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Perifosine Trials -- Anyone In One? What Kind Of Side Effects?

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Subject: Perifosine Trials -- Anyone in One? What Kind of Side Effects?
Date: 03/27/2005
I am writing on behalf of my mother in law who has lung cancer. She did chemo/radiation and now is in a clinical trial taking Perifosine. She lives near Miami, FL. She is experiencing a lot of side effects with the drug and hoping to find others taking it to discuss side effects, dosages, etc. Thanks.
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Mothersdaughtertx
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Subject: Perifosine
Date: 07/21/2005
Hi,

My name is Michelle and I live in Texas. My mother was diagnosed with liver cancer in dec 2004. She tried chemotherapy which worked for a bit and now her tumor is beginning to grow again. So, instead they are going to start her on Perifosine next week. I would be interested in keeping in contact with you to discuss side effects and results. We can lean on each other. Let me know if you want to email one another.

Michelle
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Jalm123
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Subject: Perifosine
Date: 08/06/2005
Hi, My name is Janet and my Mom has stage 3B lung cancer. Her tumor has just returned and her doctor wants her in a clinical trial of perifosine??I am interested in hearing about your experiences with this ...Im not sure how to advise my Mom . Any advice is appreciated.
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Subject: Perifosine - Side Effects
Date: 08/09/2005
Hi Janet,

My mother has stage 3 liver cancer and began taking the Perifosine last week. We were told by the research nurse that it is known to cause diarrea and, for people with stomach related cancers, nausea. They have two different dosages they are trying right now. Either you take the medication every day or you take 6 tables in four doses in about a 32 hr period. They placed my mother on the 32 hr dosage.

We began on Thursday, and about two hours after her medication she did get diarrea and pretty severe nausea. She took Phernigan and Anzemet for the nausea but still vomited. The immodium helped with the diarrea, but I did have to keep it in her system: ie. regular immodium dosing during medication days.

I don't know if your mom will experience the nausea, but be prepared just in case. During chemo they gave my mother Kytril for nausea and it worked well, and we will be trying that on her next medication days if she is not too weak to take the cancer meds as the Phernigan and Anzemet did not prevent her nausea.

I wish I could give you news on how well the medication works but she just hasn't been on it very long. At this time, I'm not sure she'll be taking it next week as she is just not eating like she should, due to pain, and is very weak. We have a doctor's visit tomorrow. I will keep in touch and let you know if she does take this weeks dose and how it goes.
Subject: Thanx For Info on Perifisone
Date: 08/10/2005
Thanx for answering...My Mom just found out today her dose will be high also 1xweek 18 pills every Monday taken 6 at a time. She is very worried about taking so much.I would like to keep in touch if that is okay with you. We live in Miami...how about you? Hope your Mom is feeling better. Janet
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Subject: Perifosine Follow up
Date: 08/23/2005
Hi Janet,

Hope everything is well with you. My mother has had to stop taking the Perifosine as it was making her so terribly sick. She is as stage III and barely eating enough to feed a mouse; so the nausea was just not helping matters any. We tried the Phernigan and Alzemet (for nausea) and she was still vomiting. Although the diarria was kept under control with the immodium. She actually went into the hospital for diarrea unrelated to the medication.
Unfortunately, she has taken a turn for the worse, as her liver is becoming larger and more malignant and is not able to work properly. She developed and infection and has developed a bit of confusion. (I won't bore you w/medical terms), but it is related to the liver cancer. She had to go into the hospital due to dehydration (also liver cancer related). When she was released they released her under hospice care (so she could come home). I have to say, though, that the hospice staff is extremely helpful and kind. I don't want to give up on her, but her outlook is not good at all. Liver cancer has always been non-surgical and terminal and we were truly hoping for a miracle. Now we are just trying to keep her as comfortable as possible (side effect meds to control confusion/diarrea/nausea), while I try to keep a brave face on in her presence.
BTW, had my first total breakdown yesterday.
I do hope and pray that the medication is working much better for your mom- I did read really good reports online about the successes of the medication and that it worked better on other cancers.
God Bless, and keep in touch,
Michelle
Subject: Perorosine
Date: 08/23/2005
Hi Michelle,
I'm so sorry to hear your Mom is doing poorly. My Mom as well found out this week she has mets to the bone. She tolerated the medication well but this news is very bad for her. I have to tell you, I cry everyday so dont feel like you are alone in that. We can only hope for as little suffering as possible.

Strength and Courage...Janet
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Subject: Mom is Off of Perifosine
Date: 08/26/2005
Hi Janet, Mom went into the hospital last week for severe diarrea and confusion and spent 4 days on an antibiotic/IV (as infection showed up in labs) I'm not sure if it was the infection or the Perifisone. The dr. suggested that she stop drinking milk, but did not explain why. It's almost the only thing I can get her to take besides small amounts of food. I personally don't believe that she has suddenly become lactose intolerant at 78 yrs old. I think it is more probable that it was the infection or post-results from the meds. We are truly glad to have her home now, but she is currently under hospice care. As you may know, Hospice's sole purpose is to no longer treat the cancer, but instead concentrate on keeping her comfortable, ie. "palletive care": which brought on my first "sobbing breakdown" (not in front of her of course). I really didn't want to admit her to Hospice as it felt like I'm giving up, but I have heard so many good things about the organization, and so far everything I've heard is true. They are a wonderful group. The only thing that they've done that I consider an "error" is prescribe Lactulose to her 2X day mainly for an "ammonia" build up due to her liver cancer which causes the confusion. I initially didn't give it to her, but the nurse told me that it was necessary. Problem is that Lactulose is also is used to treat constipation and now she has another bad bout of diarrea, and I have been advised to take her back off the Lactulose and give Immodium. They also wanted to take her off of any pain meds that contained Tylenol b/c it's bad for your liver. So this week, we have tried diuldid(sp?) and Methadone as she had a really bad experience with Morphine tablets (uncontrollable shaking and being cold). The diuladid and methodone did not control the pain as well, and basically just made her sleep constantly and eat even less; (she is already sleeping alot b/c of pain) so they compromised today and let her have hydrocodone with less tylenol. I have attempted to ask her about her final wishes (ie. life support, resucitation, etc) which is really difficult b/c I don't want her to give up hope and the only thing that she has really told me is that she would accept a feeding tube, but most importantly: she does not want to be in pain. At this point I am at a bit of a crossroads - the hospice nurse says that the Tylenol will only cause her liver to break down faster and shorten her life. But if the Norco does not control her pain and she is uncomfortable, sleeping alot more, and eating less - Will what's left of her quality of life really be improved? Especially assuming it is God's will that her time is limited? My mother and I have always been close, I think this is the only time I haven't been able to find the right words to talk to my mom. The good news is that she has been mostly in her clear mind. I think that the first chance I get, I'm gonna crawl up into the hospice bed with her and see if I can get her to open up with her feelings (as well as mine); although I do find myself saying "I love you" so much more. It's difficult to stay strong, but I am proud that I can at least keep my strength in her presence. Strength and Courage to you, too, and feel free to lean on me as I have with you.
Subject: Moms
Date: 09/07/2005
Hi Michelle,

Howis it going at your hause..I sent you a message about a week ago but I dont think it posted..maybe problems due to our recent hurricaine. My Mom is having a diarehea problem also now and she is super weak...Im not sure if this means she is close to the end? All she does is sleep and she doesnt want to eat or do anything. It would be almost a relief to have hospice so someone would tell me the truth(doc says shes doing great).But I know my mom and this is not her. I think the cancer is somewhere they havent found yet. Anyway, Im back to being completely stressed and caqnt sleep. Sorry the last message didnt post(I dont think) Hope to hear from you soon..Janet
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Subject: Mom and Hospice
Date: 09/10/2005
Janet,

For some reason I didn't get your last message, but I am glad to hear from you. I am sorry to hear that your mom is not doing very well, either. The Perifisone did the same to my mother. It made her vomit more than the chemo ever did. It also gave her severe diarrea. When she was taking it, I kept nausea pills and Immodium in her system constantly during dosage times. The nurse had told me to give her Immodium after every loose bowel movement - and the diarrea was pretty severe, so I would dose her with Immodium one hour after the Perifisone to try and prevent it. When the nurse first put mom on the Perifisone she said that it caused some diarrea and usually only people with digestive cancers would have nausea, so I should be prepared for it. I had no idea, though, that the side effects would be so extremely severe. My mother was also very weak, but she was already in a weakened state as it was. Now she it seems she is just wasting away, and I, too, am having an extremely hard time dealing with that (even though I keep telling those that ask that I am doing "okay"). I do not like to hear that your mom is not doing well, but it is good to have someone that can relate to this emotional rollercoaster. When mom first came home, she could go to the bathroom with my assistance. Then she had to use a bedside potty, now she is on a catheter :(. She is still not eating. I am lucky if I can get her to take 5-6 bites a day of soft food or soup. I have tried everything, even baby food. I think that food just doesn't taste good to her anymore. The nurses come almost every day now (either the RN or Aide)- it's nice to have someone here to help but it also makes me wonder the same thing that you are wondering. Does this mean she's close? I try not to live in denial: hospice was created for the sole purpose of just helping those that are dying- stay comfortable until their time comes, they even have a chaplin that comes to visit (they don't treat the illness-just the side effects), but I cant help to try very hard to hold onto some iota of hope for a miracle.
The vomiting and diarrea your mom has, I believe, are caused primarily by the perifisone, not the cancer- because my mom doesn't get sick to her stomach anymore, and only sometimes has bouts of diarrea, usually after a day or so of confusion/delerium. That is the scariest part, is when she becomes confused - it's so hard to keep a strong front while you watch your mother (mine was so independent and always took care of others) falling apart, but I have managed to keep it together when I'm in here presence and do what the nurses say to do: remind her of the date-etc, talk calmly and remember that even though she is confused, she can still hear me. I continue to tell her daily that I love her, and I even climbed up into her "hospital" bed to lay beside her and hug her the other day. The last few days she has been very clear headed, and that is one of the few things I find I am thankful for. I do think, though, that she has given up. I also think she is very tired of just being in that bed, doing nothing. She has no interest in TV or reading anymore and because I no longer have any sort of social life- I have nothing interesting to really talk to her about except the local news which I'm sure she could care less about. I know your stress, and I am there with you, if not in person, then in spirit.
Mom wasn't on the Perifisone long enough to find out whether it did any good. The doctor said it takes at least three months of treatment to tell anything. Also, when mom was taking the Perifisone she became very dehydrated. Watch for that: you can tell by pressing the skin on her forearms (like a very light pinch), if she is dehydrated the skin will stay kinda stuck together and very slowly go back down: if she is not dehydrated it will just "bounce back". I would suggest some pedialyte either way: IF you can get her to drink any (the nurse said adding a tsp of powdered jello helps with the taste).
One of the stressful and frustrating things is that even the doctor won't know how your mother is really doing until she can have the scan done. I pray that yours makes it through the entire treatment (unlike my mom); At least long enough to see positive results.
Another thing is that the hospice nurse tells me that if my mother won't eat, just try not to worry about it (she didn't say this aloud: but I know she means that basically I should just keep her comfortable until her time comes). It's hard not to try and encourage her, though. It's to the point that if she eats more than three bites at a time, I actually feel elation (I know: it sounds crazy) It doesn't feel natural not try to get her to eat as much as I can get her to take. I feel so helpless! I'm sure you feel the same.
It sounds like that unlike you, I have my father here at the home with us; but he was raised like a lot of older men- not to express emotion, so the house stays pretty tense, and neither of us sleep very well. As a matter of fact, I find myself dozing off sitting up sometimes and that is something I have never done, unless I was sick myself. My brother and his wife come by weekly to visit and help by bringing sheets and needed items. My sister-n-law went through this with her mother and has helped me personally by telling me what to expect and has taught me some things about being a "caretaker", but it is still surreal to me most times and I always feel like I'm not doing enough.
The hospice staff gave me an informative booklet on what to expect, when to expect it, and has great tips on dealing with all the emotions: mine, mom's, dad's, but I still don't think I'm dealing well emotionally or physically, my appetite is suffering a bit too. The fact that your doctor hasn't put your mom on hospice gives me hope that she has a chance. But I also know that sometimes physicians will wait too long and that doesn't help you or her emotionally, physically or financially.

I wonder too, about your mom's weight-if she is as underweight as my mom is then it may be doing more harm than good (but keep in mind I am certainly no expert in these matters). I've seen how miserable that medication can make a person. Does your mother still do things she enjoys? Does she seem withdrawn?
I would like to at least offer some information that I have acquired since they have put mom into hospice care.
I am going to give you a link so you can decide whether hospice is something that you think your mother needs.
It is my true hope that she doesn't need it, that she will soon be cured and this will be just a bad memory for you both. Hospice can be a depressing step, but I really think this link may be useful and will help you make more informative decisions, especially since I've heard your concern about her continual sleeping and loss of appetite.

http://cis.nci.nih.gov/fact/8_15.htm

Sorry that this has become such a long message, but, as I said, it helps to have someone to "talk to" that is going through the same things that I am experiencing. I do wish you the best in that the medication does for your mother what it couldn't do for mine because of her weakened state. Please, keep in touch.
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