• Posted by newbie08 on July 2, 2008 at 12:57 pm

    Hi all,

    Question on chemo regime….

    When we went for our 2nd opinion in the US our doc recommended neo adjuvant chemo prior to RC, at that time he mentioned a regime of 3 weeks on, one week off repeated three times. That seemed to be pretty normal when I looked through peoples chemo regimes on this website! We decided to get our chemo in Ireland (which was fine with MSK!) They said they would liaise with our oncologist over here for treatment (this hasn’t been as easy as we thought but that’s another story!!)

    Anyway our oncologist sent a letter to the doc in US about the treatment they were giving, it read “neoadjuvant chemotherapy with Cisplatin and Gemcitabine given two weeks on one week off every twenty one day cycle for three cycles in total before having a restaging CT scan.” This is a different regime than was mentioned at our 2nd opinion consult so I wrote an email to the doc in US questioning the discrepancy…after a few follow up phone calls we got a one line reply which read “Your MD is correct”…..

    Does anyone know what difference this will make? In my eyes it 3 less rounds of Gem? Can anyone explain why this is? Has anyone had this regime of treatment? We’re a little concerned, what do ye think?

    newbie08 replied 16 years, 7 months ago 3 Members · 8 Replies
  • 8 Replies
  • Newbie08's avatar

    Newbie08

    Member
    July 4, 2008 at 10:45 am

    Ha Ha…That’s so true Pat :)

    Just to keep updated, Dad had Gemzar yesterday and he is feeling good enough today which is a relief because the previous 2/3 days were really miserable – that cisplatin is really mean and evil :angry:

    Next week is his week off (with this new treatment), we discussed with our oncologist why they were using this new cycle and he said it was because alot of peoples blood counts go way down on the 3 week cycle this can cause delays and increased side effects!

    We are looking forward to my dad having a break next week! Mel09 hope your dad is doing ok!

  • 's avatar

    Guest
    July 3, 2008 at 12:12 am

    Gee ya think a class in communication might be in order? I know they have classes on how to write illegibly :P What can i say? Pat

  • Newbie08's avatar

    Newbie08

    Member
    July 2, 2008 at 8:39 pm

    Hi Pat,

    Thanks for response :) It said on my dads pathology report “Cautery Artifact present”, searched the net but couldn’t find a thing on what it actually means!!!

    It was Bochner who wrote the one liner…as I said it read “Your MD is correct” so he was definitley refering to our doc over here! At least it was an answer anyway becasue my dad has another treatment tomor so we wanted it cleared up before he went in tomor!! Seems like its always something on this journey :(

  • 's avatar

    Guest
    July 2, 2008 at 5:15 pm

    Newbie…how was it used……? I think it refers to remnants left behind after cauterization but MSK uses the latest..in an article by Dr. Herr
    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7XMT-4HMVJBR-38&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d85013b6851d80933bfb61f76d5b200f
    And i wonder if the terse reply didn’t mean “your doctor” as meaning your doctor at MSK?…Personally i would call the patient rep at MSK and tell them your difficulties in getting more than a 3 word answer to your question and ask if they can’t actually facilitate a better answer from Dr. Bochner. Explain your not in the Bronx but in Ireland…maybe that will help! The patient representative number is 212 639 7202.
    Pat

  • leigh's avatar

    leigh

    Member
    July 2, 2008 at 3:39 pm

    Dear newbie08,

    I can understand your concern and you have come to an excellent place if you feel like ranting. :)

    I would certainly get a clarification on the regime to calm your fears.

    Sorry I cannot help with the cautery artifact question but someone will assist you shortly…

    Leigh


    Leigh, 39
    Dx July 2007
    TURBT July 2007
    RC/Neobladder ,Studer Pouch, September 2007
    Erasmus Centrum Rotterdam
    TNM Classification: pT4 N2 Mo
    4 cycles aduvant chemo Gemzar & Cisplatinum
  • Newbie08's avatar

    Newbie08

    Member
    July 2, 2008 at 2:59 pm

    P.S: Does anyone know what “cautery artifact” is?

    Thanks :silly:

  • Newbie08's avatar

    Newbie08

    Member
    July 2, 2008 at 1:45 pm

    Yes Leigh as you said, I remembered the doc saying –

    Day 1 – Gem/Cis
    Day 8 – Gem
    Day 15 – Gem
    One week rest

    Then the email came from oncology here saying –
    Day 1 – Gem/Cis
    Day 8 – Gem
    One week rest

    But the doc from america has sent a mail saying that our MD is correct!?!? Why did he give us a different regime when we were in US and then suddenly change to agree with our oncologist…The reason we went to US for 2nd opinion was for “specialist” opinion/treatment plan!! Sorry for the rant but it just seems a bit strange to suggest one treatment and then change it!! Plus it looks like my dad will have 3 less gem rounds, will this change results?

    Suppose I’m just overly nervous about any unexplained changes :(

    Glad to hear you got through your chemo Leigh, it was probably good to have Day 1 & 2 instead of all on the one day because last week my dad was in hospital about 9 hours for Cis/Gem…long boring day and pretty draining!! How are you doing now?

  • leigh's avatar

    leigh

    Member
    July 2, 2008 at 1:31 pm

    Dear newbie08,

    The chemo regime gemz/cispl does differ slightly in other countries.

    Here in Holland my regime was as follows:

    Day 1 Gemz
    Day 2 Cispl
    Day 8 Gemz
    Day 15 Gemz
    one week rest

    My treatment was offered adjuvant and for 4 cycles. I have read that some patients receive a combination of Gemz/Cispl on day 1 going onto Gemz day 8 and 15.

    Three cycles seems to be the norm prior to RC though.

    Regards
    Leigh


    Leigh, 39
    Dx July 2007
    TURBT July 2007
    RC/Neobladder ,Studer Pouch, September 2007
    Erasmus Centrum Rotterdam
    TNM Classification: pT4 N2 Mo
    4 cycles aduvant chemo Gemzar & Cisplatinum

Sign In to reply.