I am on 4 cycles (3 weeks on, 1 week off) of Cisplatin and Gemzar for stage 4 urothelial cancer (tumor removed from ureter, along with 21 lymph nodes - cancer in 2 of the nodes). Treatment schedule is first week is cis/gem, second and third weeks are gemzar alone.
This morning went for 3rd treatment in first cycle, and they said I couldn't get treatment because my white blood cell count was low. They are not rescheduling or moving up the next treatment...so I will have the first treatment in cycle 2 two weeks from now. So at that time it will have been three weeks since previous chemo treatment.
I am being treated at an NCI facility and have faith in my oncologist. I also know that my type of cancer is rare, and is just treated as bladder cancer since there is not a lot of research on this. I'm just nervous about 3 weeks without treatment.....
Thoughts?
Thank you
Reply # - February 5, 2015, 12:56 PM
Marie, I'm sorry for the
Marie, I'm sorry for the forced break in treatment but it's not unusual to have to because of blood counts. Both of these drugs are notorious for just that and skipping the 3rd gemzar of the cycle is often the case.
Dr. Pinder said of this combo (in lung cancer but the reasoning is still the same), "Dose delays are pretty common in lung cancer patients, usually because of inadequate blood counts or toxicity. As Dr. Weiss mentioned, we don't have any data comparing delayed chemotherapy versus chemotherapy completely on time. I don't usually get too excited about delaying or missing a day 8 gemcitabine and I am also comfortable with giving it a day early if the blood counts allowed.",
http://cancergrace.org/forums/index.php?topic=3108.0
One thing to keep in mind and may help is when testing if a drug (or combo in this situation) works, during early stages of trials there's a drug escalation phase where the amount of drugs is systematically raised until it hits a limit of how much the general trial group is able to withstand. It's never tested how little it takes to work.
I hate this but it's an unknown territory. I hope you're feeling alright after your first cycle.
All best,
Janine
Reply # - February 5, 2015, 01:07 PM
Thanks Janine. Seems these
Thanks Janine. Seems these days I'm not happy unless I have something to worry about. Never thought I'd be disappointed about not receiving a chemo treatment!