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  • Neulasta questions

    Hi all. My husband starts Cycle 2 of EPx4 this morning. After he got his blood work done, they told him they want him to get a Neulasta shot on Saturday. I don't know much about Neulasta, except that it has the potential for some pretty bad side effects, including significant pain. I have some questions I'm hoping you all can help with.

    I've read that Claritin can help. That's regular Claritin right, not Claritin D? When should you take it, and how often? Are there other over the counter remedies that can help, or are their prescriptions we should be requesting?

    How long does it last -- will one shot last the full cycle?

    What's the difference between Neulasta and Neupogen?

    Should I expect that he'll need extra support after he gets the shot, and for how long thereafter? I have plans to take the kids away for the weekend, and I need to figure out the type of support he may need at home. Last cycle he basically just rested the weekend after chemo -- he felt like crap but he didn't need a lot of help. Now I'm wondering how the Neulasta may complicate things.

    Thanks everyone!

  • #2
    I dont think there is much of a difference between the 2. I have had both and both of them made me hurt. As for claritin im not sure which is used cause i wasnt given either.
    As for how long it last, its not like taking a pain med, its used to boost your system into over production. I know i hurt 48 hrs after tje shot and it felt like every bone in my body was broken. It only lasted a couple of hours. A hot bath helped with the uncontrollablespasms it caused. That was before i had HDC. During HDC i was given the shot everyday and felt nothing or had no side effects because my bone marrow had already been wiped out. So as i said it us used to kick your system into gear
    Jan 2012- U/S mass in Left testicle
    Feb 2012- I/O performed to remove cancer
    Mar 1,2012- pathology pure seminoma
    Mar 7, 2012 PET SCAN stage IIa
    April 2012 Mayo clinic carbolite.
    May 2012 carbolite failed, started BEP x3
    August 7th 2012- BEP complete
    April 2013 CT/PET show relapse
    May 2013 RPLND
    Aug 2013 Relapse again Started VIeP x2
    Oct 2013 HDC AUTOLOGOUS
    Dec 2013 HDC completed CT/PETSCAN 1.1 cm x .8 cm right lower lung lobe
    Feb 2014 confirmed false positive all clear FINALLY !
    Jan 2015 1 year cancer free Pet/CT scan
    Jan 2016 2 years cancer free "Pet/CT scan
    Jan 2017 3 years cancer free "Pet/CT scan
    Jab 2018 4 years cancer free "Pet/CT scan, labs, xrays

    Comment


    • #3
      Neupogen is typically given over multiple days. I had to self inject it over 3-5 days in the second week of the cycle. I did end up excruciating bone pain that lasted around 12-18 hours. The pain did not start till after I had taken all my shots. I think Neupogen is a quicker acting drug. I think it's affects don't last as long either.....a more "short-term" drug if you will.

      I was told you want to take regular Claritin...not the "D" version. You want to start taking it a few days before you start the Neupogen/Neulasta.

      Of course I was told this after I had gone through it. I was mad as h*ll that they didn't tell me before. I can't say if the Claritin trick will work or not because I didn't do it and cannot compare cycle to cycle.....only what I have heard from others.

      If he does have the pain, then he can take his favorite pain med at it's strongest does and just hunker down (curl up in a ball and go to sleep....like I did) for half the day until the pain goes away.

      Hope that helps.

      - 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
      July 10th 2018: 4 YEARS ALL CLEAR !

      Comment


      • #4
        Your post is pretty much spot on with what happened to me. First time i was given it right at ViEP. I was sent home no warning no nothing. I was at my cousins football game started to feel tightness in my lower back like i pulled a muscle around 7pm. Got home around 9pm and by then i was done. Spasms where bad the hot tub helped relax me but did not take away the pain. So i did the same thing maxed out my pain meds and rode it out til the morning.
        Jan 2012- U/S mass in Left testicle
        Feb 2012- I/O performed to remove cancer
        Mar 1,2012- pathology pure seminoma
        Mar 7, 2012 PET SCAN stage IIa
        April 2012 Mayo clinic carbolite.
        May 2012 carbolite failed, started BEP x3
        August 7th 2012- BEP complete
        April 2013 CT/PET show relapse
        May 2013 RPLND
        Aug 2013 Relapse again Started VIeP x2
        Oct 2013 HDC AUTOLOGOUS
        Dec 2013 HDC completed CT/PETSCAN 1.1 cm x .8 cm right lower lung lobe
        Feb 2014 confirmed false positive all clear FINALLY !
        Jan 2015 1 year cancer free Pet/CT scan
        Jan 2016 2 years cancer free "Pet/CT scan
        Jan 2017 3 years cancer free "Pet/CT scan
        Jab 2018 4 years cancer free "Pet/CT scan, labs, xrays

        Comment


        • #5
          My experience was pretty mundane. It was annoying having a patch on but I found it didn’t add to the General crappy feeling chemo caused. One thing that could happen is the LDH may shoot up because of it so if it happens don’t worry that’s normal according to my doctors. It went back to normal pretty quickly.
          3/29/17 Diagnosed 100% Embryonal 4/10/17 Left I/O CT scan shows a few suspicious lymph (biggest 1.9 cm) 5/8/17 - 7/3/17 3xBEP 7/20/17 CT Scan Clear, AFP has uptick to 19 8/16/17 AFP Drops in half to 10, ALL CLEAR! 9/12/18 All clears up to here!

          Comment


          • #6
            Mine was also mundane. I had it the the last 3 rounds of my 4xEP. I had no side effects from it, no bone pain, no aches. Didn't take any claritin or anything. Just the annoying autoinjector on my belly for 24 hours until after the shot was done.
            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 - 9/18/15: 4xEP
            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!
            9/27/2018 all clears up to this date!

            Comment


            • #7
              I also had bone pain for about 48 hours after the injection. I could still get up to eat etc, I just really didn't want to. For the most part I just ate and slept though for those 48 hours and took pain medication. I didn't know about the Claritin until just reading this thread now.

              It was handy to have someone at home to prepare meals etc.

              Not everyone gets side effects, or the same ones it seems.

              Comment


              • #8
                I think I had both, but never had any pain at all. it does seem to vary by individual.
                Jan, 1975: Right I/O, followed by RPLND
                Dec, 2009: Left I/O, followed by 3xBEP

                Comment


                • #9
                  I’ve had nupeogen self injections after my 3rd round of bep back in 2010. I don’t remember any significant side effects (1 injection a day for 5days)

                  Upon my relapse when I was given rounds of ep (which was incorrect treatment long story) I had that onpro auto injector twice both times no significant side effects.

                  In preparation for HDC w/ SCT after the second round of TiP I received 4 neupogen injections per day while inpatient and 2 a day outpatient for like 34 total. 3rd day inpatient with 4 a day. Everything hurt. Every bone joint everything, this lasted about 48 hours. Then subsided for the rest of the injections.

                  I was warned and suggested to take Claritin could’ve helped I won’t ever know.

                  Comment


                  • #10
                    My son never had either during BEP. He was severely Neutropenic (WBC less below 2 a few times) but Dr. E said it was not necessary and his counts would rise by day 22, and they did each cycle.
                    Son Grant
                    dx 12/21/16 at age 17

                    BEP x3
                    Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                    2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                    Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                    Comment


                    • #11
                      I started my 2nd round of 4xEP on July 19 and finished the 5 days of chemo on July 23. I received a neulasta shot on the 23rd, and it hit me pretty hard on the 30th. This is my 2nd neulasta shot, I had one during my first round that had just about as much pain, but it seems like it disappeared quicker than the 2nd round.

                      For me, it was basically throbbing pain in my lower back and hips, but the pain was so intense that my stomach was contracting with the pulsating pain, to the point my stomach was sore after it was all said and done.

                      For me, the intense part of it lasted about 12-14 hours. I didn't take anything, and just tried to sleep (easier said than done). For round 3, I plan on asking the doc for advice and/or prescriptions for pain meds, and do what I can to control the pain. It's definitely uncomfortable.

                      I thought neulasta was always more of a delayed effect based on your WBC counts dropping, so surprised some are feeling pain immediately after the shot.

                      Also, I did try Claritin both rounds, but I don't think I realized that the effects happen several days after, so I would normally take claritin for 5 days or so after chemo and then stop. That's something I plan on doing differently after round 3.

                      Good luck to your husband!
                      March/April 2018 - Started feeling tightness in right abdomen
                      6/4/18 - US+CT confirm massive tumor in right retroperitoneum (25cm x 17cm x 17cm)
                      6/20/18 - Biopsy performed (suspecting sarcoma)
                      6/25/18 - Diagnosed stage IIIC seminoma
                      6/28/18 - Started 4xEP
                      9/7/18- Finished 4xEP
                      10/10/18 - PET Scan (awaiting results)

                      Comment

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