4BEP - now moving to VIP (Stage IIIB)

[Trisha]

Hi guys.
We were about to start our 3rd cycle of 4BEP when our resp test showed lung damage. So much that they want to stop the bleo and move him to VIP. Any info about this would be helpful. I cannot launch the nccn site from where i am til sunday but from what i recall this is also the "salvage chemo" that will reduce our options is the intial chemo doesnt work or it comes back. I appreciate any info. The good news is our markers are headed down and tumors are shrinking (about 1/3 the size).

[Already Bald]

Geez Trish,
I'm so sorry to hear about the bleo tox- don't know much about VIP, but the good news is the lower markers and smaller tumors.
Maybe the Oncologist can finish you in an EP protocal?? I was started ia 4xEP because I had a chest cold the week I started chemo. (2 kids in day care...) They weren't sure if they were going to be able to tell the difference between bloe tox and day care "kenel cough".
Sorry to not be of much help, other than knowing that this is a very highly treatable disease, and by staying on top of everything I'm sure your man will be just fine.
Best of luck.
Joe

[ebfun7]

VIP verses BEP

I can speak to this becasue my husband actually had 2 rounds of VIP then 2 rounds of BEP per Dr. Einhorn because they were trying to avoid Bleo due to some lung problems he had. VIP is a chemotherapy protocol using Etoposide also know as VP-16, Ifosfamide, and Cisplatin. BEP is a chemotherapy protocol using Cisplatin, Bleomycin, and Etoposide. The only differnce is Bleo is relapced with Ifosomaide. Lance Armstong actually had four rounds of VIP not BEP due to the possible lung toxicty of Bleomycin.

VIP is not the same as VeIP which is salvage chemo. VeIP is different drugs. It is a chemotherapy protocol using Vinblastin, Ifosfamide, and Cisplatin. It is also used as salavage chemo.

Dr. Einhorn told us VIP and BEP have about the same success rates. Hope this helps.

[mrb1980]

Trisha,

ebfun7 is right, this is a substitution of ifosfamide for bleomycin. Stage III TC is routinely treated with four rounds of BEP, so with your husband's lung toxicity problems VIP is used instead.

If you recall, I had four rounds of BEP which resulted in significant lung problems which have since cleared up. Sounds like your oncologist is making the right choice.

Wishing you the best, and please keep us informed.

[Trisha]

Thanks!

Thanks everyone for your very helpful comments & well wishes It is truly appreciated. Glad to hear mrb1980 your lung function is back to normal too!

We are in our 2nd day of VIP and things are going well except he is not enjoying the hospital stay.... but it could be a lot worse!

I am happy to hear that the VIP is not the salvage treatment. Does anyone know if because the VIP has Ifosfamide & Cisplatin does that reduce the effectiveness if we had to go to salvage? Obviously hoping we don't need to but just wondering......

Happy New Year!

[dadmo]

I don't like the term salvage chemo. It sounds too desperate, it reaaly is eithrer second third or fourth line chemo. To directly answer you question they have several proven lines of chemo all of which work well against tc, they will simply have to use one of the other mixes. As things move foward with the treatment of tc some day they will find a better mix then either EP or BEP and at that point todays standards will be considered salvage because they won't the the first choice, it won't have anything to do with how effective they are.

[Trisha]

Good news... his cancer markers are now back within normal range. This is great news. We finished 2BEP and now did 1VIP with 1 more VIP to come in a two weeks.
Here is my question (yes another question - at some point I guess I hope to help someone else!) ... So what does it mean now that at the halfway point his markers being in normal range. I am so happy about the news but also want to be realistic (& prepared) for what's next. Thanks again to all of you.

[mrb1980]

Trisha,

Your husband's TC and treatment are remarkably like mine were a year and a half ago. My markers were in the normal range after 3 rounds of BEP, and I was hoping that I could forgo the 4th round. My oncologist said, "No, we're doing all four rounds."

His analogy goes like this: Think of a movie monster that's chasing you. You shoot it three times, and you think it's dead. When you turn your back, the monster is suddenly alive again! The 4th round is the final treatment that ensures that the monster is dead, and is standard for Stage III.

My 4th round was rough, but I've been cancer-free for over a year. My first normal tumor marker lab results marked some of the happiest days of my life so far.

I've also had a few not-so-positive results from 4 rounds of chemo:

--Peripheral neuropathy. This is numbness in the hands and feet due to nerve damage and is a pretty common side effect of four rounds. It gradually subsides but is a genuine pain when trying to perform everyday chores like buttoning one's shirt or tying one's shoes. Your husband may need some help at first--I did.
--Tinnitus. I have varying degrees of ringing in my ears, from a loud roar to almost silence. This is also very common.

These side effects are not present in all patients. They are no fun but are tolerable.

Your oncologist will also put your husband on a surveillance schedule including blood tests, CT scans, and chest X-rays. Just be sure and don't miss any of these. With normal markers and scans, the surveillance appointments will gradually become less and less frequent.

Congratulations! It sounds like your husband's doing great. Please let us know how things are going.

[Hopeful]

Just to make a quick reference about 'salvage chemo'. Salvage chemo is actually high dose chemo/stem cell transplant. It is VERY different than from regular rounds of chemo. HDC is used when the first rounds of chemo didn't work and this is the second line therapy like Dadmo stated.

it's hard to predict what is going to happen next. VIP tends to have different side effects than BEP or EP. It just really depends on the individual. My husband, after a round of VIP had no side effects except for losing hair. With his 4xBEP, he had throat problems, a cough and neuropathy.

Patti

[Trisha]

VIP Platelet issues

Hi all.

So it appears that VIP is not working so well for him now. So far we did 2BEP but switched next to VIIP after a 25% reduction in lung capacity. With one round of VIP his platelet level plunged very very low (9K) after just one round of VIP... and if we do another round of VIP the risk it will fall that low or even lower appears to risky. He could have a stroke or internal bleeding without any warning.
So we will retest his pulmonary function and decide. BEP with more potential lung issues, VIP with the serious risks of stroke/internal bleeding or do just EP (which doesn't has the same effective rates). We start our next chemo round early next week - just not sure which one we will do yet.
I appreciate any feedback/comment as always!
Thanks!

[Davie]

Trisha,

Just remember that even though the chemo is very tough on the body, it means the cancer doesn't stand a chance.

Davie

[Lori]

My husband went through high dose chemo with stem cell and had platelet tranfusions when his count fell below 10k. Is that something the doctor's could do and keep him on VIP?

Good Luck and keep us posted.

[Trisha]

Thanks for all the support and comments!

We just got word that we will be going EP for our final cycle. We are excited to get this whole thing behind us! Just a few rough weeks and we hope to be done.

His lung function has not recovered enough to do the Bleo and the VIP is just too risky with his plunging platelets - so EP it is! He is excited that he will not have to be hosptialized.

His markers have stayed in near normal levels since December and he may even be cured now: )

We are truly thankful for this website and all the helpful advice from everyone.

[dadmo]

He should do fine with EP. Let's keep our fingers crossed.

[Trisha]

All Clear!!!!!!!!!!!!!!!!!!!!!!

Happy to report my husband got his all clear today!

Diagnosed in October 2006 with Stage IIIB Nonseminoma and after doing 2BEP, 1VIP & 1EP we are so happy.

I can't thank all of you enough for all the support, advice and caring these last few months. I had a million questions during this whole ordeal and you all have been an amazing support system. I don't know what I would have done without this site and all of you.

Surveillance sounds pretty good now!