Colon Cancer Sucks Ass

Friday, March 02, 2007

Making Decisions

In the aftermath of my initial diagnosis, I made a vow to myself that I would do whatever it took to beat this. Up to this point, the steps were laid out for me: colon surger, chemotherapy of Folfox with Avastin, liver resection, adjuvant chemotherapy. There has always been a clear direction to go. That is until we reached adjuvant chemotherapy. What I would like to do - Xeloda and Avastin consistently for a couple of months - it not an option because my platelets are still low (55 at last count). With the low platelets, I cannot receive any chemotherapy drugs. Since mid-September, I have been receiving Avastin as a single agent; however there is limited clinical evidence that Avastin is effective alone. It really needs to be combined with something. We tried it combined with Erbitux one time in December. That led to the worst rash that I've ever had - more accurately, the worst rash my oncologist has ever seen!

At my last appointment with my oncologist, he encouraged me to at least consider trying Avastin with Vectibix. Vectibix is a new drug - I was enrolled in a clinical trial for this drug, but I was in the control group. I have been very hesitant to do this for one huge reason. Vectibix works the same way as Erbitux. 89% of patients experience a rash as a side effect and in 12% of patients, those rashes are severe. The difference between Vectibix and Erbitux is that Vectibix is a fully humanized drug whereas Erbitux still contains mouse protien. So there is a difference, therefore there is a chance that I may not have as severe a reaction.

I asked my oncologist for some time to think about it. I didn't want to even consider starting it prior to my trip to Washington DC. Really, I didn't want to consider starting it at all, but it has really bothered me that I wasn't considering it. I did vow that I would do whatever it took and my rational side says that it's just a rash. Well, I talked to my psychologist about it. We went through the pros, the cons, what I would tell someone in my position (if you're wondering - "suck it up"), and if I were to decided to try it, what would make it easier to get through. It was the last part that really started to make me think. I'm going to talk to my oncologist about this, but right now, I'm actually willing to give it a try with some conditions:

1. We don't start until April (after I get back from Seattle).
2. I see my dermatologist prior to the first dose to have a plan of attack in place.
3. If the rash is severe (painful, fever-inducing), I want to be admitted to the hospital.

Shocking, isn't it? I hate being in the hospital, but in retrospect, I think I should have been in December. It was brought up, but I didn't want to go and they didn't push it.

Since I started actually considering this line of treatment, I have been much more productive. I hadn't realized how much it was bothering me, but thinking that I might actually do it has been a huge weight off my shoulders. I AM willing to do whatever it takes to prevent a reoccurance.

4 Comments:

  • At 8:34 PM, Anonymous Wendy said…

    Hi Christine,
    I have been following your blog for sometime, and I now find me in the same position - rather the same stage of my treatment as you. I was diagnosed Jan 2006 with stage IV cc. Did 6 mths of FOLFOX and Avastin, and had my liver resection on Jan 29 of this year. I am now waiting to see what chemo I will be doing. Up to this point the plan was clear and now I am trying to determine which is the best protocol at this stage. How did you respond to FOLFOX and Avastin? Did you have much problems with it? I tolerated it very well. Have you tried FOLFIRI? or CPT11 on its own?
    I hope that you find something that works for you.
    Going through chemo and surgery and whatever you need to do to fight this disease is one thing - but there has to be something said for quality of life...

    Wendy
    www.wendysbattle.com

     
  • At 9:00 PM, Blogger Christine said…

    Wendy,

    I had a great tumor response to Folfox and Avastin. I wouldn't have been able to have the liver resection without the progress I made with those drugs. It did make me really sick the first two rounds though. And I never handled it all that well - I know some people work, but I was lucky if I could get out of bed for two days. Once the pump was disconnected though, I started to feel better quickly.

    I haven't done Folfiri or CPT-11 on its own. I like that I haven't had to use them because I know that they are available if I have a reoccurance. My oncologist's original reccommendation regarding post-surgical adjuvant chemo was to continue 5FU/Leucovorin and Avastin, but I was starting school so I requested a switch to Xeloda which in my brief experience (1 round) is VERY easy to tolerate.

    Christine

     
  • At 9:29 PM, Anonymous Anonymous said…

    Praying for you!

    Katy

    Lee's Summit, MO

     
  • At 4:18 PM, Anonymous Judi Sohn said…

    Hi Christine! We can't wait to meet you in DC in less than 2 weeks!

    There will other Stage IV survivors joining us who have been right in your shoes, so perhaps they can help you get some perspective on this decision.

     

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