Tony had his first Abraxane treatment Monday and so far so good - no side effects yet! Of course he has another treatment Monday (3 weeks on and 1 week off) so I'm not celebrating too soon. I'm not used to seeing him feeling this good after a treatment. He worked a 50 hour week, worked concession stand at basketball games last night, and removed and installed a new hot water heater in our house today. I have no idea if this Abraxane will do him any good but I'm very glad it isn't making him sick. He hasn't taken Zofran once this week and he's eating well. If we had to rank his chemo drugs from easiest to hardest, it would go like this: Abraxane, (thus far) Tarceva, Alimta, Carbo/Alimta and finally, Taxotere. If we added in MOPP and AVDB (chemo from 20 years ago) they would be just a little easier than Taxotere but worse than Carbo/Alimta. I'm amazed that his poor body (kidneys and liver) has held up with all these toxic drugs but his blood work shows no issues yet. Curious to see if Abraxane does anything for him.
Sun, 01/20/2013 - 05:19
That's good news. I agree, paclitaxel (Taxol) and the very similiar nab-paclitaxel (Abraxane) are often well tolerated, and pack a really good punch for treating most solid tumors.
The main item to watch for is peripheral neuropathy. That usually doesn't become a problem until after at least 3-6 cycles, but everyone is different. It should continue to go well and hope for successful tumor control.
Yes, I think many would find that ABVD goes a bit smoother nowadays than back then, in part because of better supportive care such as anti-emetics and keeping ABVD treatment limited to six cycles.
Sun, 01/20/2013 - 22:19
He had a bit of peripheral neuropathy with Taxotere but it went away quickly. I'm kind of expecting it again soon. As for the difference in chemo in 2013 versus 1993, many things have changed obviously. He didn't get zofran or aloxi back then. I didn't have the luxary of reasearching everything online and having this amazing site. I was given a pamphlet on Hodgkin's Disease and that was it. The public library had some books with outdated facts and information but overall, 20 years ago...it was basically blind faith. We did what our doctor suggested and just trusted him. We had no support system like this to see what others were doing. This time around, we are keenly aware of what we are facing and are like sponges absorbing as much information as we can get. We may not be able to avoid the negative outcome of the future, but we will be able to say we tried every avenue available to us and on our terms. I am grateful for cancergrace as I learn something new every day and it leaves me hungry to learn more!
Sat, 02/02/2013 - 17:59
Three weeks in and all is well. Abraxane has by far been the easiest chemo Tony has ever had. He hasn't had any disruption to his normal routine and continues to work and keep his normal pace. He gets his treatments on Mondays and I've noticed by Thursday nights, he is somewhat fatigued. He solves that by just going to bed early and he's back to "normal" Friday. The jury remains out on whether this is helping him or not but I for one am very pleased that Abraxane is nothing like Taxotere...at least on his body.
Sat, 02/02/2013 - 19:26
I was pretty resistant to Abraxane for the last few years, as many of my writings on the site will attest, because I saw it as a variant on Taxol (paclitaxel) that was quite a bit more expensive but not necessarily meaningfully better. However, I began using it in several of my patients with squamous NSCLC recently, based on the relatively favorable results with it in that subtype, and also in older patients. My experience with it is still pretty limited, but I've been quite impressed with both how well tolerated it has been, and how effective it has been in the patients I've treated with it over the past few months.
Changing my tune based on this new experience.
Sat, 02/02/2013 - 23:03
thank you to all - it's good to know that this is another good choice - another tool in our toolbox!! Nothing like knowing other's real experience.
Mon, 02/18/2013 - 20:41
Tony finished one complete round (3 weeks on and one week off) of Abraxane. He is now on his 2nd week of round two. I still say this is a very tolerable chemo. However, he is having some neuropathy, which is concerning. He's still working full days plus stays extremely busy on the weekends working at church and on my son's house. He is very tired but I can't say if it's the chemo or the fact that he pushes himself too hard. I honestly think he is afraid to slow down. He met with his doctor today and he said his lungs sounded really good today and his blood work was great. Today was the highest I've seen his RBC, hemoglobin and hematocrit in 17 months. Not 100% normal but very close. WBC and platelets were excellent. Dr. ordered CT this week instead of PET. He has so much scar tissue in his lungs that everything lights up and it's difficult to tell what is cancer and what is scar tissue. I personally am very pleased with the quality of life on Abraxane...but then again, I'm not the one putting it in my body!
Tue, 02/19/2013 - 00:50
Your husband sounds amazing, Kate. It's great to hear he's doing so well.
Tue, 02/19/2013 - 21:28
Everything you're saying makes a lot of sense, and it sounds quite encouraging. I hope you have good news to share after his CT scan.
Mon, 02/25/2013 - 20:19
Stable - we'll take it! Actually, stable with a bit of improvement. The pleural effusion sacs are at least 20% smaller. He didn't have much fluid to start with but now they are even smaller. Still has a couple of little spots in the base of the right lung that are like 8 mm but they've been there without growth for a while. Doctor said we could stay the course and continue on Abraxane alone or add carbo back into the mix. I remembered reading about Dr West's thoughts on doublets this far into the game. We chose to continue with Abraxane alone and see where it takes us first. Today Tony took his 3rd and last infusion of round two of Abraxane. He'll get next week off and then he starts round three. Again, the biggest issue for him is neuropathy and they are watching that closely and his fingernails are funky. No other word for it! They are very thick and hard to cut. Also, he is starting to get hair on his head again! We've come to accept the fact that his SOB will probably never improve. He has so much scar tissue plus all the haze of the GGO that walking any distance is work on those lungs. He's in and out of five hospitals during the day and uses portable oxygen for the treks from the car to wherever his meetings are in the hospitals. Sometimes, this can be a good distance - but somehow he manages. His sats are high 90's when he is not ambulatory so doesn't require oxygen in his office or at home. I'm anxious to hear feedback from others that are trying Abraxane alone.
Sun, 03/10/2013 - 20:44
Two weeks ago, Tony had a CT (see last post) and appeared stable with slight improvement. I'm a bit concerned about him though. For the last week, I've noticed his SOB is worse. He has always had SOB when he walks distances but this week, I noticed it when he walked from the kitchen to the living room. He is due to see his doctor tomorrow followed by the beginning of round 3 of Abraxane. The CT showed his pleural effusions were smaller two weeks ago but dang if it doesn't sound like the PE may be the culprit of his SOB. He's fine as long as he's not moving - non movement does not and will not fly well with him! I hope his doc checks him out really well tomorrow. Worried about him.
Mon, 03/11/2013 - 06:39
I'm sorry to hear he's short of breath, but it's pretty straightforward to determine whether there's a significant pleural effusion -- the exam and certainly a quick chest x-ray should clarify that. And if that's what it turns out to be, at least that's a readily fixable issue.
Good luck with tomorrow's evaluation.
Thu, 03/14/2013 - 19:49
Tony went in for his chemo Monday and told his doctor about his breathing issues. Two weeks ago, he said his lungs sounded good and Monday he heard wheezing. He sent him for a chest x-ray to check things out.
The report said the x-ray did not demonstrate any increase in pleural fluid. They did mention a mild increase in haziness which they attribute to pulmonary edema. I understand that there can be various reasons for this. His doctor started him on steroids and antibiotics for a few days to see if there was any improvement. As of today, it was no better so he called in Lasix. If Tony doesn't notice improvement by the weekend, he wants to know as he will scan him again and start checking the heart. My gut tells me it's not the cancer that it's either heart related or possibly a toxic reaction to the chemo - which would be a shame because he hasn't missed a beat on this Abraxane. I'm worried about him but that man refuses to slow down. One of Tony's co-workers used Abraxane when he had colon cancer (I believe) and it made him horribly sick. Funny how different people respond to the same drug. He started the Lasix tonight so let's see if it helps any!
Fri, 03/15/2013 - 11:11
Dear dear Kate, I hope the Lasix works and quickly. Let us know.
Fri, 03/15/2013 - 13:10
Yes, as you say, it's hard to know what could be causing that haziness, and it makes sense to focus on treating the most readily reversible causes first, then see whether it improves.
Fri, 03/15/2013 - 19:04
Thanks. I finally won a round with him today. I grounded him! He usually goes straight from work to our church to help fry 450 lbs of fish for our lenton fish fry each Friday. I begged him to take it easy and give the Lasix a chance to do it's job. For once, he listened! Dr. West, what are you hearing (lately) among your peers about Abraxane? Are they using it more and what type of response/feedback are they getting?
Fri, 03/15/2013 - 22:57
To be honest, there are fewer meetings and other occasions to catch up with each other, so we really haven't had the chance to discuss everything we'd like to.
Mon, 03/18/2013 - 20:29
The Lasix made a huge difference. I can't hear him wheezing like he was last week and doctor said his lungs sounded much better today. I was happy about this but realize we need to know the cause and that the Lasix is much like a band-aid. Doctor wants an ECHO so we can check the heart so we'll start there. He had his chemo today while working on the phone and answering emails. The nurses love my multi-tasker!
Sun, 03/31/2013 - 19:51
ECHO showed no change since his last one in June 2011 so that was good news. He took a couple more infusions of Abraxane and tomorrow starts his off week. Tony remains on lasix for now and they will watch him. Curious to see what the next scan will show. Happy Easter to those of you who celebrate the holiday. Today was a great day to be a Louisville CARDS fan...final 4! GO CARDS!!
Sun, 03/31/2013 - 20:59
The echocardiogram should provide helpful information. Great to know he's keeping busy and making the most of his time getting chemo.
Wed, 04/17/2013 - 20:55
Update - Tony is still very short of breath, still has swelling in feet/ankles and is tired. CT shows no change = stable. Blood work looks great. Cardiologist said his heart is very strong and he ruled it out as causing the problem. However, he felt the dosage of Lasix the oncologist had him on wasn't enough - not pulling any fluid off at all really. Tony is a "big ole' boy" 6'3 300lbs so he doubled it and added potassium. He had a chemo break this week. Oncologist wants him to see his pulmonary guy so he's going tomorrow. It's been 18 months since diagnosis and with the exception of a chemo sick day here and there, he has only taken one week off of work in all that time. He is mentally and physically worn down. He informed the healthcare system he works for that he is taking a leave. He will work until Friday and then take several weeks off. I support this decision 100%. He needs time to rest and regroup. He wants to get through joint commission with the 5 hospitals first. I am assuming he will continue Abraxane on Monday. It's been an ok drug so far. Our Louisville Cards won the NCAA National Championship so he has enjoyed the last several weeks watching them. The Kentucky Derby festivities begin Saturday and Tony loves these. I'm happy that he will be able to enjoy the beautiful spring weather. Life is good.
Wed, 04/17/2013 - 21:49
Hi Kate, So good to hear from you and find Tony doing alright. I'm sure the leave will provide some energy for his other activities. I know he finds it increasingly difficult to deal with cancer and treatment and maintain the carefree facade. Letting that go may well be helpful.
Let us know how the additional lasix does.
Keeping you and family in my thoughts,
Wed, 04/17/2013 - 22:49
Really appreciate the update. Sorry he's got these issues to deal with, but I hope the lasix helps. great that he can focus on other things rather than working right now.
Enjoy the Kentucky Derby festivities.