OvCa: Alternatives to Carbo & Taxol

I had reactions to both Carbo and Taxol and my Oncologist wants to discuss alternatives at my next appointment. Has anyone out there used some other chemo drugs? I think my worst reaction was to the Carbo. Any input is appreciated. I’ve tried looking online but only find that Carbo and Taxol are the current preferred treatments.

Thanks

Well
Since Taxol is such an allergenic drug, usually people are given dexamethasone in pretty high doses the night before and in the IV just prior to the taxol.
This is all done before each treatment, however the oral dose decreases with each treatment.
I guess I am a bit concerned because I feel you have not been given a proper trial with Taxol, as you apparently were not given the pre treatments.
I am not sure what everyone else gets, but I was treated at two facilities and each on gave dexamethazone the night before taxol.
Ultimately your doc makes the decisions , I would though ask him about the steroids and taxol

Here are the recommendations
Note: Premedication with dexamethasone (20 mg orally or I.V. at 12 and 6 hours or 14 and 7 hours before the dose, diphenhydramine, benadryl (50 mg I.V. 30-60 minutes prior to the dose), and cimetidine, famotidine, or ranitidine (I.V. 30-60 minutes prior to the dose) is recommended.

I just feel that sometimes the optimal drug is not given for odd reasons

Hi Iluvmint

After further checking, if they find that taxol/carbo just won't work for you, there are a lot of chemo drugs out there. You will have options.

Did your doctor perform a "tumor assay" to determine what chemo might be best for your particular cancer? It may be something to ask your gynecologic oncologist about.

Good luck!

What kind of reactions did you have? There are reactions, adn then there are REACTIONS!
And what pre-meds did you get? (As arunner said, you should get pre-meds with those drugs.)

I had an anaphylactic reaction to Taxol (i.e., I suddenly couldn't breathe) even though I had plenty of pre-meds. After that I switched drug combos, but not because of the reaction. I had chemosensitivity studies done on my tumor (my surgery was after the taxol rxn) and taxol wasn't a good choice for me anyway.

I was put on Gemzar and cisplatin for my first post-op go-round with chemo, and again after this recurrence. I breezed through chemo the first time. This time I had anaphylactic reactions to cisplatin and then carboplatin - and I was on pre-meds with both of them as well. Cisplatin was also causing other problems for me, so we ditched it and tried carbo. My reaction on carbo was much milder and by upping the pre-meds and post-meds I was able to tolerate it.

Next up for me, if/when I need it, is topotecan, probably paired with carbo again.

In short, some allergic reactions can be overcome with added medications, and there are lots of other drug options out there.

One problem I had should be fixed by the port I had put in on Friday. When I had my first chemo treatment by IV it leaked and really burned my arms (both arms because they had to move the IV from one arm to the other).

Before they began my chemo they gave me three pre-meds...one was Benadryl, one was Tagamet, and I don't know what the third one was. It might have been a steroid.

I reacted to the test treatment of Taxol but with additional Benadryl and another drug they gave me I didn’t have a reaction to the second test and did fine when they administered the actual medication.

Another reaction I had was flushing that moved about my body for several days. It started the day after chemo and was around my eyes, the next day my ears were really flushed, and then my boobs (yikes!), etc. Then I broke out with hives. It was my mistake for not calling the doctor’s office at the first sign of hives, but I let it go for a couple of days and I was quite miserable by the time I called them and they put me on Prednisone.

I also got some blistering in my mouth, but not too bad. When they gave me the Prednisone they also gave me the special mouth wash and that really helped.

Today is day 10 and my scalp is tingling a lot. So far my hair is still attached, but I’m sure it is just a matter of time.

Maybe they will give the Taxol/Carbo another try. Once I got the hives under control it wasn’t so bad. I see my oncologist next Monday.

THe thing about chemo is that it causes LOTS of side effects, the sores in the mouth are pretty common on about day 7 or so.
The job of the oncologist is to determine at what level you have to change the meds. Everyones blood counts drop, everyone loses their hair, sores in the mouth are pretty common too,
The other thing is that if you have EVER had herpes simplex, either the coldsore type OR the genital type, you are almost guarenteed to get it during chemo at some point, and worse than usual. (I just mentioned that because that is another thing that causes blisters in the mouth)

The really hard part of being an oncologist is to determine which symptoms you just have to deal with and which ones suggest that a change in the meds is necessary. It is a truly double edged sword, if you are too cautious, you may deprive someone of the best drug for their cancer, and you are not cautious enough, someone might have a very serious reaction or problem.
Its up to your doctor, but I would just ask if you were supposed to get premeds before taxol, such as meds 12 hours before, meds 6 hours before and then just before first taxol.
Perhaps his test dose thing is how he gets around doing that.
Good luck with your next visit, please keep us posted.
Do you get chemo next monday too?

No, my next chemo isn't until Friday, Feb 12th. I feel I am in good hands with my chemo specialist. I am at a very large and prestigious medical clinic/hospital and my oncologist is the director of the infusion center and specializes in ovarian and cervical cancer. I will let you know what he says next Monday.

"I feel I am in good hands with my chemo specialist. I am at a very large and prestigious medical clinic/hospital and my oncologist is the director of the infusion center and specializes in ovarian and cervical cancer."

That is great, sounds like you ARE in good hands. Hope I was not too ..... vocal....



Janet

	Quote:
Originally Posted by arunner Hope I was not too ..... vocal.... Janet

No worries! I come here looking for input and advice from those who are not afraid to be vocal. One of the great things about this site is you can get a lot of input and use it as you feel appropriate. I appreciate everyone's advice and input.

	Quote:
Originally Posted by arunner The really hard part of being an oncologist is to determine which symptoms you just have to deal with and which ones suggest that a change in the meds is necessary. It is a truly double edged sword, if you are too cautious, you may deprive someone of the best drug for their cancer, and you are not cautious enough, someone might have a very serious reaction or problem.

This is so true!

My entire team felt it was important to keep me on a platinum-based drug if at all possible. My reaction to cisplatin was fairly bad, but that isn't what tipped the scale far enough to make a switch. I was also having a MAJOR increase in my peripheral neuropathy. It was becoming debilitating. My reaction to carboplatin the following week was mild, and could be handled with some added pre-meds and post-meds.

My reactions tend to have a delayed component -- I get itching, shortness of breath, etc. later that night and maybe the following day. Because of that, I stayed on Benadryl and/or low level steroids for a few days in addition to my daily Zyrtec (or Claritin). I'm doing a couple of days with Benadryl after my Zometa treatments as well.

Let us know how it goes!