How long does each chemo session take?

[janine]

I read at cancer.com that it should take 6 hours to administer EP, and it only took 2 hours both times that I was there with my son giving EP.

I'm concerned that they might not be doing it correctly.

http://www.cancer.net/patient/Cancer+Types/Testicular+Cancer?sectionTitle=Treatment

Cisplatin and etoposide are given each day on the first five days.
IV fluid is also given before and after the cisplatin to reduce the risk of damaging the kidneys.
The treatment takes about six hours on these days.
Bleomycin is given once each week, typically on the first, eighth, and 15th day of the 21-day cycles. The treatment takes about 30 minutes on the days when only bleomycin is given.

[GJH16]

I'm on my 5th round of EP and I haven't had any treatments last less than 5 1/2 hours. The EP alone takes 2 1/2 hours to drip, plus premeds before and fluids after. Not to imply they're administering it incorrectly, but my experience has always been 5 1/2 to 7 hours.

[gilly6993]

I'm on my 5th round of EP and I haven't had any treatments last less than 5 1/2 hours. The EP alone takes 2 1/2 hours to drip, plus premeds before and fluids after. Not to imply they're administering it incorrectly, but my experience has always been 5 1/2 to 7 hours.

that's what I heard as well....I start 3XBEP on Jan 4th.....from what I hear the Bleo is "quicker"....not sure exactly how long it is though....

[GJH16]

Bleo only days seem to take just under two hours.

[dadmo]

My sons EP infusion (including fluids) took between 6-7 hours.

[janine]

Thanks, got a reply from Dr Craig Nichols, Lance Armstrong's doctor, who says he's never heard of it taking only two hours; and Mary J Brames, who works with Dr Einhorn, said this:
It usually takes us about 4 to 4 ½ hours. We give 1 liter of fluid prior to the Platinum over 1 hour, the Platinum takes about 40 minutes, the Etoposide about 1 hour then the liter of fluid after over 1 hour, and add the anti nausea meds. You can sometimes “cheat” a little if you use the Etoposide as the post Platinum hydration, but it should still take a little longer than 2 hours.


Now I just have to convince my son and his doctor to listen to the experts.

[dadmo]

Are they skipping the fluids?

[janine]

Yes they are. I know this because when I asked the staff, the one who adminsters the EP, she said, I will ask the doctor if he wants to add the fluids.

I said I didn't just want her to ask the doctor, I want her to consult with Indiana University. They are the experts. I'm the mother of the patient, so I don't have much standing.

And my son has been upset with me before for questioning the doctor; but I have caught the doctor out making mistakes before, and this scares the heck out of me. I shouldn't be able to find mistakes when I've only been looking stuff up on the internet for a week. And my sources are the best, like Dr Einhorn and Dr NIchols, these aren't crackpot websites that I'm looking at.

For example, this:
Outpatient Fluids

Back in the old days the treatment for testicular cancer was always done as an inpatient in the hospital. They did this so that they could constantly force fluid into the patient to ensure that there was no kidney damage. Nowadays, they've decided that this is overkill, and most people are healthy enough to take their chemo as an outpatient. Nevertheless, it is still important to drink as much as you can and to get the proper amount of fluid during the chemo infusion. Dr Nichols says that, "Most people would require a liter of normal saline before cisplatin, more with the etoposide (usually 500 cc) and a liter afterwards. So the patient should receive somewhere between 2.5 and 3 liters of fluid. Even at 500cc an hour, which is fast, this will take most of the day."

http://tcrc.acor.org/chemo.html

[Already Bald]

Yes they are. I know this because when I asked the staff, the one who adminsters the EP, she said, I will ask the doctor if he wants to add the fluids.

Janine,
This is very troubling. Your son's kidneys are at risk is he is not getting enough fluids. I have never learned of anyone getting infused without IV Fluids.
He needs to drink lots of water, so that the "spring runs clear".

This will be more difficult to do as he gets on with his treatments.

Greg is lucky to have you as an advocate, now you just need to convince him.
Best,
Joe

[UT-TC]

I've just finished my second weekly round of EP, and I've been both watching every drop that goes into the IV, and timing it!

Here's the average, and it hasn't varied much in the 10 days of treatments so far:

Aloxi and Dexamethasone (anti nausea)--20 min.
Potassium and Magnesium (fluids)--90 min
Cisplantin (28mg) and Mannitol -60 min.
Etoposide (170mg)-60 min.
*Fridays only--Emend (115mg) (anti nausea)--20 min.

I also get a shot of Neulasta before leaving on Fridays, in the arm muscle.

The whole process usually takes from 4 1/2 to 5 hours, in and out.

I have yet to feel any nausea even once during the whole process. A little heartburn a few times, but that's it. (Other side effects I've already posted about, and are in my blog. (hearing and taste issues, mainly)

[janine]

Thanks everyone.

Have been communicating with my son's girlfriend who has been with him at chemo today, they are now administering fluids.

[dadmo]

You're a great Mom. Super job being his advocate.

[janine]

Thanks dadmo, I needed that!

When I found this site, I thought it would be a great resource for my son...but it has turned out to be a great resource for ME.

[Scott]

...they are now administering fluids.

Thank goodness! I hope your son will recognize what you're doing is out of love -- and is making a positive difference in his treatment and his long-term health.

[Redlight]

At M.D. Anderson, when I get my chemo, it is inpatient and takes around 14 - 15 hours a day. On the first day, premeds are first for about an hour, then the bleo for only about 15 minutes. Then the etoposide for about 2 hours, and the cisplatin for the next 2 hours. Then, they force fluids for the next 10 hours at a rate of 200cc/hour...1000cc per bag and 2 bags of fluid, I know it has mannitol in it which makes you go to the bathroom a lot. I don't know if this is overkill, but that is how the inpatient is done.