Cycle 6, and Then a Break

Posted 22 February 2016

Today was infusion day (as I described in an earlier post) for cycle 6. It was one of the harder infusion days, with more abdominal cramping that previously.

The nurse increased my atropine dose to mitigate the cramping, and gave me a little Ativan (did you know it was used for nausea too?) for the nausea, and between the two they helped quite a bit.

Since getting home, I’ve been very tired and felt vaguely lousy, but other than the occasional cramp, nothing intense.

They’re planning to give me 2 units of blood on Thursday, when the chemo infusions are all done. That should give me a big energy boost.

Taking a Break

FOLFIRINOX is a tough regimen — one of the hardest of current chemo regimens, though not nearly as hard on the body as early chemo attempts.

If I pushed myself, I think I could keep going for a few more cycles without a break. My oncologist has said I could do “up to 10-12 cycles”, but that most people only do 6-8. Now I see why, though I haven’t had any of the serious side effects that cause people to quit. More cycles is hoped to give a longer remission, though I haven’t been able to find any supporting data.

This chemo is supposed to be palliative, intended to improve quality of life, and right now most of my feeling bad comes from the chemo, not from the cancer or even from the biliary stent. It is, of course, a matter of paying now for benefits later.

I’d like to get some of those good months that are supposed to be in my future, and are the reason for enduring the chemo. And I’d like to find out how my body feels with a little distance from the cytotoxins.

New Imaging, More Experts

Next week, I’ll be getting a CT, and then I’m going to meet with my local oncologist (who has to deal with all cancers) and the GI-focused oncologist at UCSF.

I might even go to Houston for a few days to talk with the experts at MD Anderson and see if they recommend a different program or can provide any additional clarity on my type of cancer or my prognosis. It would be costly, though, and probably moderately unpleasant, and Houston is not at the top of my list of places to visit. (In fact, it wouldn’t be on the list if it were not for MD Anderson.)

I’d love to have the spring and summer off, but I think that is too long for a chemo break. My current hope is to take my break in March and April, return to chemo for May through July, and then have a wonderful post-chemo late summer and fall.