Saw Onc about Trial

[Lyn]

Hi all, had my visit with Onc at big hospital, sure was different to my onc, he looked scared of me so I don't know what Boris told him, anyway checked me over and said main concern would be heart ejection fraction had to be over 50% as would have it my in 58% and rising, and other problems was he couldn't find anything wrong with me so I will have punch biopsy done on Jan 9 when my doc comes back or sooner if I can get in somewhere else quicker, if nothing to treat I have asked my on to keep me on indefinate maintence Herceptin/ Xeloda/ Cyclophosomide, otherwise you can bet as soon as I stop something else will crop up, so that is me until obviously the new year. And Lolly and Sandra how are you both doing, haven't heard much from you lately.

Love & Hugs Lyn

Love & Hugs Lyn

[lindaw]

Dear Lyn
Probably your onc was overwhelmed by your knowledge . The trial sounds good.
I am starting on doxil/herceptin after I have an echo ( start on the 28th Dec).Hope it keeps the skin mets away for a while.
love
linda

[Lolly]

Hi Lyn, good to hear from you! I'm doing ok so far on Navelbine/Herceptin, had some shrinkage initially, now seems that the nodes are stable. But, I still have four months to go so we'll see. If things don't pick up again I'll ask about going on Xeloda also, as that was the initial plan but I was having some problems with low, low, low blood counts. Now that situation is under control so I think I could handle a triple whammy if needed.

Take care of yourself, the trial sounds exciting! Have a wonderful Christmas and New Year...

<3 Lolly

[Sheila]

Linda
Good luck to you...the trial sounds very promising...once again you are pioneering the way for many of us.
Have a very Blessed Christmas.

[Sandy H]

Hi Lyn: Am not sure if you meant me for Sandra? Here I am anyway known as Sandy H and with skin mets. I am now off chemo since November 11th and everything appears stable. Will enjoy a great Christmas and see what the New Year brings for challenges. We both know there will be some. I think that some times new docs feel overwhelmed with us knowing as much as we do. Good to hear from you. hugs, Sandy

[Lyn]

Hi Sandy, yes you were tagged, I think a few of us oldies are kicking back taking a back seat, not suprisingly we have been to hell and back a lot of times now and just resting on the side lines. Have you tried Navelbine for your skin mets? I am unsure where I am at until I get some tests done, the cream Efudix made my breast red, a few scaly bits which dropped off and now smooth again so I am anxious to see if anything worked. Glad you are OK.

LOve & Hugs Lyn

[Lyn]

Hi Lolly, glad you are OK, have you had any feed back on the vaccine you had? thanks for doing it, at least we know that you were out there for us who have similar BC's and until you know for sure if it was any help we won't put our hand up for that one.

LOve & Hugs Lyn

[Lolly]

Hi Lyn,

Glad you had some response to the cream, and it'll be interesting to know what the oncs think.

When I'm done with this round of chemo (March or so) I'll either be having more blood sent up to the Vaccine Group or going up there for a procedure where they harvest my T cells for study. But no, I don't know any more about how I responded to the vaccine other than that I did have a good response by the third month but as we know had recurrence several months after finishing the vaccine. So for me, it didn't prevent a recurrence, but may have helped keep the recurrence confined to the same lymph nodes as previously, so time will tell. They still want my blood for study, so that's good!

<3 Lolly

[Sandy H]

Hi Lyn: Yes, I have tried Navelbine and it didn't work also Xeloda which didn't work. The cream you tried is that Xeloda? Wishing you well. Yes, some times we need to sit on the side lines as it does get old. Hugs, Sandy

[Lyn]

Hi Sandy, Xeloda turns into 5FU when in the blood stream, the cream is called Efudix 5 %, by chance I used if for 1 month just to see if any reaction, that was about the amount in the tube being used once daily, it is a bit on the expensive side so I got a reaction in that time frame, I have a repeat for 2 more tubes and hopefully it already did the trick, so I am actually looking forward to my punch biopsy. I have managed to get my MRI done on January 5, not what you know but who you know. My onc got Citizen of the year, so when I work out how to scan photos on to site I will put the newspaper article on the post, he turned 40 this year also. A bit of info on the cream for you.

Love & Hugs Lyn

Fluorouracil

Generic Name: Fluorouracil

Product Name: Efudix

Indication:

Fluorouracil is used as part of a chemotherapy regime aimed at palliative treatment of malignant tumours of:
- Breast (ranging from mild and early to late and inoperable)
- Colon
- Rectum
- Stomach
- Pancreas

Fluorouracil usually aims to provide temporary relief in gastrointestinal cancers.

Fluorouracil cream (Efudix) is used in the treatment of a number of skin cancers.



Action:

Fluorouracil is an anticancer drug known as an antimetabolite. After entering cells and being activated, it interferes with the replication of rapidly dividing cells (including cancer cells) by preventing the conversion of folic acid to folinic acid, a building block for new DNA.

Fluorouracil aims to reduce tumour size and prolong life for cancer sufferers.


Dose Advice:

Efudix cream
- Apply a thin layer of cream over the affected area.
- A dressing is generally not used for solar and senile keratoses.
- Other conditions, such as keratosis palmaris, may require an occlusive dressing.
- Duration of therapy is usually 3-4 weeks
- The total area of skin being treated at one time should not exceed 500cm2; larger areas should be treated in sections.

Fluorouracil Injection BP
Fluorouracil Injection BP can be administered via injection or infusion. Dosage is always determined according to body weight, using ideal weight only in patients who have gained weight due to oedema, ascites or other forms of fluid retention.

Intravenous infusion
- 15mg/kg to a maximum of 1g daily.
- Should be given in 300-500ml glucose 6% over a period of 4 hours.
- Continue infusions daily until signs of toxicity begin to appear (stomatitis, diarrhoea etc), when treatment should be discontinued.
- Maintenance therapy can be started after the side effects have subsided.

Intravenous injection
- 12mg/kg daily for 3 days.
- In the absence of toxic effects, give 6mg/kg on the 5th, 7th and 9th days.
- Maintenance therapy can then be initiated in the continuing absence of toxic effects.
- Otherwise, wait until toxic effects have subsided, then initiate maintenance therapy.

Maintenance therapy
- 5-10mg/kg by intravenous injection once a week.
- Discontinue until toxic effects subside, in the rare occurrence that they appear during maintenance therapy.
- Reduce dose accordingly when co-administering with other cytotoxic agents or radiotherapy (http://www.virtualcancercentre.com/Treatment.asp?sid=3).



Common side effects:

Efudix cream: (side effects seen at site of application):
- Pain (http://www.virtualcancercentre.com/symptoms.asp?sid=4).
- Itching.
- Change in skin pigmentation.
- Burning.

Use of Fluorouracil Injection is usually accompanied by adverse effects, as the window between effective dose and toxicity is narrow.

The following effects have been observed:
- Nausea and vomiting (http://www.virtualcancercentre.com/symptoms.asp?sid=8) - occur often and symptomatic treatment is indicated.
- Diarrhoea.
- Proctitis.
- Oesophagitis.
- Stomatitis (sore, red, ulcerated oral cavity) - an indicator of toxicity.
- Decreased blood cells - occurs commonly and may lead to fever, blood noses, infection, bruising, tiredness and weakness.
- Hair loss (reversible).
- Abdominal cramps.
- Fatigue (http://www.virtualcancercentre.com/symptoms.asp?sid=9).


Haematological - Leukocytes are inhibited more than platelets.

Mucositis- depending on dosage schedule, the lining of the digestive tract can be damaged causing diarrhoea and mouth sores.




Uncommon side effects:

Efudix cream (side effects seen at site of application):
- Dermatitis.
- Scarring.
- Soreness.
- Tenderness.

Some less common reactions seen with Fluorouracil Injection include:
- Allergic skin rashes.
- Skin pigmentation.
- Confusion (http://www.virtualcancercentre.com/symptoms.asp?sid=10).
- Depression (http://www.virtualcancercentre.com/symptoms.asp?sid=12).
- Emotional disorders.
- Speech disturbances.
- Staggering.
- Seizures.
- Loss of sex drive.



Diseases treated by this drug:


Basal Cell Carcinoma of the Skin (http://www.virtualcancercentre.com/diseases.asp?did=538)
Regimes that include this drug:


5-Fluorouracil (http://www.virtualcancercentre.com/regimen.asp?regid=54)
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