My husband finished his first-line Gem-carbo chemo at the end of April and by the middle of May he reported feeling the best he had in 2 years (even though he was only diagnosed in Dec '11).
By the middle of June he started complaining of some increased pain and by the third week of June complaining of an increase in shortness of breath with activity. He just described himself as feeling generally 'unwell' and his appetite was decreased and he actually lost 6 pounds. We then found out with follow-up CT that the 'cancer was growing again'.
11 days ago he had his first treatment of his second-line treatment of Docetaxel. The first 5 days he experienced some side effects and on day 6 post chemo he said he felt he had "turned the corner" with the side effects.
Now these last 2-3 days he reports feeling as good as he had prior back in May. His pain is much improved as well as his shortness of breath and his general sense of well-being. He is back to do home maintenance and his appetite is better and he has regained 4 of the 6 pounds he had lost.
It seems unreasonable and unlikely to me that one chemo treatment 11 days ago could be responsible for these positive changes already? My question is surrounding this. I do realize that every patient is different and every cancer is different but do patients on occasion demonstrate an early response such as this with second-line?
Thank you for your time and for sharing your expertise,
Wed, 07/11/2012 - 06:12
Yes, on occasion. As you indicated, this isn't the typical course. The reason we usually wait 6-9 weeks before re-scanning is that it tends to take at least that much time to get a real signal of the direction things are moving in. It can be much less, and I do have one clinic patient I saw yesterday who started Taxotere (docetaxel) as second line chemo and felt a real improvement inside of 2-3 weeks that was associated with a very substantial improvement on her scans a month later, but that's the exception and not the rule.
I hope your husband's right and that his next scan corroborates his clinical improvement. Patient symptoms, whether improving or worsening, are definitely correlated (though not perfectly) with what subsequent imaging shows.
Wed, 07/11/2012 - 09:05
Thank you, Dr. West for sharing your time, expertise & experience.
During my husband's first-line chemo, how he felt definitely correlated with his scan results. He started feeling much improved by the end of his second cycle & his CT after his 3rd cycle showed significant reduction in the primary tumor and metastatic nodules. He did continue to feel a bit better with the subsequent 4th- 6th cycles but his final CT did not show any additional reduction, just stable disease. However, I have since learned in this 'cancer world', stable disease is far better to hear than some of the other options.
For now we are grateful he is again feeling much improved and are hopeful that his next scan (our Onc had originally he was not planning on re-scanning until after his 4th treatment, unless symptomology indicated a need otherwise), will correlate with how well he is feeling today.
Thank you again for the incredible, selfless service provided by yourself, the other faculty & Grace members.