Lester Link

Wednesday, March 01, 2006

I am starting to feel a little better. You would think these side effects would be a little more predictable by now, but they keep catching me off guard and knocking me down again. Lots of people have had questions regarding chemo and how it works and why my hair hasn't fallen out, etc... I found a pretty good description of how my "platin" drug works if any of you would like to read the specifics. I have copied the article below for your reading pleasure. There will be a quiz on the subject, so study hard! :)

EloxatinTM

Generic name: Oxaliplatin

Eloxatin is the trade name for the generic drug name Oxaliplatin. In some cases, health care professionals may use the trade name Eloxatin when referring to the generic drug name Oxaliplatin.

Drug type: Eloxatin is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Eloxatin is classified as an "alkylating agent." (For more detail, see "How this drug works" section below).

What Eloxatin is used for:

This medication is used to treat colon or rectal cancer that has spread (metastasized), it is often given in combination with other anticancer drugs (fluorouracil and leucovorin).
Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Eloxatin is given:

It is given by infusion into the vein (intravenous, IV).
There is no pill form of Eloxatin.
The amount of this medication you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dosage and schedule.
Side effects of Eloxatin:
Important things to remember about the side effects of Eloxatin:

Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
Infusion related side effects of Eloxatin:

The feeling of difficulty swallowing, shortness of breath, jaw spasm, abnormal tongue sensation and feeling of chest pressure. This has been reported rarely (<5%). It generally starts within hours of Eloxatin infusion and often occurs upon exposure to cold. Avoiding exposure to cold (see self care tips below) helps to prevent this adverse reaction. Future infusions may be given over a longer time frame to help reduce the incidence.
The following side effects are common (occurring in greater than 30%) for patients taking Eloxatin:

Numbness and tingling (peripheral neuropathy) and cramping of the hands or feet often triggered by cold. This symptom will generally lessen or go away between treatments, however as the number of treatments increase the numbness and tingling will take longer to lessen or go away. Your health care professional will monitor this symptom with you and adjust your dose accordingly.
Nausea and vomiting
Diarrhea
Mouth sores
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
Fatigue
Loss of appetite
The following are less common side effects (occurring in 10-29%) for patients receiving Eloxatin:

Constipation
Fever
Generalized pain
Headache
Cough
Temporary increases in blood tests measuring liver function. (see liver problems).
Allergic reaction: a rare side effect, however, call for help immediately if you suddenly have difficulty breathing, your throat feels like it is closing, or chest pain. Other signs of allergic reaction include rash, hives, sudden cough, or swelling of the lips or tongue.
This list includes common and less common side effects for individuals taking Eloxatin. Side effects that are very rare, occurring in less than 10% of patients, are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

Fever of 100.5º F (38º C), chills (possible signs of infection)
Shortness of breath, chest pain or discomfort, jaw pain, pain or tingling in your arms
The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:

Nausea (interferes with ability to eat and unrelieved with prescribed medications)
Vomiting (vomiting more than 4-5 times in a 24-hour period)
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Diarrhea (4-6 episodes in a 24-hour period)
Severe abdominal pain
Mouth sores (painful redness, swelling or ulcers)
Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
Severe numbness, pain in your joints or muscles (arthralgias or myalgias).
Constipation unrelieved by laxative use.
Extreme fatigue (unable to carry on self-care activities).
Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decreased amount of urine, or dizziness.
Always inform your health care provider if you experience any unusual symptoms.

Self Care Tips:

While receiving treatment with Eloxatin: avoid cold temperatures and cold objects.
Cover your skin, mouth and nose if you must go outside in cold temperatures.
Do not drink cold drinks or use ice cubes in drinks.
Do not put ice or ice packs on your body.
Other ways to reduce the side effects caused by cold:
Cover yourself with a blanket while you receive your Eloxatin infusion.
Do not breathe deeply when exposed to cold air.
Wear warm clothing in cold weather at all times. Cover your mouth and nose with a scarf, mask or a pull-down cap (ski cap) to warm the air that goes to your lungs.
Do not take things from the freezer or refrigerator without wearing gloves.
Drink fluids warm or at room temperature.
Always drink through a straw.
Do not use ice chips if you have nausea or a sore mouth. Call your health care professional.
Be aware that metals are cold to touch especially in the winter. Wear gloves to touch cold objects including your house door, car door, or mailbox.
Do not run the air conditioner on high either in the house or car in hot weather.
If your body gets cold, warm-up the affected part with warm water.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. This will decrease your chances of being constipated, and prevent dehydration.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your healthcare provider.
Wash your hands often.
Use an electric razor and soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated doses. You should discuss this with your healthcare provider.
Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by this medicine.
Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
In general, drinking alcoholic beverages should be avoided. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
Monitoring and testing:

You will be checked regularly by your health care professional while you are taking Eloxatin, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How Eloxatin works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Chemotherapy (anti-neoplastic drugs) is divided into five classes based on how they work to kill cancer. Although these drugs are divided into groups, there is some overlap among some of the specific drugs. The following are the types of chemotherapy:

Eloxatin is classified as an alkylating agent. Alkylating agents are most active in the resting phase of the cell. These drugs are cell-cycle non-specific. There are several types of alkylating agents.

Mustard gas derivatives: Mechlorethamine, Cyclophosphamide, Chlorambucil, Melphalan, and Ifosfamide.
Ethylenimines: Thiotepa and Hexamethylmelamine.
Alkylsulfonates: Busulfan.
Hydrazines and Triazines: Altretamine, Procarbazine, Dacarbazine and Temozolomide.
Nitrosureas: Carmustine, Lomustine and Streptozocin. Nitrosureas are unique because, unlike most chemotherapy, they can cross the blood-brain barrier. They can be useful in treating brain tumors.
Metal salts: Carboplatin, Cisplatin, and Eloxatin.

1 Comments:

Anonymous Anonymous said...

Thanks for the lesson, Kelly! Now I'm all ready for my new career at MD Anderson. If only they would call... =)

1:04 PM  

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