To Patty and Cathy re Xeloda

[al from canada]

Dear Ladies,
Sorry for not replying sooner but I cleaned the cookies off my laptop and forgot that it also cancels the "new message" function from the list.

Cathy,

The DPD deficiency can kill you if you were to continue taking Xeloda. I'm surprised they gave it to you a second time. This enzime nuetralized 5FU (which xeloda turns into) therefore you were over-dosing on the 5FU. Here is an article: www.pslgroup.com/dg/24cBca.htm

Patti,

The manufacturer's insert states that the doseage can be lowered first by 75% and again by 50% if required (due to dose limiting side effcts). This effacy of the drug due to the dose reduction is very well documented in numerous trials. It's just that the starting dose was set so high during the initial trials that dose reduction doesn't effect any of the treatment end points. Nose bleeds are also mentioned in the manufacturer's insert and taking coudamine or aspirine or any other blood thinners is contraindicated.

Have a great weekend,

Al

[jojo]

Al, I never knew that Xeloda turns into 5FU. IF memory serves right, 5FU is the type of a conventional chemo (infusion), huh? If this is true, why Xeloda? Is it the only factor of taking in the pill form for convenience? Anyway, thanks for sharing info on Xeloda.

[al from canada]

JoJo,

Xeloda is considered a "smat drug" and technically, it is a "pro-drug". The definition of a drug is a compound that has a meaurable physiological of psycological effect. Xeloda on it's own, has no effect until it is activated by certain enzymes in the cancer cells and is turned into 5FU. Theoretically, xeloda will only attack cancer cells because the only ones which contain the activating enzyme are cancer cells.

Take care,

Al

[*_Cathy_*]

Hi Al- Thanks so much for your help. I tried to read that article you suggested but I can only get to the site. Do you know about what date the article was- I can look it up that way. I thought that I had the nosebleed because my white cell count was down. Is that right? And isn't that expected? I'm thinking that my dose is too high- 4000 mgs daily.The chemo nurse said I needed it but I would really like to cut it down to 3000.I'm nervous anyway because I got a second opinion and he said that if my cancer isn't her2+ anymore, then the xeloda and herceptin wouldn't work. He said that I may now have a lymphoma, in which case I would need completely different drugs. The problem was that it's between my lungs and it would be too hard to biopsy. I guess I have to wait to have another petscan in a few months time. Thanks again, Al and God Bless- Cathy

[Lyn]

Hi, I too had nosebleeds but I had a nose swab done and it was caused by a staff infection that we all have in our noses and it just needs to be triggered, so rule that out first because it is treated with a cream.

Hugs Ly

[al from canada]

Dear Cathy,

From everything I've read, if you are normal hieght and wieght then 3000 mg/day probably sounds right. What really interests me is the changing of HER2 status.
Anyone else heard of this???
Al

[Lyn]

Hi Al, I have heard of changing status, so when I get a lump or skin mets they do the HER2 for me, thankfully mine has stayed the same, and hopefully those who weren't able to have herceptin can change for the better. Those on herceptin have a 45% or maybe more, better chance than those who are not.

Hugs Lyn

[al from canada]

Lyn,

This is VERY interesting! Am I to conclude from the stats you quoted, (Those on herceptin have a 45% or maybe more, better chance than those who are not), that being HER2+ AND getting herceptin gives you a survival advantage? That is contrary to all the stats but something all of us have suspected to be true. In other words, herceptin has given HER2+++ a survival advantage over HER2 (-)?

Al

[Lolly]

I went on a search and came up with this very interesting article by Dr.'s Burstein and Winer.

<3,
Lolly

[Lolly]

I went on a search and came up with this very interesting article by Dr.'s Burstein and Winer.


HER2 or Not HER2: That Is the Question
http://www.jco.org/cgi/content/full/23/16/3656

<3,
Lolly