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Do BEPx 3 side-effects predict tumour response?

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  • Do BEPx 3 side-effects predict tumour response?

    Dear All

    I thought I had read before that there was no correlation between presence/severity of side-effects and treatment efficacy. But I have since discovered a couple of articles that seem to suggest that presence of side effects was related to treatment outcome in advanced colorectal cancer, and more worryingly in (the more related to TC) ovarian cancer.

    I am only in the middle of cycle 1, but I have had no nausea, vomiting thus far. Only a couple of mouth sores and a brief 12 hour shake and bake on the Bleo.

    I am guessing that the cumululative effect of cycles and 3 may not leave me so unaffected but......

    Should I be worried that the chemo is not working?

    Best wishes

  • #2
    I found this, but it's not from a credible source (

    How will I know if my chemotherapy is working?
    Your doctor will give you physical exams and medical tests (such as blood tests and x-rays). He or she will also ask you how you feel.You cannot tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well. Or that no side effects mean that chemotherapy is not working. The truth is that side effects have nothing to do with how well chemotherapy is fighting your cancer.


    • #3
      No, you should not worry. And trust me, round 3 will kick your ass a bit. I found round 1 to be pretty easy.
      6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
      6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
      7/7/15: bHCG 56, AFP 42, LDH 322
      7/13/15: begin 4xEP, end 9/18/15
      10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
      10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
      4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
      4/20/16: RPLND @ IU - teratoma only!
      10/22/19: all clears up to this date!


      • #4
        I asked my sons oncologist this specifically, because he had so few side effects, and didn't lose all of his hair. Don't does not mean the chemo isn't working.


        • #5
          Everything I have read says there is no correlation, plus they give you drugs to counters ome of the worst problems (like nausea) & they work very well for most people.I got a bit queasy the weekend after each long week, but didn't vomit once. Don't worry, your chemo ks almost certainly doing it's job.

          PS: stop googling so much, especially about other cancers, very few other cancers have protocols that are as effective as those for TC, so the info about them is basically useless for you.

          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP


          • #6
            Biwi, thanks I suspected as much. PNW Mom, thank you, that's is encouraging. I hope your son is doing well.
            Point well taken, Dave. I will add that I "do" have very low energy levels and I seem to be looking skinnier and less healthy but that is perhaps partly due to the "very" short haircut I have given myself.
            Best wishes to all


            • #7
              Fatigue was my biggest problem so low energy is not surprising.It is temporary & your energy will return post chemo. I was hoping to lose some weight from chemo, but actually gained 15 pounds i stead of losing them. You will not "look" healthy while getting poison, you will look like you are getting the poison you need. That is to be expected.

              Jan, 1975: Right I/O, followed by RPLND
              Dec, 2009: Left I/O, followed by 3xBEP


              • #8
                Round 1 of BEP was easy for me: little nausea over the weekend, but I was golfing/working/exercising during my off weeks will little problem.

                I was hospitalized during Round 3, as I was feverish and couldn't stop vomiting. By Round 4, I couldn't keep anything besides breakfast cereal down, had lost all of my hair, and needed a cane to get up the stairs in my apartment.

                That said, the only way to know if this particular treatment is working for you is the golden standard: tumor markers plus CT scans. While my tumor markers responded well, my CT scans revealed a large residual mass, so I need more than just chemo (RPLND now)...despite my bad side-effects.
                March 2016: Right IO, Stage 3B Embryonal with bulky mass in retroperitoneum
                April-July '16: 4xBEP, AFP ~1800,
                August '16: PC-RPLND --> Only teratoma found
                September '16: Markers negative, ALL CLEAR, Surveillance!


                • #9
                  Thanks EdoneBall. I have to confess the image of potential cane reliance is a cause for concern. Yes, I am concerned about Tumor markers, or side-effects, or anything
                  else being used to predict the outcome of treatment. My concern is that I will get to the end of round 3 and they will say the results are not great and that they may as well throw in another round for good measure (which I will have serious doubts about).

                  This is why I raised the issue of my potentially needing the surgery. I want to be positive, but fear the emotional free fall from any letdown. As I recall, you are due for the surgery on 12 August and are in the best possible hands. It sound like like this eventuality, daunting as it might possibly be, is one step close to be disease-free

                  Best wishes to you


                  • #10
                    Indeed, just had my last appointment with the surgeon...we're very optimistic!

                    Best advice I can offer is to grow comfortable with the unknown. There will be anxiety before every tumor marker draw and scan, regardless of how treatment goes. I'm losing sleep before my RPLND, no doubt. Even once you are cured, you'll be on-edge for some time wondering if/when it'll recur. As many of the veteran members have written on this great site, you'll need to adapt to and accept that anxiety in the long-term.

                    What happens, happens, and we'll face it head-on. We can't control the outcome of our battle with cancer, but we can control how it mentally affects us.
                    March 2016: Right IO, Stage 3B Embryonal with bulky mass in retroperitoneum
                    April-July '16: 4xBEP, AFP ~1800,
                    August '16: PC-RPLND --> Only teratoma found
                    September '16: Markers negative, ALL CLEAR, Surveillance!


                    • #11
                      Truer words were never spoken Ed.

                      The treatments are brutal. My 3rd cycle laid me real low. Walking 20 feet would cause me to collapse into a chair and have to rest for 3 hours while my heart would be pounding and I'd be sweating bullets.

                      Then treatment finished and physically I rebounded very fast. I had my PET/CT four weeks later and was really feeling good after that.

                      I've heard the chemo nurses say that "the chemo must be working well because of how sick it is making you" to many patients. I believed it at first, but I dug around and cannot find any scientific research whatsoever that validates how sick you get from chemo equates to it's effectiveness against your cancer. I doubt there's any truth to it.

                      Your only job now is to be in warrior mode and get through the treatments, whatever it takes, then you can worry about what the chemo did to it and to you.

                      - Matt
                      March 4th 2014: [AFP = 2.5; bHCG = 6; LDH = 618]
                      March 13th: Left IO 100% Classic Seminoma
                      6.3 x 5.1 x 3.8 cm, no invasion of anything
                      LDH never fully normalized
                      Stage: IS
                      Watchful Waiting
                      May 1st: promoted to Stage IIB with two PET active tumors in the para-aortic lymph nodes 2.5 & 2.4 cm
                      May 12th: started 3xBEP
                      Neupogen during Cycle 2 and 3
                      July 8th: Last Bleo shot of Cycle 3 -- chemo completed !
                      August 4th: Post Chemo CT/PET scan
                      September 4th: Port removed
                      Jan 9th 2019: 4.5 YEARS ALL CLEAR !