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  • inpatient chemo next week

    Hello again everybody.... long time no see.

    after my markers went down to practically normal for a while, they are now back up, with both BHCG and LDH just a tad over the limit, and AFP at 70 already since the last test a month ago when it was at 10.

    so, off to inpatien chemo, prolly 3x BEP (can I even have a say in this? I doubt it - Belomycin scares me though)

    QUESTION
    What's inpatient like in the first round? Starts Monday, they say 3 days. How soon - if things go normally of course - can I go to work again would you say?

    QUESTION 2
    I have mostly embryonal carcinoma and yolk sac tumor, which is considered aggressive. how aggressive? Is my timing to begin chemo early, late, or right on time? I think my oncologist is knowledgeable and professional. He was leaning towards chemo already a month ago but without rising markers I felt apprehensive about it.

    Thanks for reading.
    pT1, nonseminoma (embryonal carcinoma, teratoma, yolk sac), S2 markers

  • #2
    Hmmm... a month ago, your AFP was at 10 - which is considered above normal. Your other markers never normalized either and only now that your AFP is 70 your doc is recommending chemo??? That just doesn't seem right to me.

    Your doc should have been following your markers weekly until he saw them normalize. And, as soon as they stopped dropping and still above normal, that's a clear sign that you still have something going on.

    EDIT: I see now that your Doc did want to start chemo a month ago but you choose not to. Can't understand that thinking but it's your choice.

    Yes, EC and YS are aggressive forms of TC but certainly not any more difficult to treat, when handled properly. Honestly, it sounds like your doc is not completely on top of things and should have been more persistant with his treatment recommendations.

    Why inpatient chemo and not outpatient??? And, yes, you do have a say in the chemo regimen. I didn't want Bleo either so I pushed my doc to go with 4xEP instead of 3xBEP. It was an extra round but I had good reasons to avoid the Bleo.

    I also don't understand why they told you 3 days for the 1st week of inpatient chemo. It should be 5 days.

    You will probably be able to work during the 2nd and 3rd weeks of the first "cycle" but after that, it's going to be tough. Plus, you'll need to avoid people in general to avoid getting sick (infection).
    Last edited by Dave40306; 11-22-06, 08:28 PM.
    TC diagnosed 4/3/06, [email protected]; Left I/O 4/10/06; Stage IIa Non-Seminoma, 100% Yolk Sac; Started 4xEP 5/22/06 with [email protected]; Finshed 4xEP 8/11, AFP normal, CT scans clear! Now on surveillance

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    • #3
      Dave brought up some good points & concerns. I did my chemo as an outpatient,and was glad to be at home after each session.Added some "normality" to the whole thing. I along with many others had "bleo",with no lasting side effects. I also took a leave of abscence from work during my chemo,and was GLAD that I did. !

      Best Wishes,
      Dec/04-Right I/O-nonseminoma (95%E/C),Stage 1, surveillance
      Nov/05- 2.2 cm lymph node= Stage II A
      Nov/05 -Jan/06-3 x BEP
      Jan/06 -Surveillance



      ___________________________________________

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      • #4
        My son was inpatient chemo 3 x BEP. He went in Monday noon and came out Friday noon. He was tethered to an IV 24/5 (continually flushed the chemo out of his system). Did not have any bad side effects of the chemo. They were always on top of things. He was in a private room and he pretended it was a hotel room. He could keep his door closed except when they were doing the chemo. He worked from the hospital and from home and went into the office occasionally after 5:00. He did not want to deal with the sympathy factors of his co-workers. If you do have the bleo, you should have a pulmonary function test at the start (baseline) and checked each cycle. They should stop the bleo and put you on 4 x EP if you start having a problem. My son's doctor thought the BEP had a better cure rate but only by a few percentage points. He did take him off the bleo for the last round because he started to have a decline in the PFT. At that point the doctor felt the benefits did not outweigh the risks. At one year post chemo his PFT was normal. So from this quarter, the inpatient chemo was less stressful for all concerned. He saw his urologist and oncologist every day, plus because he was young and ambulatory, the nurses loved him!
        Spouse: I/O 8/80; embryonal, seminoma, teratoma; RPLND 9/80 - no reoccurrence - HRT 8/80; bladder cancer 11/97; reoccurrence: 4X
        Son: I/O 11/04; embryonal, teratoma; VI; 3XBEP; relapse 5/08; RPLND 6/18/08 - path: mature teratoma

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        • #5
          Originally posted by Dave40306
          Hmmm... a month ago, your AFP was at 10 - which is considered above normal.
          keep in mind, normal ranges vary from lab to lab. some labs consider 18 noraml, mine doesat 9. THe other markers were actually in normal range. Doc followed biweekly and ordered chemo immediately as markers went up.
          pT1, nonseminoma (embryonal carcinoma, teratoma, yolk sac), S2 markers

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          • #6
            Originally posted by Mom
            My son's doctor thought the BEP had a better cure rate but only by a few percentage points. He did take him off the bleo for the last round because he started to have a decline in the PFT.
            I am told the same thing: bleo increases cure rate, and they feel they need to be more aggressive because if 4xEP doesn't do the trick they would need to put me on another 12xBleo-only.

            Thanks for making me aware that it is possible to stop bleo in 3rd cycle if needed.
            pT1, nonseminoma (embryonal carcinoma, teratoma, yolk sac), S2 markers

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            • #7
              Originally posted by Mom
              My son's doctor thought the BEP had a better cure rate but only by a few percentage points.
              A couple of weeksago I found some dutch study comparing long-term results (over 11 years, 500 respondents/patients) of 3xBEP and 4xEP with a cure rate of 95% and 87%, respectively.
              pT1, nonseminoma (embryonal carcinoma, teratoma, yolk sac), S2 markers

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