Surviving side effects from Carboplatin and Premetrexed - 1289249

lmlb7665
Posts:48

I am a newbie to chemo therapy. On November 15 I received my first treatment of Carboplatin and Premetrexed. Eight days out I am still experiencing severe side effects of nausea and extreme exhaustion. This added to my pain in my hips where my LC has metastasized has me almost comatose.I am due for my 2nd treatment on 12-6-2016.

Maybe some of you can share your experiences with me. Does it get better? easier? Is it just the first treatment that is this bad? Are there difference doses of these drugs for different people. I have a very low tolerance level to drugs and alcohol of all kinds. 1 beer is good, 2 is too much. 1 glass of wine is good, 1 1/2 is too much. I think you get what I mean.

I would appreciate the ideas and thoughts of those who have come before me.

Louise

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JimC
Posts: 2753

Hi Louise,

I'm sorry to hear that you are having such a rough time with your first chemotherapy treatment. It's pretty typical for the first couple of days to be not too difficult, but then the effects become more pronounced. Most patients begin to feel better after the halfway point in the chemo cycle (day 10 or 11 in a 21-day cycle), because blood counts reach their lowest point at about that time, then begin to rebound. That may help with energy, and the nausea should decrease as well.

There are several things you can do to combat nausea. First, if your doctor has prescribed an anti-nausea medication, take it on a schedule rather than after you begin to feel nauseous. So if your nausea set in around day three, start taking it that day or the night before and take it as frequently as the prescription instructions state (e.g., every four hours). It's much easier to prevent nausea than to treat it. Try to eat frequent small snacks rather than large meals, and choose foods that are not too tough on your system (just say no to the jalapenos!) That may take some experimentation to find foods that do not upset you and foods that sound good to you. Some GRACE members have reported some unusual choices that worked for them, so think outside the box. If you feel nausea coming on, try to eat a few crackers or something else bland. It can also help to take a walk (as much as you can tolerate) in the fresh air. All of these suggestions seemed to help my wife a great deal during her chemotherapy.

JimC
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JimC
Posts: 2753

Hi Louise,

I neglected to address the bone pain and dosage. It's pretty early to tell whether the chemo is helping your bone mets, but you may want to talk to your oncologist about pain medications, as well as some of the drugs used specifically to address bone mets, such as Zometa or Xgeva. There is some evidence that they can not only prevent bone issues, but that survival may be improved as well.

It is not uncommon for some patients to require dose reductions or chemo schedule modifications due to treatment toxicity. When standard dosages are determined in clinical trials, the dosages are set at the maximum level that is fairly well-tolerated by a majority of patients, not the minimum dosage necessary to kill cancer cells. As a result, you may be able to reduce the dose without sacrificing efficacy. Treatment at a lower dosage is better than full-strength treatment that you can't complete due to side effects.

Good luck with your next round of chemo.

JimC
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cards7up
Posts: 636

I had carboplatin/alimta and was one of those who suffered extreme fatigue all throughout. Chemo is cumulative, so it gets worse the more you have. As for nausea, I had none my first time around. I was given IV aloxi on chemo day and you're supposed to take the anti-nausea meds as prescribed. That is usually starting the next day whether you feel nauseous or not. Normally you'd take it for the first three days after chemo and if you're feeling ok, then you can stop. But if not, you continue to take it. I had two meds. If I had not felt better after three days, then I would have to take the second medication. Really not much you can do for the fatigue. I would be cooking and have it hit and go lay down. You don't sleep normal, so schedules are out the window. Rest when you need to. I walked a lot, but it still didn't make a difference. For some like me and it sounds like you too will have the extreme fatigue. Some people ask to take Ritalin for the fatigue, but I never tried it. I figured it was only going to last a short time 4 treatments to hopefully give me a longer time on this earth and it did. So I rode it out and became NED. You can also ask for palliative radiation to relieve the pain from the bone met. Wishing you the best. Take care, Judy