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Medical Forum / Diseases and Disorders / Cancer / April 2005Question about Taxol: ovarian cancer
My mother has been diagnosed with stage III ovarian cancer. She had surgery. Now, the doctors prescribe a course of chemo, using Taxol. She is very worried about side effects. Can anyone comment on the benefits of using Taxol at this stage? Is there a better chemo drug for this stage? What supplements/drugs can she take to reduce the side effects? Your comments will be much appreciated. Gianna > My mother has been diagnosed with stage III ovarian cancer. So has my mom, last july. You have my sympathies. >Now, the doctors prescribe a course of chemo, using Taxol. Probably, he means Carboplatin and Taxol, which is the current 'gold standard'. > She is very worried about side effects. Sorry to be blunt, but the side effect of NOT getting chemo for Stage III OvCa is most likely death. > Can anyone comment on the benefits of using Taxol at this stage? CarboTaxol is the best bet she has to avoid recurrance. Recurrances in OvCa are... very problematic to say the least. My mom recurred 3 months after entering remission. She is currently on Doxil, but... I know the stats. If your mom can avoid recurrance, she will lead a long and happy life. > Is there a better chemo drug for this stage? Since most women with advanced stage OvCa recurr, and since recurrance is so serious, I would suggest that you: 1- get into a clinical trial as soon as possible, containing Carboplatin, Taxol, and <some third investigational drug>. This has the best odds of giving a prolonged remission. (but it may not give better results than standard CarobTaxol therapy, and _may_ have greater side effects) 2- Hopefully, she will achieve remission. At that point, I would get into another clinical trial ASAP (like Ovarex) to try to prolong remission. You have plenty of time to look for them, since CarboTaxol therapy will last a few months. I wish someone had told me this at the time my mom was diagnosed. Actually, I wish someone had told me about the CA-125 test a year before she was diagnosed, but that's another story. > What supplements/drugs can she take to reduce the side effects? Take NOTHING without telling your doctor. Supposedly 'natural' and 'herbal' junk sold at the pharmacy can be harmful, and can interfere with the chemo. Remember, none of that stuff has been proven to do anything, except enrich the scammer selling it. You'll want to skim this article and bookmark it for future reference: http://www.quackwatch.org/00AboutQuackwatch/altseek.html Finally, you or your mom will certainly want to join the Ovarian list. It's been a great help to me and my mom. Over a thousand women discuss OvCa issues daily. http://listserv.acor.org/SCRIPTS/WA-ACOR.EXE?SUBED1=ovarian&A=1 A heartfelt THANK YOU goes out to all medical research scientists and doctors for extending my mom's life, and to computer scientists for creating the Internet and giving us such an amazing information resource. > My mother has been diagnosed with stage III ovarian cancer. She had > surgery. Now, the doctors prescribe a course of chemo, using Taxol. She [quoted text clipped - 7 lines] > Your comments will be much appreciated. > Gianna All chemo has side effects and taxol is not the worst of them. The doctors use the best first so I would advise her to just go with it and see how she copes. Chemotherapy hasn't changed much over 20 or 30 years but symptom management has. MIKE "Mike Radcliffe" said: > Chemotherapy hasn't changed much over 20 or 30 years I don't understand how you can say that. Taxol, for example, is relatively new. It certainly wasn't around 20 years ago for OvCa. It has added years to the life of OvCa patients. Herceptin, an even newer drug, is showing very promising results http://www.post-gazette.com/pg/05117/494842.stm which might apply to Her2 positive OvCa patients. Many other examples I could give... > "Mike Radcliffe" said: > [quoted text clipped - 9 lines] > http://www.post-gazette.com/pg/05117/494842.stm > which might apply to Her2 positive OvCa patients. I don't see what you claiming here (in the tables) and the patients were carefully selected for the higher levels of Her2 overexpression. I don't have the trails criteria. Perhaps they also carefully selected for potential comorbidities.. . http://www.rxlist.com/cgi/generic/trastuz_cp.htm#her2 Relationship to Response: In the clinical studies described, patient eligibility was determined by testing tumor specimens for overexpression of HER2 protein. Specimens were tested with a research-use-only immunohistochemical assay (referred to as the Clinical Trial Assay, CTA) and scored as 0, 1+, 2+, or 3+ with 3+ indicating the strongest positivity. Only patients with 2+ or 3+ positive tumors were eligible (about 33% of those screened). Data from both efficacy trials suggest that the beneficial treatment effects were largely limited to patients with the highest level of HER2 protein overexpression (3+). (See Table 2.) A longtime regular on the breast cancer newsgroup is calling Herceptin "dangerous". <start quote> "Herceptin is a "dangerous" drug, in that is has a significant risk of severe side effects (in particular congestive heart failure) and at the moment outside of some clinical trials, is only given to stage IV patients, who have relatively little to lose. I have not heard of any trials that are recruiting at the moment. It is also quite expensive, and to justify its use you have to be stage IV, HER2+, and likely to benefit from it in terms of prognosis, e.g. not already at death's door or suffering form other major complications. Even then a significant proportion of patients who receive it do not see any benefit, but for those who respond it can be dramatic.<end quote> J J <esprit@anon.inv> said: >> Herceptin, an even newer drug, is showing very >> promising results >> http://www.post-gazette.com/pg/05117/494842.stm > > I don't see what you claiming here (in the tables) and the patients were > carefully selected for the higher levels of Her2 overexpression. Yes, the patients were carefully selected because it looks like Herceptin is part of the "new wave" of cancer drugs. In the near future (already today in some cases), cancer care will no longer be about giving drugs which work on a broad range of patients. Instead, cancer cells will be tested, and specific drugs will be administered to fit each particular mutation. Herceptin is one of the first such drugs. I expect many more to emerge over the decades to come. > A longtime regular on the breast cancer newsgroup is calling >Herceptin "dangerous". All chemo drugs are "dangerous". But so what? Nothing is more dangerous than cancer! Basically, if you don't have the HER2+ mutation (most patients), you should stay far away from Herceptin. If you do have it, you should definitly consider herceptin. Thank you all for the responses. My mom will undergo the chemo--there was never a question about that. What worries me, however, is that it is not in combination with a platinum-based drug, as this combination seems more common. Finally, how can she minimize the side effects? Any specific drugs? Gianna > What worries me, however, is that it is not in combination with a >platinum-based drug, as this combination seems more common. "Platinum compounds represent the core of the treatment" for OvCa. http://tinyurl.com/bdovy Before starting treatment, get a clear answer from your doctor as to why she is not getting Platinum + taxol, the current gold standard. There may be good a reason, but this reason must be mentionned to you. (Is she in a clinical trial? Is she alergic to platinum? etc.). If you have time, get a second opinion on treatment ASAP, even if only by fax/telephone. Lots of cancer centers offer this service. I think Memorial Sloan Kettering (NY, NY) and MD Anderson (Texas) are among the best. As for side-effects, she will be assigned a chemo nurse which will help her through these, as they come up. Science cannot (yet) predict which patients get which side effects. Small tips: take anti-nausea meds even if you feel fine, or just a little queazy. It's a lot easier to keep away nausea than to fight it off once it's entrenched. If she does wind up taking a platinum drug, she may have a "metallic" taste in her mouth. Try "Big Red" chewing gum, or lemon flavored bubly water (eg: Perrier). They may help a little. >> Chemotherapy hasn't changed much over 20 or 30 years > [quoted text clipped - 5 lines] > Herceptin, an even newer drug, is showing very > promising results There is about one new chemo drug reaches the market each decade. Most of the apparent improvement in survival time is due to earlier detection. Of course earlier detection also improves the likelihood that surgery will be curative and will give drugs a better chance of working but really that is the same old treatments being given a better chance. MIKE |
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