Chemotherapy Drug Combinations

I was wondering if anyone out there has been referred to the triple drug regimen of Xeloda, Gemzar, and Taxotere; or the combination of Gemzar and Xeloda. In late May 2005, my husband, age 62, was diagnosed with pancreatic cancer after being admitted to the hospital for a stroke. He had back pain and abdominal pain since October 2004, and in November 2004 they did a colonoscopy, and removed four polyps. His pain continued and in December 2004, so they started him on pain medication and gastrial reflux medication for gastrial esophogial reflux disease (GERD). After several visits with his GP, he was then sent early May 2005 to have an abdominal ultrasound and a CT scan, and more blood tests. After the reviews of the scans, they told him then that he had pancreatitis, and a pancreatic cyst. His GP spoke with a GI specialist, and after they reviewed his case, they determined that the cyst was not malignant, and to continue his diet and pain medication for pancreatitis; and if his condition didn't improve after three months, they would reevaluate the condition, although he had elevated liver function tests and was very jaundice. If it hadn't been for the stroke mid-May 2005, and the wonderful doctors in the hospital pursuing his abdominal pain, he would not have been diagnosed with the pancreatic cancer until it would have been out of control. While hospitalized for his stroke, they ran several tests, MRI, abdominal CT and ultrasound, ERCP, blood work ups, and biopsies. His symptoms from the stroke have subsided. He was not eligible for surgery for the pancreatic cancer as it had metastized. Prior to release from the hospital he started his first chemotherapy treatment. At this point, he is in Stage IV pancreatic cancer, which has spread to the liver, lymph nodes, and the pancreatic duct. He is currently on Gemzar IV -- days 1 and 8, and Zeloda by mouth (twice a day) -- days 1 through 14, with one week off in between cycles. He takes dilaudid and a patch for pain, Zofran for nausea and vomiting, and a laxative for constipation. So far he is doing pretty well with the chemotherapy, but continues to have to undergo a theraputic paracenthesis to drain the fluids from his abdomen, as the fluids build up and cause him to have problems breathing, increased pain, and a very swollen abdomen. While in the hospital, they did test his antigen levels (CA 19-9) -- blood workup. He had another blood test done last week, and we will have the results next week. A repeat CT scan will be done in two weeks. I have also added supplements to his diet: COQ10, Vitamins A, B's, Potassium, and Centrum. Also, have refrained from adding Folic Acid, as I read that if someone was taking Zeloda, that it was not recommended to add a Folic Acid supplement as it increases its side effects. We have three wonderful children, ages 19, 12, and 10. Our family is staying strong, hoping, praying, and staying optimistic for a positive outcome -- to shrink the cancer and put him in remission. I try to stay very optimistic, enlight of what the odds are. A positive atmosphere is very important, and he has a very positive attitude towards fighting this cancer. We are thankful everyday that he is still with us. I have found a wonderful site for pancreatic cancer: www.pancan.org. It is the only one that I have found that is specifically related to pancreatic cancer. They sent me a lot of information in the mail, and have been a great resource for inspiring stories of hopes, and much more information about pancreatic cancer than I could find on most of the other cancer web sites. God bless you all. Please be strong and have hope.

I am very sorry to hear about your husband. I am involved with pancan because of my father who we lost to pancreatic cancer in Nov.of 2003. I was so glad to hear of your optimism and hope. I understand what your children are going through. I am 36 and my sister is 27. It is tough to to through this but God will surround you with strength and peace. God bless you all.

Hi there - my aunt has been on the Gemzar/Taxotere/Xeloda regimen (GTX) with Dr. Fine in NYC since her diagnosis in late Sept. 04 with Stage IV PC. She had over 20 tumors on her liver at that time, as well as at least one on the pancreas. Since then, most (if not all) her tumors were eliminated or at least reduced. The side effects in the beginning were pretty strong (most being sensitive hands and feet, I think that's from the Xeloda), and there were times she had to take a "break" from one part or another of the combo. But she had great progress, and has been looking great. However, 9 months later, she may be developing a resistance. This is not to dissuade you for exploring GTX - but just an FYI that the therapy may work for a while but then lose efficacy, so if you decide to go this route, make sure to monitor progress. She's now looking for another option - but GTX really did wonders while it was working. Hope this helps - best of luck. Elizabeth

Hi - I just came across your message and felt compelled to email you. Your story of your husbands long road to diagnosis of pancreatic cancer is so similar to my situation. My husband was finally diagnosed in Feb 2005 after the severe abdominal pain starting in Nov 2004. Dr's kept testing, and testing and trying to come up with answers. Blood test markers and even a biopsy had come back negative, so when he went in for exploratory surgery in Feb, and they told us it was cancer we were really floored. I can not really respond to your question of the triple drug regimen - I know that my husband was on a chemo pump 24/7 while he was undergoing radiation. Now he is on Gemzar treatments every other week, for the next 6 months. His oncologist has also placed him on Tarceva, which I understand is more for lung cancer, but they are also trying it for pancreatic cancer. The positive news is that his oncologist says the last MRI shows a clear pancreas, and no indication of spread, so appears the radiation has done its job so far. I would like to inquire though about the treatment called theraputic paracenthesis you mentioned your husband is receiving. My husband is still having bad pain, and the MRI did show fluid buildup. Our dr though has never mentioned this treatment. Does this seem to have eased some of your husbands pain? Does this require hospitalization, or out treatment type? I would appreciate any info you can pass on. Finally, I am with you on the hoping, praying and staying optimistic part....we have a super 13yr old son, and I too realize that every day we have all together now is a gift. You and your family are in my thoughts and prayers...continue your positiveness ...as I am sure it is half the battle. God Bless. DKV

My husband accumulates a lot of fluid in his abdominal cavity -- his abdomen gets swollen and distended, and causes alot of pain, discomfort, and difficulty breathing. This build up is normally referred to as "ascites"--which is the presence of excess fluid in the peritoneal cavity (his oncologist said that it is common with individuals with advanced metastatic pancreatic cancer.) His doctor sent him to the ultrasound/radiology department to have an ultrasound guided paracentesis -- this procedure is done on an outpatient basis, no hospitalization was required. The radiologist performs the procedure after determining the best location with an ultrasound. The radiologist uses a local anesthetic, and then places a catheter into the abdomen, and then attaches the end of the tube to a suction bottle. The levels of fluid drained is monitored and they repeat the ultrasound during the procedure to see how much fluids are left. He has had this done several times, and the last time the radiologist removed almost 7 liters of fluid. This procedure has really relieved a lot of his pain and discomfort, can breathe so much better, and has more energy. He has not had any complications with the procedure, and feels so much better after it has been done. Check with your oncologist about the procedure. He is doing pretty good with his chemotherapy - so far limited side effects. He is scheduled for a repeat scan next week -- after completing the third cycle of chemotherapy. I'm hoping that we do not have to change the course of his chemotherapy, but I continue to monitor other options just in case. Good luck and God Bless you and your family.

I am so sorry to hear about your situation. I have a long story, but will keep this message short. I have been on GTX since Dec for liver mets. I had the whipple operation in Aug 04, but mets in my liver showed up in Oct 04. The GTX has been working to stabalize and even shrink some of the tumors. I would highly recommend this therapy. Also, there are drugs called Avastin and Tarceva that I would keep in mind if the GTX stops working. There is a website message board from Johns Hopkins Hospital that I visit regularly which has very, very good conversation and help. It is http://www.path.jhu.edu/pancreas/. Click on "Discussion Board". These people are either patients or caregivers of PC patients. I would be more than happy to expand on my situation if you like. Keep your positive attitude and faith.

Thank you so much for your detailed information about the theraputic paracenthesis. We will definitely check with our doctors about it - but it amazes me that no one has told us about it, especially since they have mentioned a couple times about the fluid build up. I guess this just goes to show how valuable this kind of site is to provide the sharing of knowledge... Thanks again and keep the hope.....

Your very welcome. My husband was so uncomfortable from the fluids. The paracentesis really helped out alot. One web site that has been a big help in finding information is www.pancan.org The sent me alot of information in the mail and their website contains sources that I couldn't find from other cancer websites. Staying optimistic and hopeful...

Mom was dx october 2004 with pc and started on the gemzar avstin combo with good results, srinkage and stable until recently.. Her cancer has now spread to her liver and we are trying the 5fu/xeloda combo right now.. This treatment is the hardest on her, fingers, toes cold, not being able to drink hot/cold for about 1 week after iv chemo. She is a strong person, great support system but i don't know how much longer she can do this combo..she has stopped taking her xeloda as of right now until her dr visit next week, and once off this drug she feels great.

On Jul 20, 2005 12:00 AM Rbh11890 wrote:

I am so sorry to hear about your situation. I have a long story, but will keep this message short. I have been on GTX since Dec for liver mets. I had the whipple operation in Aug 04, but mets in my liver showed up in Oct 04. The GTX has been working to stabalize and even shrink some of the tumors. I would highly recommend this therapy. Also, there are drugs called Avastin and Tarceva that I would keep in mind if the GTX stops working. There is a website message board from Johns Hopkins Hospital that I visit regularly which has very, very good conversation and help. It is http://www.path.jhu.edu/pancreas/. Click on "Discussion Board". These people are either patients or caregivers of PC patients. I would be more than happy to expand on my situation if you like. Keep your positive attitude and faith.

Dear Rbh11890,

Much time has passed since 2005, but I am hoping you are still doing well.  I am currently into my third year on GTX at Johns Hopkins, and am wondering what the future might hold.  Please respond if you can and tell me how you are.  Thank you.