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Today I received my third Abraxane treatment (chemo drug). I reacted twice to the Taxol, so they stopped it. Now I am receiving Abraxane which has been easier on me than the other drugs. The Adriamycin and Cytoxin made me feel like I drank a gallon of gasoline. My body felt like it just burned on the inside and there were times I didn’t have any energy whatsoever. I would sometimes just lay on the bed and just stare.
My energy is getting better now. I usually get tired about one or two o’clock in the afternoon. I have lymphedema in the left arm (hand is swollen) due to the removal of the lymph nodes. I have to go to a specialist to get fitted for an arm glove that help decrease the swelling. The drug that I’m taking also causes joint pain and peripheral neuropathy (numbness and tingling in the hands and feet) which I am having both.
Last week, my doctor did a test on my blood sugar and it was too high, so she put me on a diabetic drug called Metformin. I am now checking my blood sugars at home twice a day and so far they have neen running too high. Time to really change my eating habits.
Sorry I haven’t felt like blogging for awhile. I will try to do better.
LeAnn
LeAnn had her first Taxol treatment today. She went in at 10:45 am. Melissa took her there (Thanks Melissa!!) I have no more sick days left, so that has been very helpful. Were still down to one car, so it makes it very difficult on us with all these dr’s appointments.
She saw the Dr and they went over her liver scan she had on Friday. About a month ago, they did a liver scan and it showed a strange spot or 2 on her liver. They didn’t know what to make of it, thought it might be some dye or something left over from her surgery. They saw a spot again, but they don’t seem to overly concerned with it.
So they hook her all up and as soon as they start the Taxol, within 5 mins, LeAnn said she felt like she was on fire, she could hardly breath, she was all red and she felt all of her muscles tightening up. The nurses ran over there and shut down the Taxol…gave her some steroids and antihistamine to combat the reaction. They also had to give her some oxygen. After her symptoms calmed down, they proceeded with the Taxol again, but gave it to her in a slower dose. She was there for about 5 hours today.
She seems to feel ok right now… I guess I will update in a few days and see what it does to her.
Greg
How Taxol Works:
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. “Normal” cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The “normal” cells will grow back and be healthy but in the meantime, side effects occur. The “normal” cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Taxol belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May Apple plant. Camptothecan analogs are derived from the Asian “Happy Tree” (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division.
- Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine.
- Taxanes: Taxol and Docetaxel.
- Podophyllotoxins: Etoposide and Tenisopide.
- Camptothecan analogs: Irinotecan and Topotecan.
Antimicrotubule agents (such as Taxol), inhibit the microtubule structures within the cell. Microtubules are part of the cell’s apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.
Side Effects
The following Taxol side effects are common (occurring in greater than 30%) for patients taking Taxol:
- Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
- Hair loss
- Arthralgias and myalgias, pain in the joints and muscles. Usually temporary occurring 2 to 3 days after Taxol, and resolve within a few days.
- Peripheral neuropathy (numbness and tingling of the hands and feet)
- Nausea and vomiting (usually mild)
- Diarrhea
- Mouth sores
- Hypersensitivity reaction - fever, facial flushing, chills, shortness of breath, or hives after Taxol is given. The majority of these reactions occur within the first 10 minutes of an infusion. Notify your healthcare provider immediately (premedication regimen has significantly decreased the incidence of this reaction).
The following are less common side effects (occurring in 10-29%) for patients receiving Taxol:
- Swelling of the feet or ankles (edema).
- Increases in blood tests measuring liver function. These return to normal once treatment is discontinued. (see liver problems).
- Low blood pressure (occurring during the first 3 hours of infusion).
- Darkening of the skin where previous radiation treatment has been given (radiation recall – see skin reactions).
- Nail changes (discoloration of nail beds – rare) (see skin reactions).
Nadir: 15-21 days
It’s Thursday and I took her to the Emergency Room. Lately she has had a lot more problems with her heart skipping beats and feeling funny. About a month ago, due to her blood pressure being low, they halved her precription of Atenolol. I believe this along with the Chemo has resulted in more issues with her heart.
A little history on this…… She has had issues with her heart for quite some time. It feels like it’s skipping a beat and racing sometimes. Other times, she describes it as squeezing. Having this condition and combining it with her anxiety and panic, fuels it even more. She has always feared death and dying. So a person could only assume how terrifying it must feel to have your heart skipping beats and racing, you start to feel anxious and a feeling of panic sets in, it gets more frequent, you get more anxious and you probably feel like you could have a heart attack right there and die.
I have felt my heart start to hurt before and was alone and I started to panic, because I thought I was going to have a heart attack while alone and die a lonely death. Not able to yell out that I love my family and my wife one more time.
She has went to a cardiologist before and had a whole battery of tests done, work a heart monitoring box for a week and it all came out ok. But if you feel your heart acting weird, having someone tell you in the past it’s ok, doesn’t help much.
So Thursday, we had some pizza (donated by a friend of hers at work, Thanks again) she laid down with the cat and I and it must have started skipping, because she sat up and then went in the living room. I think she took some Ativan, which is supposed to make her less worried about things in general. She then came back in and sat next to me, It comforts her to be next to me and hopefully gets her thru it. She then went in the bathroom and I could tell it was really bothering her at this point. I always just try to get her calmed down and hopefully it will pass, but this time I could not. She told me she needed to go to the emergency room and I knew at that point, there was nothing I could do to help, except take her there.
We get there and they do a EKG and hook her all up. Take some blood thru her port and test that. Her potassium was low and they gave her a couple of horse pills for that. Gave her some more Ativan and said it was ok to get her dr to up her Atenolol back to her original level. Got there about 7:00 or so and left about 10:30.
She keeps on telling me, she’s worried about her heart and no one else seems to be, so when she keels over, she wants people to know she was concerned about her heart. So, there ya go, honey.. I let everyone know, you got lots of witnesses!
Sorry we haven’t been keeping up. She just has been very fatigued lately. Her 4th chemo of the 2 drugs was on Wed. Neulasta shot on Thursday. She will now start the Taxol for 12 weeks. Those treatments are every week instead of the every other week before. After that it’s radiation for 8 weeks. We figure she might be all done with this treatment stuff around middle of October.
LeAnn’s been real tired on this last chemo of the 1st round of 2 of Chemo Treatments. She’s had some issues with her heart racing more that usual. I went with her to her last appointment. It’s pretty boring. We sat in chairs next to each other and the nurse hooked up the saline first. They feed that into her port for while, then it’s time for the 1st of 2 drugs. The first one is red. Seems to take forever for those bags to get into her. The IV machine makes too much noise for me to sleep so I just sit there. LeAnn takes a nap most of the time. The next drug is clear… then more saline.
I’ll post some pics I took of her with my phone probably tomorrow.
Kids are out of school as of Friday.
Greg
Today, I finished my last round of Adriamycin and Cytoxin, I am so glad about that. I’ll be starting on Taxol now once a week for 12 weeks and they informed me that this medication should be easier on my body with less side effects. I want to be able to enjoy summer without feeling so tired all the time. It’s been difficult to keep the blog updated because of being tired and having so much to do with work and home.
Last week, I began wearing a wig. My insurance paid for it with a doctor’s prescription. That was nice! At first, I was against wearing a wig because I felt I would be uncomfortable around my co-workers with them knowing it’s not my real hair. But, I did it and now it doesn’t bother me so much. Sometimes it’s really a pain trying to match the headscarves with what I’m wearing for that day and especially tying them in the back. It still hurts lifting up my left arm to tie the scarves because of the surgery. Now, I see it’s easy just to put the wig on, brush it a little and go. I keep a turban or headscarf in my bag because the wig gets itchy sometimes or it gets too hot.
I attended the Look Good Feel Better Program last week also. I would very much encourage anyone to attend this! There were 8 of us in the program that day and we all had a fun time. We were given a bag containing quite a bit of make-up, facial cleanser, lotions and make-up brushes. It wasn’t the cheap stuff either. They also brought in wome wigs, scarves and headbands for us to try on and take home if we wanted. The American Cancer Society is wonderful!!!!
Made it through my third chemo treatment. This one made me pretty tired but then it also wears you down when you have to work full time, take care of kids and the everyday stuff at home. I’ve had some issues with lymphedema in my hand from the surgery and I’ve had some swelling in my feet. One more round of Adriamycin and Cytoxin then I switch to Taxol for 12 weeks.
$6000.00 is what our oncologist said it was… reading around on the web, it could be $3800.00….. haven’t seen the bill yet. I also read on a forum that a oncologist posted that it cost $18.00 to produce and wholesaled at $1800.00.
So the deal is this… The day after she goes in for her Chemo Treatment, she has to come in for her Neulasta shot. In a nutshell, here is why she needs to have this. The chemo kills fast growing cells which could be cancer cells, but can also be white and red blood cells. She needs the white blood cells count to stay at normal levels or else she could catch a infection and possibly die. White blood cells are needed to fight infections. The Neulasta stilmulates the bone marrow to produce more white blood cells.
Now a little history on the Neulasta… it is made by a company called Amgen. They also make Neupogen, which is kindof the same thing but is only good for several hours, whereas the Neulasta is good for much longer. So one shot of Neulasta can last thru your 2 week chemo cycle, whereas you might need daily injections of Neupogen.
Here is something I found regarding the Amgen company……
Neupogen & Neulasta
Neupogen and neulasta both treat a condition called neutropenia — a weakening of the immune system as a result of chemotherapy. Patients on high-dose chemotherapy sometimes develop infections that can be life-threatening due to their inability to fight off germs. Neulasta boosts these patients’ immune systems, making it less likely they will develop infections, and allowing the to tolerate higher doses of chemotherapy. Neulasta is a longer-acting version of Neupogen, requiring less-frequent injections. Neulasta is also significantly more expensive than Neupogen, and more profitable for Amgen as a result.
- Contracting: Oddly enough, Neupogen and Neulasta have been important levers to help the market share of another Amgen drug, Aranesp. Amgen ties discounts on Neupogen and Neulasta to the market share of Aranesp at an individual oncologist’s clinic, reserving the bests discounts on Neulasta for oncologists who use Aranesp almost exclusively. Neupogen and Neulasta do not have any significant competitors. Because oncologists purchase both red blood cell growth factors (such as Aranesp and Procrit), as well as white blood cell growth factors (such as Neupogen and Neulasta) oncologists have a financial incentive to use Aranesp. In fact, Because of the dynamics of medicare reimbursement, oncologists must receive discounts on Neulasta in order to break even — the reimbursement rate is less than the list price. As a result, oncologists who use J&J’s procrit lose money on Neulasta. Amgen competitor Johnson & Johnson (JNJ) alleges these contracting practices will push it out of the market, and violate anti-trust laws, in a lawsuit against Amgen.
Anyways, here is a couple of pics of these lovely drug in action.
The second chemo treatment last Wed, on April 29th, really hit her hard. It seemed she lost a lot of energy and everything was a chore to do. On Friday, May 1st, she stayed home. She was starting to have trouble with her back too. Friday night, I took her out for a bit but she just didn’t feel good and needed to go home. Sat was a very bad day for her. Her back was very painful and she felt her heart was beating too fast and she just didn’t feel right. She was laying on the couch and was in tears because of the way she felt.
She has always had a fear of her heart giving out on her. She feels her heart “skip” and worries her alot. At one point, she went to the heart doctors and had a complete checkup, even had to wear a machine for a week or so that recorded her heart activity. They seem to think it was ok, but it has always scared her. With her anxiety, throw in a heart that does funny thing and that just adds to the panic and fear.
As she said to me on Tues, on the way home… God sure does love me, huh? I’m special! She said that because, not only is she battling the chemo reactions, but now she has a back that’s killing her, a sore on her foot and a couple of other things that are painful.
Her hair situation has also bothered her quite a bit. We we shaved it off, she had started to adjust to that, but a few days she was starting to lose her 1/4 inch or so stubble. It started coming out in patches when she would take a shower or she would find alot of her hair in her head wraps. So, her head had patches of almost bald spots mixed in with stubble. I know this bothered her alot, as she just feels ugly. I understand where she is coming from but I try and reassure her that her hair is not what makes her such a wonderful person. I tell her (and mean it) that she is still very beautiful. She’s concerned that I might be embarassed to be seen with her, that I don’t find her attractive anymore. Both could not be further from the truth.
I am trying to impress upon her that she can feel comfortable in her own home… no need to wear any caps and such. Her head is very sore from losing all the hair and everything going on with that.
It has been a very difficult week for her and it has been hard for her to be strong thru it. She has her moments but each time, she trys and picks herself up and move on. I am so proud of her for the strength she is showing thru all of this. I do my best to pick her up and to try and put a smile on her face and make her laugh. I guess I could border on being annoying to her, but hey, whatever works!!!!
I’ll try and write more as we go along thru this journey…
Made it through chemo #2. When I go to the Oncologist, I have to sit and wait to see the doctor to discuss any new problems and discuss lab work. Then they take me back to the treatment room and hook me up. Before starting the chemo they take a blood sample through the port and check the WBC levels. If it ever becomes too low, they won’t give you chemo that day. My blood levels have been fine. It takes about 3 hours to have the Adriamycin and Cytoxin given through the port. For the first few times I go to the bathroom, the Adriamycin turns the urine a light red in color but then it goes away. Chemo #3 is scheduled for Wed the 13th.
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