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  • Reduced last chemo cycle medications by 20%

    After having another crazy reaction to my last bleo last Tuesday my oncologist is reducing the stengh of all chemo medications by 20% she said it should not have any effect on my overall outlook. Last Tuesday evening I started getting the most intense body chills so I got in bed but even though I had the chills I was boiling all over but no fever this last a couple of hours I was still in bed and I looked at my Fitbit and my heart rate was 145 bpm very scary so I went to to ER they did a lot of blood tests and a chest x-ray all come back ok they gave me IV fluids and they kept me there about 6 hours and eventually I dropped into the low 90s they said I had tachycardia due to chemo reaction so my questions did anyone have this reacion to the bleo and is it ok in reducing the strength of my last cycle by 20%

  • #2
    I would ask your oncologists to confer with the experts. At minimum, I would have a discussion about not reducing the Etoposide and Cisplatin dosages since your issues seem to be with the bleo. What was your complete staging?
    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!
    3/29/2018 all clears up to this date!

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    • #3
      My staging was 2a I had 2 slightly enlarged abdominal lymph nodes my oncolist ensured me if it was going to put my cure at any risk she would not do it she has been in this field for over 20 years

      Comment


      • #4
        I have not really heard of arbitrarily reducing the last round of BEP by 20% due to bleomycin reactions. I have seen where BEPx3 is switched to EPx4 after a round or two of BEP where there were issues with lung function or other reasons. I do believe there may be a little data on BEPx2 in low-volume seminoma but only done in a handful of patients.

        Mike
        Oct. 2005 felt lump but waited over 7 months.
        06.15.06 "You have Cancer"
        06.26.06 Left I/O
        06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
        06.30.06 It's Official - Stage I Seminoma
        Surveillance...
        Founded the Testicular Cancer Society
        6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

        For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

        Comment


        • #5
          The SOP when someone is having bad reactions to Bleomycin is not to reduce dosages, but to switch them from BEPx3 to EPx4 without the Bleo.
          Young Adult Cancer Survivorship by Steve Pake
          April is Testicular Cancer Awareness Month!
          www.stevepake.com
          Feb 2011, Stage IIB, 4xEP, RPLND, PTSD
          My Survivorship Thread | All of my Blogs
          C
          ONTACT ME ANYTIME!

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          • #6
            During my husbandís BEP x 3, his oncologist chose to skip a dose of bleo due to low WBC and then delayed a round because she did not want to give him a G-CSF. I donít want to be a downer but I will always wonder if any of this led to his recurrence. I wish we would have kicked into 4x EP. This page has some helpful information about delaying or reducing chemo.

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            • #7
              I've had terrible chills and shakes with Bleo unless I took Benadryl 30 minutes before. Benadryl helped me get rid of the worst effects.
              Jan '11 - Stage IIIc, Mets in lungs and liver, abdo 7*7, pulmonary embolism
              Right I/O AFP 13,000, bHCG 110, Scrotal Hematoma, IVC Filter
              4*BEP AFP 20 end of 4*BEP
              May '11 - RPLND @ Indiana U - inferior vena cava dissected, necrosis, AFP<5
              Surveillance (blood & X rays) and all clear for 24 months
              April '13 - AFP 26 , went up to 46 in a week, Negative CT Scan, Ultrasound and head MRI
              4xTIP - almost normal AFP, but started rising again
              2 x HDC with Autologous Stem Cell Transplant - AFP almost normal but started rising again
              Lost kidneys, damaged liver, chirhosis, ascites 2 liters per day, dialysis 3 times per week, disabled
              2 Lung Wedge Resections -

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              • #8
                Skywalker, my understanding is that bleo does not affect WBC, I have no idea why they did that. Scotty, I've heard of eliminating bleo, but never about reducing the other drugs. You might want to email Dr E & get his opinion.

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

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                • #9
                  That is absolutely correct. Bleo doesn't reduce white count and it shouldn't have happened. I was 9 months pregnant and skipped that infusion day unfortunately. They also say it's better to receive the G-CSF and stay on schedule even though that is a little riskier with the Bleo and lung function.

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                  • #10
                    My son has had a reaction to it, every other time. They do Benadryl, Tylenol and steroids. Then he does the Tylenol and Benadryl again, five hours later. They are taking him off of the bleo, but only for the last round, of four. I was curious as to why not before.

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                    • #11
                      Bleo offers a significant advantage in treatment over EP alone. Unless it is shown to be causing possibly permanent lung damage most docs will continue with it even though it might be difficult to get through. BEP is the "gold standard" of TC treatment & has been proven to be the best option for a cure, even though lessor options may work.
                      Jan, 1975: Right I/O, followed by RPLND
                      Dec, 2009: Left I/O, followed by 3xBEP

                      Comment


                      • #12
                        Dave said it well. So sorry momof4 ! My son also had issues with Bleo, we conferred with Dr. Lawrence Einhorn via email.
                        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


                        • #13
                          I believe in certain cases of Intermediate Prognosis metastatic testicular cancer that the use of BEPx4 or VIPx4 may be considered over-treatment, based off of data that has been presented out of Indiana University. Thus, using BEPx3 + EPx1 has been advocated by some experts in Intermediate Risk patients.

                          See: http://ascopubs.org/doi/abs/10.1200/....15_suppl.4534 (The Abstract is a bit messy) The poster is at: https://meetinglibrary.asco.org/record/69989/poster and can be clicked on to enlarge.

                          Mike
                          Oct. 2005 felt lump but waited over 7 months.
                          06.15.06 "You have Cancer"
                          06.26.06 Left I/O
                          06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
                          06.30.06 It's Official - Stage I Seminoma
                          Surveillance...
                          Founded the Testicular Cancer Society
                          6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

                          For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

                          Comment

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