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Old 09-08-2008, 12:24 PM   #1
grandma2
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xeloda trouble already

am just starting my 2nd week of xeloda, 4000mg. i'm feeling just terrible. some of my se's are not the usual but i don't think they're good. lungs hurt, blood sugar readings going up each day, just had a doozy bloody nose. totally exhausted and it's just 1 week. today am to start tykerb and i'm a little scared. talked to onc office this am and was told this is the standard dosage. yet i read most are on lower dosage. i need advice fast please.
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Old 09-08-2008, 01:58 PM   #2
Believe51
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Thumbs up Hey Grandma

Is there anyway he would adjust your dosage?? If you feel that you need a lower dosage or that you would want to explore that possibility, call him back to discuss your needs! You call the final shot. If we were in this situation I would be calling back to talk again with the doctor. Express to him how you feel! See what he thinks when you approach him. Many have adjusted their meds with their doctors help. Good luck>>Believe51
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Old 09-08-2008, 02:22 PM   #3
grandma2
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just talked to onc.

just got off the phone with my onc. why do they do this. she insists that these se's are not from the xeloda. i asked her about taking daily baby aspirin before i started and she said ok. now she said that the nosebleed was because of the aspirin. but finally did say that i can stop the xeloda till the 17th when i see her but to start the tykerb tonight. she keeps saying i have alot of disease in my abdomin and need the xeloda. she doesn't give me much chance to talk. when i see her i'll ask about taking a lower dosage of xeloda but i already know what her response will be. thanks for your advice.
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Old 09-08-2008, 03:21 PM   #4
Sheila
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Grandma2
I was on Xeloda for over a year and I was on 2500mg a day, with little or no side effects....they have found that the old standard 4000mg a day is not needed to get effective treatment....talk to your onc. and get it lowered!
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Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 09-08-2008, 07:14 PM   #5
Diana1993
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Thank you Sheila for that info. I started with 4000mg and then had the dose lowered to 3600mg. and changed from two weeks on and one week off, to: one week on and one week off. Also, without permission I lowered it to three to 3300mg. I still have some hand/foot syndrome, but at least it is tolerable. Is there anyplace you can lead me, to get the info on lower doses?
Hugs,
Diana.
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Old 09-08-2008, 07:57 PM   #6
grandma2
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thanks sheila. do you think the lower dosage is why xeloda didn't work or stopped working? that is what she will probably tell me...that if i lower then it won't be helpful. diana i'm wondering about you also. is your lower dosage keep you stable or even improving your situation. thanks, grandma2
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Old 09-08-2008, 08:39 PM   #7
Sherryg683
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I was on Xeloda with Taxotere and herceptin, and I know I wasn't put on 4000mg. That sounds high. If I can remember right I think I was put on 3000mg and still had hand foot syndrome really bad. It was reduced a little but I can't recall the exact dose, been awhile. I was 2 weeks on/ week off. I remember my oncologist saying that they had adjust the doses on everyone because in the beginning he had patients coming in with their skin peeling off their hands and feet and no one wanted to take the drug. I guess the lower dose of Xeloda worked for me as I am still doing well.
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Diagnosed: December , 2005 at age 44
13+ positive lymph nodes
Stage IV , Her2+, 2 small mets to lungsChemo Started: Jan, 2006
4 months Taxotere, Xeloda, Hercepin
NED since April 2006!!
36 Rads to follow with weekly Herceptin indefinately
8 years NED now
Scans every year

Life is not about avoiding the thunderstorms, it's about learning to dance in the rain!
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Old 09-08-2008, 10:42 PM   #8
hutchibk
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Sheila is correct!! And it will probably help you to start one first before the other when it comes to Tykerb/Xeloda. I started Xeloda 10 days before Tykerb and I think it really helped my body get used to the new regimen. I didn't have any of the probs you have described and am hanging in there just fine 18 months later... very very few se's.

Lowering the dose of Xeloda won't necessarily get you a worse result efficacy wise - the real work is done when the Xeloda and Tykerb work together synergystically. You must convince her to seek out the info about this and adjust you accordingly.

Conventional and approved Xeloda dosing is on a 14-on/7-off schedule 1250 mg/m2 twice daily (total of 2500 mg/m2/day). http://www.rocheusa.com/newsroom/cur...007060201.html

However, this link below sounds like the plan she is probably working from, but you are supposed to do 7 days on and 7 days off if you are taking 4000 per day (not 14 days on and 7 days off on this regimen). http://www.reuters.com/article/press...08+PRN20080418

Regardless, you can be adjusted down on your dose so that you are not so riddled with side effects - and still get the same efficacy.
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NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."

Last edited by hutchibk; 09-08-2008 at 10:44 PM..
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Old 09-09-2008, 05:30 AM   #9
Sheila
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Grandma2
Brenda is right....I was on the 14 day on, 7 off regime, but last year it was discussed at ASCO about the lower dose not affecting the efficacy.....I got over a year out of Xeloda, and that seems to be by path, as Taxol has yielded me a little over a year. I would talk to your ONC!!! There are many who are not "up to par" on the new dosing amts., as 4000 mg a day used to be the norm.
__________________
"Be kinder than necessary, for everyone you meet
is fighting some kind of battle."



Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 09-09-2008, 05:50 AM   #10
kk1
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A word of encouragement, I actually feel better during the weeks when I am taking both Tykerb and Xeloda together compared to the week when I have Tykerb alone. I guess it is a ying and yang type of thing with the se's. Together they balance each other out.

btw-When I started the treatment I had both at the same time eg. no intro with Xeloda alone to start, I am also on the same dosing 1250mg 2x daily 2 weeks on 1 off as Brenda.
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April 2004 de novo metastatic left breast 1.5cm her2++,er+/pr+ with 2 small liver mets
weekly taxotere,herceptin, xeloda
Sept 2004 NED-3 herceptin, zoladex,aromasin
Dec 2006 recurrence in liver
Feb. 2007 liver resection left lobe removed-herceptin, zoladex, switch to Arimidex
NED 16 months added zometa
May 2008 new lesion in liver 15mm Tykerb/Xeloda/Herceptin
July 2008 stable...yeah!
Sept 2008 NED again !!!
Jan 2009 fell off the wagon again spot back in the liver and fell out of menopause.
Feb 2009 RFA and 2nd liver resection to remove spot ---back on the NED wagon again continue Tykerb, Herceptin.
March 2009- oophrectomy added Femara and bi-annual Zometa
May 2009- scans clear but suspect lung nodule
June 2009- Lung VAT wedge resection to remove nodule---fungus ball not cancer!! phew
Aug 2009- NED
Nov 2009-scans again clear YAHOO!
March 2010- scans clear continue Tykerb, Herceptin, Femara, Zometa Q6mo
Nov 2009-Nov 2019 scans clear done every 6 months


Feb 2020 - Fell out of the NED wagon hard! single liver lesions and large infect cyst. 3 weeks in ICU.
March 2021- 5 cycles perjeta, herceptin, navelbine. lesion stable.
June 2021 - 3rd liver resection to remove single liver lesion. Continued perjeta, herceptin.
Nov. 2021- PET scan show 5 hot nodes near liver. 9 cycles Kadcyla
June 2021- PET scan shows progression. nodes size unchanged but even more SUV uptake.

July 2021- start ENHERTU
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