A Change in Chemo Treatment

Unfortunately, it looks like the chemo treatment David has been receiving since March of 2017 is no longer working for him.  Since about August, his tumor markers have been slowly, but steadily increasing.  On a CT recheck done last week, things look pretty stable.  There are signs of some new compression of his common bile duct (most likely from tumor progression), but there are no signs of metastases within his liver or new lymph node enlargement -- so, overall pretty stable, which we are happy about!  Today we are at the infusion center & David is receiving a different chemo treatment -- Gemcitabine & Abraxane.  David did receive Gemcitabine about four years ago after his surgery, but wasn't able to complete all of the treatments they had wanted him to have at the time because it caused his neutrophils (one of the white blood cells) to drop significantly.  At that time, they had wanted him to have Gemcitabine three weeks in a row & then a week off, but he was never able to have treatment two weeks in a row because of the neutropenia.  This time round, the plan is to have treatment every other week -- he was able to do that in the past, so hopefully he will be able to stay on that schedule this time.  Abraxane is a new drug for us -- it was only FDA approved for the use of pancreatic cancer when David was first diagnosed four & a half years ago.  For most people, the side effects from Gemcitabine & Abraxane are gentler than the previous chemo David received (5-FU, Oxaliplatin, Irinotecan, & Leucovorin).  The most common side effects that people experience are fatigue; hair loss (don't think we will notice that one!); a drop in white blood cells, red blood cells, & platelets; peripheral neuropathy; & nausea / diarrhea.  We have a friend, Dan, that works as a nurse in the infusion center, who was a research nurse for decades before he switched to oncology nursing, who is also battling pancreatic cancer.  Dan is currently receiving Gemcitabine & Abraxane & found through some of his career contacts that if the Abraxane is infused over a longer time period, people have fewer issues with peripheral neuropathy (because David already has a degree of peripheral neuropathy from his previous treatment, we are concerned about this potential side effect).  So, of course we brought this up with Dr. Fanta who was very willing to use the longer infusion time of two hours versus 30 minutes.  Our total time in the infusion center this morning should be around three hours instead of the four hours that it was taking with the previous chemo & this time when we leave the infusion center, David doesn't have to be hooked up to a chemo pump for two days -- yea!!!

Here's hoping that the start of your new year has been a good one & here's hoping that this new chemo will prove to be easier on my David & provide better control of his disease!  Continuing to fight the fight!!!

Much love, Janet