vomiting the first night. This lasted about an hour for me. Then I was done. I had anti nausea drugs but when I took them I spent 4 days feeling nauseous. So I quit taking them and just letting the nausea take me for an hour. It was much easier for me.
The other side effect is slight flu symptoms and elevated temperature for some. I had that on the second day (but that might have been from the Gemzar, also).
I hope this helps.
BTW, my tumor shrunk so well on the Gem/Ox cocktail that I ended up feeling the side effects were definitely worth it!
Good luck and I hope that soon you hear the words shrinkage! I hope your husband's side effects are minimal.

Kris

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: XELODA with OXALIPLATIN Chemo TX

To kris000j:
Hey, thanks for your heads-up of what to expect!
I placed gloves and a cap in my belongings to take to chemo next week. I am already planning on his dress for that day considering what I have learned. Your message led me to another question, which I'll ask his doc... if he will be receiving meds via infusion for NAUSEA (like he did before) or if I need to PRE-TREAT for NAUSEA with either ZOFRAN or COMPAZINE.

My actions (when a new chemo regimen begins) makes me think of birds for some reason... cause it's like I am "nesting," and preparing for what I know is ahead. That's just the way I operate. And you have certainly helped! This website is a God-send and imput from others is exactly what I seek.

What GRAND NEWS you had! Your tumor shrunk! I JUST LOVE HEARING YOUR GOOD NEWS, and I immediately told my husband as I feel there is strength in hearing positive news!  Thanks so much; my prayers are with you. Just know how much your message is appreciated!!!!!

Re: XELODA with OXALIPLATIN Chemo TX

Hi Appreciate:
I don't know where you live, but i it's cold you might want to add a scarf for him to cover his mouth with. My chemo was in the summer so I never needed a scarf, and I don't remember quite how quickly those effects hit, but it's better to be safe.
As for the nausea: they SHOULD give him anti-nausea meds along with the benadryl. I got both. The meds wore off after about 7 hours or so and that's when I let myself get sick.
I will wait to hear the good news from you, too. Oxaliplatin is a wonder! Bad stuff, but from all I've heard, it's pretty darned effective.
Kris

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: XELODA with OXALIPLATIN Chemo TX

KRIS:
We're in Macon, Georgia. Although today it's supposed to be in the 70's, the norm is much colder weather. So I will add the scarf.  We're geared up, just waiting on UPS to deliver the XELODA which will begin same time as the OXIPLATIN infusion.
 
I sure pray this combination of chemo drugs obliterates his cancer. My husband has been a real trouper going through these last 20 months. The Whipple surgery alone was a challenge, and I even "got me some nursing skills" then. Never was able to stomach some things, but that changed quickly, with me adamant about doing all I could for him. I can jump through any hoops put at me to help my husband, and I just pray for good results each time and that my husband's body can have time off to repair. 

Thanks for the nausea info too. The infusion center has been really good to us and I feel they will know about the adverse reaction and anti-nausea med, but I always ask/check!! Thanks.

If you think of any other info beneficial to us, just send it our way please. Keep me posted on your news too!

Have a great Monday!!  AppreciateHelp

8 (edited by PCL1029 Mon, 09 Jan 2012 12:32:24)

Re: XELODA with OXALIPLATIN Chemo TX

Hi,

" If he does NOT have a reaction the FIRST time with Oxaliplatin, then am I understanding correctly that he may not thereafter????______"

the second type of neuropathy is a persistant and will appeared after 14 days and it may interfere with daily \activities(eg.\buttoning\,writing\,swallowing etc.)
Continuing to monitor calcium and magnesium level while onoxaliplatin is advised base on experiences in the hospital setting practice.

cumulative oxilaplatin treatment will increase the risk of developing functional impairment in 10-50% of the patients but is dose dependent and usually occurs after the maximal response to therapy.

If you need more detailed info. and others suggestions , I will prefer using emails to communicate and  I will discuss them in more details  with you and in that way will also protect your privacy too.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.