CMF Question
Comments
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Hi CMFers...it is raining in Southern Cal today...lots of it...
I got a new onc and I just love him...where was he when I
needed him most??
This season just has too much "to do" for me...
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Rita - thanks for boosting this thread. I suppose that fewer and fewer women are opting for CMF (or maybe the oncs are not considering this regimen good enough...?), and that's why it is so quiet here. We have cabmom and Mary, as far as I know, as the only ones going through this now.
I've been very busy with all kinds of doctors' visits and tests in preparation for radiation, to begin in January (and also in preparation for a cataract surgery in two weeks.That's something I didn't count on, l but if it needs to be done than I better get it over with.) My brother-in-law is now going through very tough times with leukemia, which is so much worse than what I had, and my heart goes out to him and to my sister, who is ever so dedicated and wonderful.
As always, best wishes to all of us. Elisheva.
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Yes, I had my last AC treatment today. I'm scheduled to have my first CMF treatment on Monday, 21 Dec. Onc suggested giving them to me two weeks apart (dose dense). Have any of the rest of you had them like that? She said she knew I wanted to get finished soon but then went on to say that I might want six or eight doses instead of the four we had initially agreed on. When I asked if she had any other patients on a similar regimen, she said no-one on AC-->CMF, although CMF alone is pretty common. However, she said before the taxanes became the drug of choice, there were patients on Adriamycian alone, followed by CMF. She said they referred to this as the "Bonadonna regimen."
Question for any of you who have finished CMF and are still checking in here ... what SEs might I typically expect with my first treatment and how long are the SEs likely to last. I'm wondering if I have treatment on Monday, 21 Dec, followed by my Neulasta shot the next day (Tue), how might I feel on Christmas Eve (Thurs)? Will I be able to eat? I so used to a long week's nausea with AC, I'm not sure what to expect with CMF.
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HI Mary
As one who went through AC in 2000 and then CMF in 2008, I can tell you that CMF is a cakewalk compared to the AC. AC would knock me on my butt for a good 2 weeks, the CMF about 2 days. After 4 AC, however, with its cumulative effect, your system has taken a good whomping ...so I would guess at first the bounceback may not be quite as immediate? I've never taken the neulasta shots, so cannot comment there. Based on most of our experiences, with just CMF, the nausea usually fades after about the 3rd day, so you could (?) be okay Xmas eve? For me, side effects were two days of mild nausea, and then a good deal of heartburn, actually. I devoured a lot of Tums. Dry mouth too. I refused the decadron*, however, and did not have the sleep issues that some here did. (*bad reaction to it after first AC and never let it near me again- had no issues with either regime managing nausea without it)
I'm wondering, however, about 6 or 8 CMF after 4 A/C? 6 alone seems a lot to me- but 8? If it were me...I might seek a second opinion on that or find out if there were any other variations of the "Bondonna" regimen-- ie-- was there much variation in reoccurence rate if the patient received 3 vs 6 vs 8 doses? Wondering what is the basis of her recommendation.
I'm so sorry you have to go through this right before the holidays though. Yuk.
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Thanks Julie: Will have to read up a bit more on the Bonadonna regimen. Eight treatments (even six) sounds like a lot to me too, esp when until recently, I though this week's AC treatment would be the end. This onc really believes in moving the goalposts.
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Mary, You are really getting the heavy duty chemo treatment. I think the CMF should be easier on you than the AC but I didn't have the AC right before it either. When I did the CMF, I did 6 treatments (3 weeks apart) and it was very doable. However, you're still going to have some of the AC in your system when you get the first CMF. If I had any discomfort, it was usually the 3rd or 4th day after my CMF infusion. It passed quickly and I was able to continue most of my regular activities. Fatigue became a slight issue and irritation toward the end.
Be sure to ask for some ice chips to suck on while having your CMF treatment. That will help keep the mouth sores away, and purchase some Biatene mouthwash and toothpaste and use it faithfully every day. It can be purchased at Wal-Mart/K-Mart, etc. and it's wonderful for warding off the mouth sores and other mouth irritations.
Have you had problems with any previous Neulasta shots? I was so worried about them but I didn't ever have all the painful issues that many have had.
Just think..........this is a rough time for you right now but next year at this time you will be frantically involved in all the Christmas and holiday activities again and believe me, they will mean so much more to you than they ever did before.
Come back often and post. We will help you through this, hon.
Elisheva...Cataract surgery.....just what you need to add to the rest but at least you're getting everything done at the same time and once the rads are over (and I don't think you'll mind them except for the inconvenience of having to show up each day) you'll be ready to get started on your "new normal." There is life after bc and it's a good one....just a little different.
Well, today I am getting a start on the Christmas cards! Hugs to all of you!
Lisa...I'll trade you our sleet and snow for your rain! LOL
Rita
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MaryNY, just wanted to post a quick note on the neulasta shots. I'm on CMF now and have had two treatments, so far, I've not had to have any shots so I'm thankful. You may have to because of the lasting effects from AC but maybe you'll get lucky and the shots will be a thing of the past. I've heard they can cause some issues with pain. Good luck!
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Rita: What kind of discomfort did you typically have on the 3rd or 4th day after CMF treatment? They don't supply ice-chips at the treatment center but with the AC I haven't had any issues with mouth sores so far. In the beginning I was very careful about using the Biotene mouthwash and toothpaste but then became less vigilant and went back to regular toothpaste and a tea-tree mouthwash which doesn't taste as bad as the Biotene. However, today I notice that my mouth is sore for the first time (this is Day 3 post AC) so I'm going to gargle with Biotene when I finish this.
Cabmon: I've had Neulasta shots after each of the four AC treatments. I had some pain after the first one but less and less after the others. I certainly have found it easier than others report. I had my shot yesterday so maybe I shouldn't speak too soon as it's usually one or two days later that I feel sore. Onc thinks I will still need them when doing CMF as she intends doing the two-weekly cycle so I suppose that would allow less time for the WBC to come back up between treatments.
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Mary, typing with my thumbs so bare with ... I like some of the others felt a bit cruddy day 2 and 3 after my infusions of "MF", my "C" part was taken orally. Cruddy meaning that I did have much of an appetite (kinda a blah) feeling. I faithfully took Zofran to ward off any possible nausea. All in all it was very doable, I was able to work in a rather physical job, with usually just taking my infusion day off as a "treat" to myself! I did the ice chips to first few txts, (12 in all) but got rather lax. I'd swish with biotene every once in a while (kinda made me gag)! As some of the old timers here know, I had some difficulty with my GI tract. Seemed to be "full throttle or stuck in neutral". Finally got that regulated with some Miralax.
I truly think you will find this chemo a cake walk in comparison to AC. Bummer might be some of the residual effects of the AC lingering on while getting hit with the CMF. Boy your onc certainly is giving you a lot to take in !
Be well, Carol0 -
Mary...I mainly felt tired and had some nausea after a few CMF treatments on either the 3rd or 4th day for me....just that achy, "not quite with it" feeling. Carol summed it up better...cruddy!!! I usually didn't do too much on those days. I just bummed around the house and took it easy and it went away.
Carol...I put your book in the mail today. I read it twice. The first time I just soared through it. The second time I took time to ponder it more. Thanks so much. After seeing her in person, I really enjoyed the book.
BRRRR!!! It's just darn-right cold in Illinois tonight!
Take care everyone!
Rita
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Thanks so much for all your advice. It's great to have this thread to come to for information and I appreciate the fact that you check in and still post here though I think most of you are now finished treatment. There is no-one on the October Starting Chemo thread (where I spend most of my time) who is doing CMF.
I'll be back here for more advice once I start CMF.
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Mary, for some reason the cancer center's ice chips nauseated me, so I brought my own lemon flavored "italian " ices to chomp on during the treatment. My onc even suggested chomping on the ice as a way of preventing mouth sores---I think it may be the M that causes them. So you might think about bringing a little cooler with the iceas for yourself. It was pretty easy to do. Just a thought.
Anyway you have time and will undoubtedly hear from many of us here on the CMF Board. The gals here were so helpful to me, that I feel I should try to share my experience with the next group on CMFers.
Anyway, I was going to post good news here....my older daughter can't get home for the holidays, so home is going out to San Francisco to be with her. On December 23, hubby, younger sister, and I will all fly out to San Fran for a week! It will be so wonderful to be together. I hope that everyone will get to spend the holidays with their loved ones. I will be back here before the holidays, but in the meantime cyber hugs to all.
Mandy
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Okay, ladies, I need some reinforcement. I've just finished round 5. It has been tolerable (3 - 5 days of "chemo hangover" after each treatment) and I've continued to work, but truthfully, I am quite (mentally) weary at this point. I am also more tired at night (I guess fatigue is not unexpected) and having a harder time bouncing back from each treatment. Have skipped my morning exercise all week, just feel too tired. Will this continue to get worse through 6, 7 and 8? I've only got about 8 more weeks until I'm totally done, so I'm trying to hang on (not that there's a choice). Again, it's not unbearable, I'm just starting to feel tapped out. So wish this were to be finished before Christmas!
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Yea Kate! Only 3 more to go! I only had 6 treatments but I got very tired at the end because the chemo is cumulative. There is still some left in your body when they give you the next dose. I did feel much better if I could get myself moving. I took short walks and didn't do anything too strenuous but did try to get somewhat active. It is too bad that you won't be done by Christmas but believe me, there is life after chemo and next year you'll be running around all over the place getting ready for the holidays! And then you'll be tired, too! Hugs to you, hon. Just take it one day at a time and it's easier to manage and try to work in a bit of activity.
Rita
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Hi all - I just thought I would pop in and check on everyone. I have not been here in awhile!
I noticed a woman posted on the chemotherapy forum a question about CMF, and directed her here.
Kate - Rita is right, is is cumulative. However, I found that just past 1/2 done I hit a mental wall. Did not see HOW I could get thru the rest of the infusions. I did, and you will too. I think you just have to do as Rita said - try to do short walks, and really check off the last few infusions!
Mary - I had the same problem - I was the only one in the January 2009 chemo group doing CMF so I really relied on these wonderful women for support.
Cabmom - hope you are doing well on CMF.
Happy Holidays everyone!
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Hi all - I just thought I would pop in and check on everyone. I have not been here in awhile!
I noticed a woman posted on the chemotherapy forum a question about CMF, and directed her here.
Kate - Rita is right, is is cumulative. However, I found that just past 1/2 done I hit a mental wall. Did not see HOW I could get thru the rest of the infusions. I did, and you will too. I think you just have to do as Rita said - try to do short walks, and really check off the last few infusions!
Mary - I had the same problem - I was the only one in the January 2009 chemo group doing CMF so I really relied on these wonderful women for support.
Cabmom - hope you are doing well on CMF.
Happy Holidays everyone!
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O.K. Cabmom...we haven't heard from you iin a few days so check in! Here's hoping that you're just busy gtting ready for Christmas! Thinking of you...........
Rita
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Hi all....sorry I haven't posted in a few days. Tomorrow is #3 and as always, I'm a little nervous but ready to get it over with and then I will be 1/2 way done. I AM SO READY FOR THAT
! They are going to try me on a new anti-nausea med called zofran or zofan, has anyone been on this? After I had such a bad reaction to Kytril, I'm a little nervous about trying another new one but compazine did nothing so I really have no choice. Hope everyone is well and getting ready for the holidays......we're heading back East to be with family and I can't wait (another reason that I'm praying all goes well with this treatment). Almost all of my shopping is complete, just a few little items and I will be ready to sit back and enjoy family, friends and Santa coming to town
! My little one is so excited and can't wait....makes the holidays so much fun! 0 -
Cabmom, I took Zofran daily during my txts, first thing when I got up in the morning/prior to popping my oral cytoxan pills. Seemed to work great for me .... and with that said, I never tried a day without taking it. Hope you have some good luck with it as well !!!!
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Thanks golfer779.......I'm hoping for the best with this med
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Is Zofran the anti-nausea drug most people use while on CMF? I took Emend and Decadron for three days each AC treatment and they also gave me a couple of Zofran tablets on the first day just prior to the infusion. I'm not sure if I will still need the Emend and Decadron with CMF since that drug regimen is not supposed to be so nauseating.
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Mary and Aprilgirl - I also was the only one starting in July who did the CMF regimen. It seems not to be recommended by doctors anymore, but I'm sure that for our early stage, node negative, it is plenty safe.
I have used Zofran and comapzine, and rotated them. The best thing to do is not to wait for the nausea to start but take the pills early. Mary, you can count on being at least a little nauseous. That's the most common side effect. But try to get them to drop the Decadron - you don't need the sleep problems that come with it. I did excellent without Decadron and had very few side effects (but the nausea was still there!.) Good luck! Elisheva.
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Good morning ladies! Well #3 is complete.....YEAH! Unfortunately it didn't go without issues. My blood pressure shot through the moon, had to take additional med's, stop the treatment until it came down but it finally did. Yesterday took forever there but it's over and I'm thankful. I've taken one dose so far of the Zofran and it seems to be working but the real test will be over the next few days......anyway, I'm staying positive that this one is the RIGHT one and I'll no additional problems.....hope my positive attitude pays off
!MaryNY, as for the normal anti-nausea med's that they use for CMF. I think they want everyone to use compazine because it's the mildest and most cost friendly, the insurance companies don't usually kick up to much fuss over this one. However, it really is individual and each person is different. I think the oncs basically then cater to whatever needs the patient has and does their best to make it okay with whichever one seems to work. At least that's been my experience so far. Compazine and Kytril didn't work for me but we tried both. Good luck with your treatment on CMF.....as always......this group of ladies is great so don't hesitate to ask anything, I'm sure someone on here will know and understand.
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OH I almost forgot.......NOW I'm ready to celebrate Christmas......heading East to be with family and I can't wait. I feel that now I can enjoy it and not think about Chemo for a few days, well other than getting my lab work done on Wed's but even that isn't so bad......Merry Christmas to all of you if I don't get to get back on.
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Cabmom, now stay on top of that Zofran!!! It is a non drowsy med too, unlike Compazine, so you should be "up to snuff" in the head dept !!!
Time to get over the hump of the next couple of days, and then fully enjoy your holiday.0 -
Hi All,
I am new to this board. I had a lumpectomy in August and started CMF (every three weeks/8 cycles) in November. I had 2 rounds so far but after each one my wbc and neutrophils were very low. Round 3 was delayed due to the low counts. I was told from now on I will have a neulasta shot the day after the chemo. Meanwhile, I am fighting a sore throat and was put on antibiotics yesterday. I'm just wondering if I will still be able to have round 3 followed by nuelasta next week, if I'm still on antibiotics. I was told that CMF would be tolerable but I feel so tired and crummy, I guess due to the low counts. Does anyone else have experience with the low counts and neulasta shots? I also take Compazine following treatment and Lorazapem to sleep. I hope everyone is doing well!
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Hi Curly girl.....hugs to you! The low counts are causing the fatigue and crummy feeling. Once they get them up, you will feel lots better. Eating protein the week before treatment does help some. It was the perfect excuse for me to eat a steak and other red meats. The neulasta shot helps stimulate the formation of blood cells. I had heard nightmares about the side effects of the shot and was pleasantly surprised to find that I had no problems with it at all. In fact, it worked wonders and I was back to feeling perky very quickly. Some people take a claritan tablet before getting the shot to ward off aches and pains. I did not need it but we are all different. Once they get your counts regulated, I think you will indeed find that CMF is very doable.
You are very susceptible to infections and colds when your counts go down so I'm not surprised that you have a sore throat. One of my friends was given a CMF infusion while taking antibiotics. I think it will depend on where your counts are on infusion day. If they are up, they will probably go ahead with the treatment.
Hang in there. Some days seem tougher than others, but rest assured that there is an end to the treatments and that there is a good life after them!
Sending cyber hugs your way!
Rita
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Hi Curly,
I didn't get CMF, I am an honorary member of this thread, because I thought I was going to get CMF, but my dr. vetoed it... but, I did have low wbc after my 1st tx. The dr. gave me 500 mg of an antibiotic, I don't remember which kind it was, but I had to take them for 5 days to prevent me from picking up an infection. Then they gave me NEUPOGEN shots for 4 days. They chemo nurse gave me the 1st one, and I took them home, and gave them to myself for the rest of the time. They helped to boost the wbc.
After that 1st time, I got Neulasta after every tx, and it did the trick... no more low wbc.
Hope you are feeling better soon.
HUGS!!
Harley
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Thanks RitaJean and Harley! Your explanations help relieve the anxiety. I'm feeling better already and hoping to get round 3 over with next week. I hope everyone here is doing well!
Hugs to you too!
CG
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Curly,
When I got the Neulasta shot, I was instructed by my chemo nurse to take a Claritin tablet the day I got the Neulasta shot, and for three days after, to prevent the bone pain you can sometimes get from the shot. It's because Neulasta takes bone marrow from our bones and makes white blood cells with it. Anyway, I didn't have ANY bone pain from the Neulasta, and I figure it was because I took the Claritin. Now take REGULAR Claritin, not Claritin D. I didn't really believe it, but when I saw my onc before my next tx, he asked me "are you taking the Claritin?"
I am only mentioning this because I had TERRIBLE lower back pain from the Neupogen shots. Later I found out that the Claritin could have prevented that, too.
Glad to hear that you are feeling better!!
Harley
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