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1xBEP vs 3xBep

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  • 1xBEP vs 3xBep

    Hi guys;

    Looking for some quick information. Just returned from Dana Farber in Boston and have been told that based on my Stage 1 Embryonal Carcinoma that I have 3 options.
    1. Watch and Wait with month blood checks and chest x-rays and exams and 2-3 month CT scans
    2. 1xBEP
    3. RPLND
    I have question with regard to be 1xBEP vs 3xBEP. My understanding of a single cycle lasts for 3 weeks. Are people typically able to work during that time frame? Is 3XBEP last for 9 weeks or longer? Are people typically able to work during that time frame?
    I/O 09/18/12 Stage 1a 100% EC
    1xBEP 10/29
    AFP: 2 01/02/12
    BHCG: <1 01/02/12

    CT All Clear 12/20/12
    Chest X-ray All Clear 01/02/12

  • #2
    3 weeks per round, so yes, 3 for 1 and 9 for 3. Some people can work and some people can't. Some people are in bed all day, others go to work like nothing happened.

    Comment


    • #3
      Is there typically any break between them?
      I/O 09/18/12 Stage 1a 100% EC
      1xBEP 10/29
      AFP: 2 01/02/12
      BHCG: <1 01/02/12

      CT All Clear 12/20/12
      Chest X-ray All Clear 01/02/12

      Comment


      • #4
        The break is built into the 3-week period. Only the first week of each cycle is full-time chemo, 6-8 hours a day. On the second and third weeks you just come in once a week for a bleo infusion - usually less than an hour. The second week you feel pretty bad, the third week you start to feel better, and then you get to start again.

        Comment


        • #5
          Hi mcpowers,

          There is no break in between UNLESS there is a medical reason for doing so. In my sons case, his third round was postponed for a week due to a very low WBC count.

          If you choose adjuvant BEPX1, then you would be in the clinic for the better part of the day for week 1. (We would arrive around 8:30 AM and leave around 4 PM....sometimes later.) The first 2 days were a breeze for Austin. By day 3, he began not feeling so hot and was fatigued and lost his appetite. Days 4 and 5 he slept quite a bit. At the completion of the first week, he became nauseous on the ride home. He went upstairs and slept for 23 hours and did not venture downstairs for 3 days. We switched meds, so no more sickness, just extreme fatigue. This is the time when it seems to hit most guys the hardest!

          Week 2 and 3 are supposedly one trip in for a quick push ( usually Monday or Tuesday), which takes less than an hour. Austin began to feel better by Tuesday and had no real issues with his Bleo, other than some shivering for a few minutes. By Wednesday, he felt well enough to go to school ( but we had pulled him out), and meet some friends one evening. We even went to the beach that week-end. That is when his hair began to shed. It was everywhere! I had just trimmed it some in his picture above, but he refused to let me shave it!

          Week 3, he began to develop mouth sores on Sunday and though we used the mouthwash, Monday they were worse. He had his Bleo and came home and felt kind of "yucky", but not sick. I kept a close watch on his temperature, which was fine until my last check around 11 PM. It was just above the threshold, so we were advised to bring him back up to Hopkins, where we ended up for 5 days until his counts went back up. That was a miserable week. The mouth sores were out of control, ( he had braces on at the time, which were later removed) AND his hair was falling out in clumps and itching him like crazy AND he was on steroids that kept "us" up all night, AND had a morphine pump that caused bladder irritation, so he thought he had to be every 5 minutes! He was so weak at this point that we had to steady him so he could stand and pee in the bottle.

          The GOOD news is, the next two rounds went MUCH smoother, other than the one week delay for the final round. The low WBC, doesn't make you feel bad, it just lowers your threshold for fighting off infection.

          The point is, it's REALLY hard to know how you will feel ahead of time. If you have flexibility and can work from home, that makes life easier. Besides fatigue, if your counts are low at certain times, you do not want to be around a lot of people. Another consideration is "chemo brain". We had a tutor come to our house, but quickly realized Austin was unable to concentrate on schoolwork and it was too stressful for all of us, so we made the decision to just focus on his treatment and let his schoolwork slide. For us, it was the only way to go.

          Hope this helps! There is no wrong choice. Best of luck whatever you decide.

          Diane
          Cook/Maid/Chauffeur/ATM Machine/Personal Asst. to Austin

          12/07/11 I/O AFP: 291 hCG: 151
          12/08/11 CT Scan, Xrays - clear
          12/15/11 Non Seminoma Stage1-B
          EC, Teratoma, Yolk Sac, Intratubular
          4/21/12 Relapse- Start 3XBEP
          6/25/12 Finished BEP
          7/02/12 Markers and CT Scan normal
          10/3/12 3 month post-chemo check-up - All Clear!
          2/28/13 8 month post-chemo check-up - All Clear!
          6/30/13 ONE YEAR- ALL CLEAR!!
          2/14/14 20 month post-chemo check-up - All Clear!

          Comment


          • #6
            I have just finished my second cycle of BEP. For me, it would not hav been possible to work. Between the tiredness and general "chemo brain"... Others have different stories.
            2011: July 7 - Right I/O, Aug 4 - Seminoma - 2.7cm - Surveillance 2012: July 30 - Relapse, 3cm paraaortic node, blood work normal. Nov 6th - Finished BEPx3 Jun 24 - 1.5 years post chemo all clear

            Comment


            • #7
              I could have went to the office during cycle 1 (I worked at home) but for the last six weeks plus two at the end I could not have worked. I was a sick and beaten man but 9 weeks out I am cancer free and feeling great.
              Tony

              Diagnosed 4/12/12
              AFP 31, HCG 32
              I/O 4/25/12
              Nonseminoma Stage 1S
              Embryonal Carcinoma 95%, Yolk Sac 5%
              Lymphatic Invasion, Markers did not normalize
              BEPx3 Finished 8/5/12
              Post Chemo APF 2 HCG Undetectable

              Comment


              • #8
                My 23 year old son started his first week of 3xbep on 10/15 so today is day 4. Chemo brain has been a real issue for him from the beginning. He feels like he cant focus or as he said it was hard to order a burrito. I agree with everyone that each person s chemo experience is unique and this may not be the case for you.

                Also my son had a reaction to the etoposide and he receives benadryl which may be partly responsible for the chemo brain.

                Good luck with your decision, as diane said there is no wrong choice.

                All the best...

                Lori
                Eli s mom
                6/15/12 left i/o
                50%yolk sac 35%embryonal 15%seminoma
                No lvi markers normalized
                stage ia surveillance
                8/12 chest xray blood markers normal
                9/12 ct enlarged retroperitoneal lymph nodes 3cmm
                10/12 markers elevated
                10/15/12 3xbep
                Lori
                Eli s mom
                6/15/12 left I/o
                50%yolk sac 35%embryonal 15%seminoma
                No lvi markers normalized
                9/12 ct several enlarged retro peritoneal lymph nodes 3cm
                10/12 markers elevated
                10/15/12 3xbep
                1/13 complete response
                Surveillance

                Comment


                • #9
                  My husband worked while on weeks 2 and 3 of each cycle, but on light/desk duty.
                  Tracy
                  Cancer pharmacologist, caregiver blog here

                  Wife to Kel, dx 12/30/11 Stage IIIc (poor) embyronal, AFP 13700, 10x11 cm retroperitoneal mass, 1 cm^2 lung met
                  Left I/O 12/31/10.
                  4xBEP 1-4/11, AFP=22, 5*7 RP mass, tx failed
                  1.5 x VeIP 5-6/11; tx failed, AFP/b-hCG rising
                  Salvage RPLND @Indy 6/29/11, metastatic mixed germ cell tumor with yolk sac, seminoma and teratoma
                  Remission! AFP steady since 9/2011; 2+ years ALL CLEAR

                  Comment


                  • #10
                    Just finished day 3....aint as bad as I was anticipating.. I am sure the worse is yet to come. I am seriously exhuasted everyday, and cannot focus well. Work for me is a not happening...
                    TSgt, USAF, Ground Radio / ATCALS

                    18 June 2012 Diagnosed
                    29 June 2012 Left Orchiectomy
                    Stage 1A Tumor, no lymph invasion
                    CT Scans/ X-ray all negative, AFP markers good
                    Surveillance was prescribed
                    Oct 5 2012 CT Scans/ x-ray negative
                    Oct 10 2012 AFP markers HIGH (64, zero = norm)
                    Oct 10 2012 HCG high
                    Oct 11 2012 Prescribed CHEMO BEP x 3
                    Oct 12 2012 PET scans of Brain, MRI, Pulmonary/ECHO test
                    Oct 16 2012 Chemo day 1....
                    Dec 22 2012 Finished Chemo
                    Aug 8 2013 Still all clear

                    Comment


                    • #11
                      Thank you all for taking the the time to respond. It is greatly appreciated!
                      I/O 09/18/12 Stage 1a 100% EC
                      1xBEP 10/29
                      AFP: 2 01/02/12
                      BHCG: <1 01/02/12

                      CT All Clear 12/20/12
                      Chest X-ray All Clear 01/02/12

                      Comment


                      • #12
                        Hi all. It looks like I am going to take 1xbep. Thank you all for your time!
                        I/O 09/18/12 Stage 1a 100% EC
                        1xBEP 10/29
                        AFP: 2 01/02/12
                        BHCG: <1 01/02/12

                        CT All Clear 12/20/12
                        Chest X-ray All Clear 01/02/12

                        Comment

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