4BEP - now moving to VIP (Stage IIIB)

[Trisha]

BEP vs. VIP vs. EP

The NCCN guidelines call for 4xEP or 3xBEP for stage IIIA and 4xBEP for stage IIIB non-seminoma.

Tammy,

The standards are different for IIIA vs IIIB as Scott points out above. However you are doing the right thing for your son by questioning it. So keep up the good work and your remain in my thoughts. I am sure you will be celebrating an ALL CLEAR soon.

The other question was why we moved from BEP to VIP to EP. BEP was causing lung damage and the VIP caused his platelet levels to drop extremely low. The risk of doing VIP again was too great. So we moved to EP which was much easier on his body than either BEP or VIP.

Meanwhile thanks to everyone for the kind notes... off to celebrate some more!

[Scott]

The NCCN guidelines call for 4xEP or 3xBEP for stage IIIA and 4xBEP for stage IIIB non-seminoma.

[mstlyn]

1 The post that says stage 3 non -sem is routinely treated with 4x BEP is not correct. It is routinely treated with 3x BEP or 4xEP. Both have the same percentages of cure. 90 %... 3x BEP or 4x EP is the IU ( and just about everywhere) protocol for stage 3 non seminoma.

In trisha post, he had to switch because of Bleo complications and toxicity, at which point they change as they dont want it to be refractive. In other words, if someone where doing BEP and it wasnt working, they will not give them BEP again.

I can see your confusion, but again, your sons protocol is right on.

I will post the TCRC info which will say the same thing, but i think the site is down right now.

Try to relax. give it a chance to work. The chance is 90 % that he will be cured, and that's pretty darn good for any cancer.

Alright Robert, thank you again for answering all of my questions.

I am as relaxed as any mom in the same situation would be, I guess. I do ask questions when something does not make sense to me though.

When something does not add up for me, I can't leave it alone until it does add up. =)

Bless you for being so patient and helpful

Hugs

[mstlyn]

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!

Congratulations to Tricia and Hubby. I know the sky must be a few extra shades of blue for you now.

Tammy

[mstlyn]

No, the post here doesnt mean anything to your case. I am sure that there are variables that were not posted. what was posted is that he was having problems with the regiment. Your son is not.

He is doing the right thing. Give it a chance to work, it has only been one cycle.

An example would saying that 5x BEP would be even more effective than 3 BEP. It would be another set of problems. More is not better with chemo. You want to stick with the tried and true, proven treatment that give a 90% cure rate. Your sons prognosis is excellent.

Try to relax ok?

Robert

Ok thanks Robert.

My concern is that if they do not treat his cancer aggressively enough the first time around, it will spread more and lower his prognosis.

This treatment needs to be the right one, the first time.

Tammy

[mstlyn]

Another thing I have been meaning to ask.

My sons cancer is mostly embryonal carcinoma.

Is the 5% yolk sack going to respond to the 4xEP as well?

Is yolk sack what they refer to as teratoma? Are they the same thing?

[mstlyn]

Stage 3 tc protocol calls for 3xBEP or 4x EP. That is the standard protocl for stage 3 Non-seminoma. It has a 90 % cure rate for both protocols. I think they had a little difference because of the lung problems. Which is why they are not taking that chance for a 21 years old youndg man. It is the right thing to do. Give it a chance to work, and please post the blood work on monday when you get it. Give it a chance to work ok ?

Relax, everything is fine . it sounds like so far he is tolerating it very well.

Robert

I am trying to relax, it is difficult to do that when it doesnt make sense to me.

Since 3xBEP and 4xEP are the same thing.

Why are other people being treated differently? Like this post from
mrb1980:

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.
--------------------------------------------------------------------

And since the bleo was hard on Tricias husbands lungs he received this treatment...

Originally Posted by Trisha
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 see other people with stageIII getting 4xBEP or in tricias husbands case he got the 2BEP, 1VIP and 1EP.


I am not trying to be difficult, I am just trying to make 1 and 1 add up to 2.

Tammy

[mstlyn]

Tammy,

4xEP is the same effectiveness as 3xBEP. As with your son, and myself, you want to avoid the POTENTIAL toxicity with Bleo, as your sons age is a factor. My chemo schedule on my profile should say 1 BEP, 3x EP but I didnt have that choice to list it on my profile. I elected to not do any more Bleo as I was concerned about lung scarring. Dr Einhorn and Dr Roth both agreed that it was more than ok. I would never give up scuba for this cancer. I mean I already lost a "little buddy" and was ripped open for it, and I was assured that this treatment, by the eperts was appropriate. I was also 3b and I am here, alive and fine, 10 years later. Alot of people do only EP. remember, your sons oncologist is following Dr Einhorn's protocol across the board. It is fine. It is just as effective.

Robert

Robert,
I understand the reason we are not using the bleo. What I do not understand is this:

If 3xBEP is equal to 4XEP

what is equal to 4xBEP?

This tells me that my son needs more than just 4xEP for stageIII TC

Do you understand what I mean?

[mstlyn]

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.

I have mentioned this before, but after reading your post I have to bring this up again because I am confused.

My son has stageIII TC 95% EC 5% yolk sac

When we first met with his oncologist, we were told that he wanted to go with 3xBEP

I asked about treating my son without the bleo, and the oncologist told us that he could be treated with 4xEP and he explained that 3xBEP and 4xEP are equivalent treatments.

Your post says that stageIII is treated with 4xBEP

I am guessing that 4xBEP is more aggressive treatment than 4xEP

Can someone please clear this up for me.

If 3xBEP is the same as 4xEP

and stage III is usually treated with 4xBEP

Is my son not getting the right chemo?? Since he is stageIII I feel there is no room for mistakes.

Opinions please???

[Fed]

Definitely a great start to the day! Awesome news Trisha! Congrats to you and your husband on this occasion! Have a great weekend,

[Already Bald]

Terrific News!
I'm so happy for you Trisha!

[dadmo]

This is turning out to be quite a good morning. Two all clears in the same day. Congratulations Trisha.

[Scott]

surveiliance (will i ever learn to spell that darn word!!)

Here's a mnemonic:

sur * veil * lance

• Sur - as in Big Sur, on the central California coast where mountains rise abruptly from the ocean, offering stunning scenery
• Veil - a covering often with symbolic significance
• Lance - as in Lance Armstrong, an icon of survivorship.

[ivannabanana]

Hi

Thys is brilliant news for you both i am so happy, we have had similar news and in surveiliance (will i ever learn to spell that darn word!!).... My hubby had 4 X BEP from Aug - Nov and hys tumour reduced to 6cm and was also dead ... He had first follow up scan on 2/2/07 got result yesterday it has reduced again by 25% so we over the moon... And i also say big thanks to all you guys N gals on thys forum, you have been a God send for us.... I hope everyone continue to feel good and get better... Bless you all, Yvonne

[mrb1980]

Trisha,

I had to smile when I read your post. This is great news!

My wife took great care of me after 4xBEP, so please look after your husband...I speak from experience, four chemo cycles can take a lot out of a guy.

Robert's right about surveillance, and I'm sure that you and your husband will do fine. Congratulations!!!