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Old 06-17-2002, 07:17 PM   #1
WorriedDaughter
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Join Date: May 2002
Location: Canada
Posts: 20
Post Metastases/Chemo - Need Feedback ASAP!

My 66 year old father has just been confirmed with Bone Metastases (from colonrectal cancer to the base of the spine). He currently has nightly fever and high pain which is reduced by 60mg morphine each morning and night. Due to past radiation damage he can have no more radiation and due to metastases at spine base they say no surgery. They are doing follow up MRI to see if it has grown but plan on starting chemo (once a week for four weeks and then off for a few). Specialists said this usually has good results but often bad side effects. Can anyone please give me feedback ASAP! ME
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Old 06-17-2002, 08:55 PM   #2
Jay Tor
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Join Date: Dec 2001
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For first-hand accounts, try ACOR [Association of Cancer Online Resources] which has patient/family support groups for different cancers.

Have you done any literature or clinical trials searches? Below are links to Cancerlit and the NIH clinical trials site. The clinical trials site is useful as a way of checking which therapies are being researched and why.

[url="http://clinicaltrials.gov/ct/gui/action/SearchAction?JServSessionIdzone_ct=mkm8v hqwr1&term=bone+cancer&submit=Search"]http://clinicaltrials.gov/ct/gui/action/SearchAction?JServSessionIdzone_ct=mkm8v hqwr1&term=bone+cancer&submit=Search[/url]

[url="http://www.nci.nih.gov/clinical_trials/doc.aspx?viewid=fbd81f89-9e50-44b8-ae35-875b84b6bb7f"]http://www.nci.nih.gov/clinical_trials/doc.aspx?viewid=fbd81f89-9e50-44b8-ae35-875b84b6bb7f[/url]

A few recent studies suggest that some osteoporosis drugs can reduce bone pain in bone cancer patients. No idea whether this would help in your father's situation [metastasized colorectal cancer], even though these drugs are currently in clinical trial for several different cancers. Much depends on the nature of the cancer cell, kidney health and blood calcium levels.

Good luck,
Jay
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Old 06-17-2002, 09:47 PM   #3
Jay Tor
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Some more info about calcium's involvement:
[url="http://lpi.orst.edu/infocenter/minerals/calcium/calcium.html"]http://lpi.orst.edu/infocenter/minerals/calcium/calcium.html[/url]

Adjuvant therapies - COX-1 & COX-2 inhibitors and statins:

This is a cut & paste:

"The Life Extension Foundation predicts that COX-2-inhibiting drugs will eventually be approved to treat cancer, but in the meantime, we are asking physicians treating cancer patients to consider prescribing a COX-2-inhibiting drug as an adjuvant therapy. The COX-2 drug of choice will be described later, but first we want to briefly discuss another prescription drug that may benefit cancer patients:

The regulation of cancer cell growth is often governed by a family of proteins known as RAS oncogenes. The RAS family is responsible for modulating the regulatory signals that govern the cancer cell cycle and proliferation. Mutations in genes encoding RAS proteins have been intimately associated with unregulated cell proliferation (i.e., cancer).

The "statin" class of cholesterol-lowering drugs has been shown to inhibit the activity of RAS oncogenes. Some of the "statin" drugs that have shown efficacy are lovastatin, simvastatin, and pravastatin.

There are mechanisms other than inhibition of RAS oncogene activity that make the "statin" drugs attractive as adjuvant anticancer agents. According to a study in the Journal of Biological Chemistry (1998, Vol. 273, No.17), prostate cancer cells are very sensitive to the induction of growth arrest and cell death by lovastatin. This study showed that lovastatin was particularly effective in inducing prostate cancer cell G1 arrest and cell death in human androgen-independent (hormone-refractory) lines. This study is confirmed by other studies showing that "statin" drugs interfere with critical growth pathways that enable cancer cells to proliferate out of control.

A suggested combination therapy to inhibit COX-2 and provide "statin" regulatory control of cell hyperproliferation is as follows:
Lodine XL is an arthritis drug approved by the FDA that interferes with COX-2 metabolic processes. The maximum dosage for Lodine is 1000 mg daily. The most convenient dosing schedule for the patient involves the prescribing of two Lodine XL 500-mg tablets in a single daily dose. As with any nonsteroidal anti-inflammatory drug (NSAID), extreme caution and physician supervision is a must. The most common complaints associated with use of Lodine XL relate to the gastrointestinal tract. Serious GI toxicity such as perforation, ulceration, and bleeding can occur in patients treated chronically with NSAID therapy. Serious renal and hepatic reactions have been reported rarely. Lodine XL should not be given to patients who have previously shown hypersensitivity to it or in whom aspirin or other NSAIDs induce asthma, rhinitis, urticaria, or other allergic reactions. Fatal asthmatic reactions have been reported in such patients receiving NSAIDs.

Nimesulide is a safer COX-2 inhibitor, but is not approved by the FDA. It is available from Mexican pharmacies, or can be ordered by mail from European pharmacies. The suggested dose for nimesulide is two 100-mg tablets a day.

The two newest COX-2 inhibitors are Celebrex and Vioxx, but we suggest that cancer patients consider other drugs that have a more predictable safety history. Suppression of COX-1 is associated with the severe gastrointestinal complications induced by NSAIDs in humans, whereas selective inhibition of COX-2 reduces this side-effect risk. It is the COX-2 enzyme that fuels cancer cell proliferation, so the objective of choosing the proper NSAID in the treatment of cancer is to find one that suppresses the minimum percentage of COX-1 and the maximum percentage of COX-2. In other words, it is critical not to overly suppress COX-1 because the digestive tract needs COX-1 to maintain its structure, whereas it is important to suppress COX-2 because it is this enzyme that cancer cells use to proliferate. "

-----------

This is a relatively old article [1998] as far cancer research goes - but the "COX-1, COX-2" and "statin" effects have been repeated in several studies since.

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Old 06-17-2002, 11:36 PM   #4
SamQKitty
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Location: MA
Posts: 3,020
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Regarding the side effects of chemo...nausea can usually be avoided these days. Ask his doctor for the following: On the days he receives chemo, he should receive IV Zofran BEFORE he gets the chemo. He should have a compazine pill for that night, and then oral Zofran, at least one pill a day for the next 3 days.

If that doesn't work to eliminate or minimize nausea, there are other medications that can be tried. The keys are a) IV anti-nausea meds BEFORE the chemo is started and b) follow-up meds for the next several days.

And if all else fails, there's marijuana, which usually works even when all else has failed. You can actually get a prescription from the doctor for the "marijuana pill", but most people I know found the real stuff works better.

Hope this is helpful. Most people don't have to resort to the marijuana if they get good anti-nausea regimens.


[This message has been edited by SamQKitty (edited 06-17-2002).]
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