Mom's chemo starts 12/6 - Carbo-Plat and Alimta - 1250579

Sun, 11/25/2012 - 20:04

Ok. Mom is starting her first chemo treatment on 12/6 so she will be feeling better by Christmas. Plan is to do 4 treatments - scan at 6 weeks etc. Sounded pretty standard. They are testing for the mutations and if they come back then on the day of her chemo appointment she will just get the other meds. He warned it was pretty unlikely.

She is on Plaquenil (however you spell it) for her Lupus - though they asked for a prescription list do you think I need to mention it to the dr as I thought she may not want to take it during treatment?
Also, they want her taking 1 mg of Folic Acid every day - is it ok if she's over that? The pills come in 800 and 400 mcg tabs and the 400 mcg's are a bugger to split. Is it ok if she takes 1200 mcg? I know I need to ask her dr but was curious.

She has a prescription for her wig and I wanted to make sure she gets it before her hair falls out assuming at some point she won't be up for outings.

For now I guess I'm glad she's trying chemo - though I'm really scared. She's mostly non-symptomatic. No pain and the blood that she coughed up sounds like it was a mostly isolated event. She coughs quite a bit - and of course she's still smoking.

That's what I know. What should I bring to the chemo suite for her? I thought a blanket, a movie on my ipad - what else?

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Dr West
Posts: 4733

The plan sounds good, but the dose for folic acid should really be 400-1000 mcg and not more. I usually recommend 400 mcg, though 1000 mcg is OK too, but above that, there's a risk that it will help rescue cancer cells from the effect of the chemo, whereas at lower doses of 400-1000 mcg per day, it should help rescue the normal cells but not the cancer cells.

We'd generally advise that the doctors be informed of ALL medications a person is on or has been on recently.

As for things to bring, with that regimen, there probably won't be very much down time, so she probably won't have enough downtime for a whole movie.

Good luck.

-Dr. West

Posts: 36

That's good to know. I'll make sure the Dr. is aware of the Plaquenil and that she not take more than the 1mg of the Folic Acid.

I'm also glad that it won't take terribly long either. I think my mother-in-law had all day session though for stage 4 SCLC so I'm sure we're talking about a totally different animal here.

Will post after the first treatment is complete.

how long until she will want/need a wig on this med combo?


Hi Carrie, nice picture.

I'm glad everything is in order for your mom to start chemo. I so hope she benefits much from it. Chemos take varying times to administer depending on how many agents given and how fast or slowly it needs to be administered. My husband has been close to both ends of the spectrum.
As for her hair she may not lose it. Carbo alimta aren't the big culprits of hair loss. But usually if it's going to happen it will start 1 to 3 weeks into treatment.
This is a transcript to a discussion on dermatologic side effects. You will find the discussion on hair loss starting on the 3rd page. I'll continue to look for the slides and video that go with.…

From Mayo Clinic (BTW their website has a really good facts sheet that is easy to navigate.)

I hope this helps Keep asking,
forum moderator


This is the Q and A from the discussion with Dr. Lacouture with a question on hair loss on pg 2 (note that most of the discussion is about skin related side effects common with the use of TKI tx such as tarceva not a typical chemo drug).…

Here it is,…
and the Q and A video etc.

Posts: 635

I had carbo/alimta and didn't lose my hair. It did thin out while on treatment, but no clumps. The chemo suites usually have blankets and may even have a kitchen with eats and drinks. I know ours here does. Surprised she wasn't given the tour. Just make sure to keep her hydrated after chemo and take something for constipation before starting. Wishing her the best. Take care, Judy

Posts: 36

WOW that's really good to know. Would you say it's best to get a wig in case or wait until you need it? I'm just trying to manage as much as I can help with when I'm there and not sure how much energy she will have. My dad works full time so I'm trying to help where I can.

I think she is scheduled to go to a little Chemo class this week - it's a couple hours long and will probably tour her through and show all that is availalbe. I'm not able to be there but at least she will see where everything is.

I'm really hoping that her hair just gets a little thin and that's that! Crossing my fingers for the little things.

laya d.
Posts: 714

Hi Carrie:

First and foremost, I want to wish you Mom the best with her upcoming treatment. I hope she sees maximum benefit with minimal side-effects. I also wanted to let you know that my Mom didn't loose ANY hair while on Carbo-Alimta (no thinning either). I know everyone is different - - but just wanted to share our experience with you.