Bleo--What is the draw?

[UT-TC]

I'm likely facing either 3X BEP or 4X EP. From what I've read here, and from other sources on line, it appears that both treatments are equally effective. Correct or not?

If I'm to believe that they are, then what's so special about Bleo? From what I understand, the cumulative doses of EP are equal in both treatments. If that's the case, what does the extra "boost" of Bleo benefit? Given its side effects of possible lung toxicity, possibly irreversible, why take the chance if both treatments are nearly equally effective?

Or, do I have it all wrong, and 4X EP is NOT as effective as 3X BEP? Why, if both treatments are fairly equal, would one even use Bleomycin? What's so magic about that drug?

Just to add, my main concern is that I've been a smoker for over 20 years. Yes, I MUST QUIT NOW, and I WILL SOMEHOW. But, the damage is likely done. My Chest x-ray shows nothing on my lungs, but we all know 20 yeas of puffing has done damage. Bleo scares me, but I want to kill the cancer I already have in the best manner possible, the FIRST time around!

My signature outlines my diagnosis so far:

[dadmo]

The cure rate for both treatments is the same. My sons chemo was directed by Sloan Kettering and they favor 4xEP, if he was at IU it would have been 3xBEP.

[Paul54]

I agree with dadmo. This question has been studied extensively. If one were superior to the other, everybody would go that route. Dana-Farber favors 3xBEP, but they and many others go with 4xEP, especially for older guys who may have had a history of smoking, lung damage from pneumonia, excessive exposure to pollutants, etc., or just can't cope with Bleo. It sucks any way, but I wouldn't worry about the difference.

[Aegean]

I just had this talk with my onc yesterday... he comes from Princess Margaret Hospital... and he too favors 4xEP.

[dadmo]

In my non medical opinion if there was a heavy tumor load on the lungs I would lean toward Bleo. Remember that's just me and not a medical opinion.

[UT-TC]

I guess I'm just looking for the reasoning behind one group of talented specialist favoring one, while equally talented specialists favor another. While they both may be correct in their decisions, I'm curious as to why, for example, IU would favor adding Bleo to the treatment. What so special about it that they prefer it?

There must be SOME reason, and I've searched like heck for an answer.

On a side note, I have an appointment Tuesday with an oncologist in SLC who works closely with Dr Einhorn, so he may have an answer if we can't find it elsewhere. I guess we know in advance he'll likely favor BEP over EP. My cancer is limited to the abdominal lymph nodes at this point, but they're quite large. No lung evidence on X ray or CT, blood markers all normal, and pure Seminoma.

I'd just like to hear each's case as to WHY they favor one treatment over the other if both produce similar results. They didn't decide by flipping a coin, I hope!

Thanks to everyone who has chimed in, and those who recommended the oncologist I'm going to see.

[Already Bald]

The risk of 3XBEP: You are exposed to lung tox.
The risk of 4XEP: Higher exposure to potential secondary maligancy and heart disease.
Both are curative, but are not without their costs...
With your smoking history, I think your SLC oncologist will suprise your ane favor 4XEP.
Good luck,
Joe

[UT-TC]

Thanks Bald. I had read about the lung toxicity with BEP, but had not read about greater risk of secondary malignancy and heart disease with the extra round of EP.

The smokes are GONE. We'll see how that goes, but at this point, I have no choice in the matter if I am to live on, and even survive the Chemo. Cancer sure doesn't need any help from other villans!

[Elliott]

Cancer sure doesn't need any help from other villans!

Thats the truth.
I agree with Dadmo, I think they use BEP when there is a larger tumor load.
Best of luck and ask your onc about the difference. Bleo is nasty stuff and I would veer away from it with just now stopping smoking<---personal opinion