Most recent edit on 2007-11-10 11:47:57 by KathyFromEngland [Restored to Original Version by Kathy]
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Edited on 2007-11-10 11:07:26 by EltrlEtoro
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cbasdelorc4
Edited on 2006-07-27 02:27:35 by KathyFromEngland
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Categories
CategoryCancer
Edited on 2006-07-25 11:00:38 by KathyFromEngland
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Chemotherapy for advanced bowel cancer
Chemotherapy for bladder cancer
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Chemotherapy for advanced bowel cancer
Chemotherapy for bladder cancer
Edited on 2006-07-25 10:59:24 by KathyFromEngland
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Chemotherapy for bowel cancer
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Chemotherapy for bowel cancer
Edited on 2006-07-24 01:21:50 by KathyFromEngland
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About Chemotherapy
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About Chemotherapy
Edited on 2006-07-23 15:04:36 by KathyFromEngland
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* CarboMV - carboplatin, vinblastine and methotrexate
Chemotherapy Research
Edited on 2006-07-20 01:18:43 by KathyFromEngland
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The most common chemotherapy drug for Colorectal Cancer is called 5-fluorouracil or 5-FU for short. You may have 5-FU with a vitamin called folinic acid which makes the 5-FU more active against cancer cells.
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The most common chemotherapy drug for Colorectal Cancer is called 5-fluorouracil or 5-FU for short. You may have 5-FU with a vitamin called folinic acid which makes the 5-FU more active against cancer cells.
Edited on 2006-07-19 23:41:39 by KathyFromEngland
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Chemotherapy is treatment with drugs that kill cancer cells or make them less active.
The most common chemotherapy drug for Colorectal Cancer is called 5-fluorouracil or 5-FU for short. You may have 5-FU with a vitamin called folinic acid which makes the 5-FU more active against cancer cells.
There are a few different combinations of chemotherapy drugs used to treat Bladder Cancer. These are
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Chemotherapy is treatment with drugs that kill cancer cells or make them less active.
The most common chemotherapy drug for colorectal cancer is called 5-fluorouracil or 5-FU for short. You may have 5-FU with a vitamin called folinic acid which makes the 5-FU more active against cancer cells.
There are a few different combinations of chemotherapy drugs used to treat bladder cancer. These are
Edited on 2006-07-19 23:38:50 by KathyFromEngland
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Contents
Definition
Chemotherapy for bowel cancer
Chemotherapy for advanced bowel cancer
Chemotherapy for bladder cancer
Definition:
Chemotherapy for bowel cancer
Chemotherapy for bladder cancer
Deletions:
Chemotherapy drugs for bowel cancer
Chemotherapy drugs for bladder cancer
Edited on 2006-07-19 23:35:52 by KathyFromEngland
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Chemotherapy courses can seem to go on for ever. Particularly if you are getting very tired towards the end of your course. But they do finish. And the side effects will go once your treatment has ended.
Chemotherapy drugs for bladder cancer
http://www.cancerhelp.org.uk/help/default.asp?page=4210∞
The drug combinations
There are a few different combinations of chemotherapy drugs used to treat bladder cancer. These are
* MVAC - methotrexate, vinblastine, doxorubicin, (Adriamycin), cisplatin
* CMV - cisplatin, vinblastine, methotrexate
*
CarboMV - carboplatin, vinblastine and methotrexate
* GC - gemcitabine and cisplatin
*
CarboG - gemcitabine and carboplatin
GC is gemcitabine and cisplatin. This drug combination has also been widely used to treat bladder cancer. It has been used before surgery to try to cure invasive bladder cancer, and also for people who have bladder cancer that has spread (advanced bladder cancer). Clinical trials have been comparing the effectiveness of GC with GC plus another drug called paclitaxel (Taxol). We don't know the results just yet.
In some people with bladder cancer, their kidneys may not work so well. It this is the case, you need to have carboplatin instead of cisplatin, because cisplatin can put further strain on the kidneys. So you may have carboMV or carboG instead of CMV or GC. In some patients, poor kidney function has been caused by a blockage in the ureter or kidney. If this is relieved, kidney function often gets better. Your specialist may be able to do this by putting a drainage tube in during a minor operation.
Side effects
There are pages on CancerHelp UK∞ on the specific side effects of CMV and the specific side effects of MVAC. There are also pages on the specific side effects of methotrexate, doxorubicin, gemcitabine, vinblastine, carboplatin and cisplatin. Below is a general overview of likely side effects with bladder cancer combinations.
All chemotherapy does have side effects. Which ones you get depends on
* Which drugs you have
* How much of each drug you have
* How you individually react
Not everyone gets every side effect with every drug. Some people react more than others. And different drugs have different side effects. So we can't tell you exactly what will happen to you. But here is a list of some common side effects
* A drop in the number of blood cells
* Feeling sick
* Diarrhoea
* Hair loss or thinning
* Sore mouth and mouth ulcers
* Feeling tired and run down
* Loss of fertility (ability to have a baby)
There are some more unusual side effects from some drugs. Methotrexate can make your eyes sore - as if they had grit in them. If you are having treatment with doxorubicin (Adriamycin), do remember that it can make your urine turn red for a couple of days after you have the drug. It is not blood back in your urine!
Some of the chemotherapy used for bladder cancer is quite intensive. If you are having this type of treatment, you are almost certain to get some side effects. But there is quite a bit that can be done to help. And most side effects only last for the few days that you are actually having the drugs. Tell your doctor or nurse about any side effects you have as soon as they develop so that they can help you as much as possible.
Ask your doctor or nurse which of these side effects are most common with the chemotherapy drugs you will be having.
Edited on 2006-07-19 23:29:07 by KathyFromEngland
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Some people prefer the newer drugs because they are tablets, not injections and can be taken at home. They are also less likely to cause diarrhoea or a sore mouth. They do cause another side effect more commonly than 5FU. It is called hand and foot syndrome and makes the skin on your palms and soles become sore, red and sometimes peel. There is more about the specific side effects of capecitabine and tegafur with uracil in the chemotherapy section of CancerHelp UK∞.
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Some people prefer the newer drugs because they are tablets, not injections and can be taken at home. They are also less likely to cause diarrhoea or a sore mouth. They do cause another side effect more commonly than 5FU. It is called hand and foot syndrome and makes the skin on your palms and soles become sore, red and sometimes peel. There is more about the specific side effects of capecitabine and tegafur with uracil in the chemotherapy section of CancerHelp UK.
Edited on 2006-07-19 23:28:19 by KathyFromEngland
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If you are going to have 5FU, folinic acid and oxaliplatin together, you may hear your doctor or nurse talk about 'FOLFOX'. This is a name for this chemo regimen. There is information about FOLFOX and its side effects in the chemotherapy drugs section of CancerHelp UK∞.
There is more about taking part in a clinical trials in the Research section of CancerHelp UK∞.
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If you are going to have 5FU, folinic acid and oxaliplatin together, you may hear your doctor or nurse talk about 'FOLFOX'. This is a name for this chemo regimen. There is information about FOLFOX and its side effects in the chemotherapy drugs section of CancerHelp UK.
There is more about taking part in a clinical trials in the Research section of http://cancerhelp.org.uk/.
Edited on 2006-07-19 23:23:37 by KathyFromEngland
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Chemotherapy for advanced bowel cancer
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Chemotherapy for advanced bowel cancer
Edited on 2006-07-19 23:22:52 by KathyFromEngland
No differences.
Edited on 2006-07-19 23:22:15 by KathyFromEngland
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Chemotherapy for advanced bowel cancer
http://cancerhelp.org.uk/help/default.asp?page=2931∞
Treatment with chemotherapy at this stage is unlikely to cure your cancer. But it can help you live longer. Other aims of the treatment are to slow the cancer down and control symptoms such as pain, loss of appetite and losing weight.
Remember - chemotherapy for advanced cancer is given to help you feel better. If you are unhappy about the side effects, you don't have to continue with the treatment.
How do you know if it's working?
Your doctor will arrange a scan before you start treatment and again about 3 months later. Your doctor can measure the tumour on the scan and so will be able to see how it is doing. It may have
* Got smaller
* Got bigger
* Stayed the same
If it has stayed the same size, your doctor will want to talk to you about whether or not it is worth carrying on with the treatment.
If it has got bigger, despite your treatment, your doctor will stop the chemotherapy and may suggest trying something else.
If it has got smaller, you may have a break and then have more treatment. According to a recent study, it may be just as helpful to have chemotherapy for 3 months for advanced bowel cancer as it is to have it for longer. You may benefit from a break. Your doctor will talk through the pros and cons with you.
Whole body chemotherapy
This is the same type of treatment as chemotherapy given for colorectal cancer when it is first diagnosed. The drug most commonly used is 5-fluorouracil or 5-FU. You can have this drug by continuous infusion, or by a 48 hour infusion.
There are 2 newer drugs called capecitabine (Xeloda) and tegafur with uracil (Uftoral) that are very similar to 5FU but can be taken as tablets. These drugs change to 5FU once they are inside the body.
In May 2003, NICE said that 5FU, capecitabine or tegafur with uracil should be the first treatment options available for people with advanced bowel cancer.
Some people prefer the newer drugs because they are tablets, not injections and can be taken at home. They are also less likely to cause diarrhoea or a sore mouth. They do cause another side effect more commonly than 5FU. It is called hand and foot syndrome and makes the skin on your palms and soles become sore, red and sometimes peel. There is more about the specific side effects of capecitabine and tegafur with uracil in the chemotherapy section of CancerHelp UK.
Other drugs used for advanced bowel cancer are
* Irinotecan every 3 weeks
* Oxaliplatin with 5FU every 2 weeks
In August 2005 NICE (The National Institute for Health and Clinical Excellence) issued guidance to doctors on these drugs. They now recommend that you can have either 5FU, oxaliplatin and 5FU together or irinotecan and 5FU as your first chemotherapy treatment when you have been diagnosed with advanced bowel cancer (bowel cancer that has spread to another part of your body). You may have irinotecan on its own if you've had 5FU before, or if your specialist thinks 5FU is not suitable for you, for any reason.
Unfortunately, none of these treatments help every patient. There are trials carried out to try to find treatments that will help, even when previous chemotherapy has not worked. Another drug, raltitrexed (Tomudex), can be used for advanced bowel cancer. But NICE say that you should only have it as part of a clinical trial at the moment.
Experimental Chemotherapy
5-fluorouracil is the most commonly used treatment for advanced colorectal cancer. It is not given to cure your cancer, but to try to shrink it or slow its growth down. Unfortunately, it does not work for everyone.
If your doctor believes that 5-FU is unlikely to help you, you may be offered treatment with an experimental drug that is being tested. If you are offered experimental treatment
* You should always be offered it as a part of a clinical trial
* All the risks and possible benefits will be explained to you
* Previous research will have suggested that the drug will help bowel cancer
* Your doctors will find out how much it is likely to help from the results of the trial you are taking part in
* Your doctors will find out more about the side effects of the drug from the trial results
* You can pull out of the trial at any time
There are organisations that can provide information about new treatments for colorectal cancer. Or they can put you in touch with cancer support groups where you can talk to others who have been through similar experiences to your own.
Regional chemotherapy
This has been tested for some years for bowel cancer that has spread to the liver. It involves having chemotherapy through a small tube into a main blood vessel in your abdomen (the hepatic artery). A pump attached to the tube gives chemotherapy straight to your liver. You may hear this type of treatment called hepatic artery infusional chemotherapy.
In 2004, a research review found that there is no benefit to this treatment over chemotherapy given into any vein. So hepatic artery infusion is still thought of as experimental and shouldn't be offered to you outside of a clinical trial. You can read this review of hepatic artery chemotherapy in the Cochrane Library. It was written for researchers and specialists so is not in plain English.
There is more about taking part in a clinical trials in the Research section of http://cancerhelp.org.uk/.
Edited on 2006-07-19 23:17:55 by KathyFromEngland
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rinotecan (Campto)
Irinotecan is also called CPT-11. You may have this drug as a first treatment (1st line chemotherapy) for advanced bowel cancer. It has been approved as a first treatment option since August 2005. Or you may have it as a second type of treatment (2nd line chemotherapy) if earlier chemotherapy hasn't controlled your bowel cancer. Depending on treatment you've had before, you may have irinotecan on its own or with 5FU.
You have irinotecan once every 3 weeks into a vein. It does have side effects, and you may find the side effects are worse than you had with 5-FU. Irinotecan can cause
* Complete hair loss
* Low white blood cell count and so increased risk of infection
* More severe diarrhoea
You must be careful not to get dehydrated if you are having this drug. Tell your doctor if you do have bad diarrhoea. And make sure you drink plenty to replace the fluid you have lost.
Oxaliplatin
In August 2005, NICE approved oxaliplatin and 5FU as another option for chemotherapy for advanced bowel cancer. You may have this as the first choice of treatment. Or your specialist may recommend the other options above. In April 2006 NICE approved oxaliplatin with 5FU and folinic acid as a possible treatment after surgery for Dukes C bowel cancer.
Oxaliplatin side effects are usually mild but may include
* Numbness or tingling in fingers and toes
* A temporary drop in the number of white blood cells in your blood
If you are going to have 5FU, folinic acid and oxaliplatin together, you may hear your doctor or nurse talk about 'FOLFOX'. This is a name for this chemo regimen. There is information about FOLFOX and its side effects in the chemotherapy drugs section of CancerHelp UK.
Taking supplements with chemotherapy
There is increasing concern amongst doctors about dietary supplements and herbal medications. We don't know what people with cancer are buying over the counter or getting from alternative and complementary therapy practitioners. There's nothing wrong with trying to help yourself get better. But we don't yet know enough scientifically about how some supplements may interact with chemo.
You should talk to your specialist about any other tablets or medicines you take while you are on active treatment. It may not be a good idea to take anything that claims to boost your immune system, for instance. Some doctors are already telling people with lymphomas or leukaemias that they should avoid these. We just don't know how supplements may interact with treatment for other types of cancer yet.
Oldest known version of this page was edited on 2006-07-19 23:01:10 by KathyFromEngland []
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Chemotherapy
Chemotherapy is treatment with drugs that kill cancer cells or make them less active.
Chemotherapy drugs for bowel cancer
http://www.cancerhelp.org.uk/help/default.asp?page=2929∞
5-Fluorouracil
The most common chemotherapy drug for colorectal cancer is called 5-fluorouracil or 5-FU for short. You may have 5-FU with a vitamin called folinic acid which makes the 5-FU more active against cancer cells.
You can have 5-FU in a few different ways, depending on where you are being treated, what stage your bowel cancer is and how easy it is for you to come to the hospital. Hospitals may not be able to offer a choice between all of these forms of treatment. You may have 5FU
* As a daily injection for a few days
* As a weekly injection
* As a 48 hour infusion
* Continuously through a pump
Daily injections
Doctors usually use daily injections after surgery for early bowel cancer, to help stop the cancer from coming back. This is adjuvant chemotherapy. You usually have these every day for 5 days. You then have 3 weeks rest, and then another 5 days of injections. You repeat this treatment cycle 6 or more times. So you have a total of about 30 injections over 6 months.
Weekly injections
Doctors usually use weekly injections after surgery for primary bowel cancer to help stop the cancer from coming back. This is adjuvant chemotherapy. You have weekly injections about 30 times over about 6 to 7 months.
48 hour infusion
This treatment is most often used for advanced bowel cancer. The treatment may shrink the cancer, slow it down and help to control symptoms. In trials, giving 5FU slowly over a period of time seemed to cause fewer side effects and work better for advanced bowel cancer than 5FU by injection. You can have 5FU through a drip, over 2 days. You have this treatment once every 2 weeks. You may have to come into hospital for this because the drip stays up for 2 nights. Or your hospital may be able to give you a pump that you can go home wearing. Then you come back the next day. To use a pump, you need to have a central line or PICC line fitted.
Continuous treatment through a pump
This treatment is most often used for advanced bowel cancer. The treatment may shrink the cancer, slow it down and help to control symptoms. In trials, this way of giving 5FU slowly over a period of time seemed to cause fewer side effects and work better for advanced bowel cancer than 5FU by injection.
With this type of treatment, you have a continuous small dose of chemotherapy through a pump all the time, day and night. The treatment is often called continuous chemotherapy, or sometimes continuous ambulatory chemotherapy because you can walk around wearing the pump. The pumps are about the size of a personal tape player. You usually have this treatment for several months at a time.
To be able to connect to the pump, you need to have a central line (for example a Hickman line or Portacath) or PICC line. Sometimes you need a short operation to have one of these lines put in. But increasingly, they are done under local anaesthetic in out patients.
A central line is a length of plastic tubing, which goes into your chest, runs up under your skin and into a main vein near your neck. A PICC line is similar, but goes into a vein in your arm and runs up through that to the main vein.
You don't need to have injections or needles put in if you have a central line. All your chemotherapy can go straight into the line.
5FU tablets
There are 2 new drugs available called
* Capecitabine (Xeloda)
* UFTORAL
These are both 5FU tablets. In trials, they seem to work as well as daily injections of 5FU. But they have fewer side effects. And, of course, you can take them at home. These 2 drugs were both approved for the treatment of advanced bowel cancer by NICE in May 2003.
You take capecitabine for 14 days out of every 21 days (2 weeks out of 3). You take UFToral for 28 days out of every 35 (4 weeks out of 5). You have to take a folinic acid tablet along with UFToral to help stop side effects. Which drug you have will depend on your doctor?s preference and on which suits you best. The side effects for the 2 drugs are slightly different. The commonest side effects for UFToral are
* Sickness
* Diarrhoea
* A drop in white blood cell count and platelet count
The commonest side effects for capecitabine are
* Reddening and soreness of hands and feet
* Numbness and tingling in hands and feet
* Sore mouth
* Diarrhoea
Capecitabine is approved by NICE (The National Institute for Health and Clinical Excellence) for treatment of advanced bowel cancer. And it April 2006 NICE recommended it as a possible treatment after surgery (adjuvant treatment) for Dukes C bowel cancer.