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Oct 19, 2021 02:45PM
Yes, definitely awful news to get any time. I wonder if your daughter/ you could talk to her doctor about adding in an additional prescription anti-nausea, like compazine and/or Ativan? Waiting 6-8 hours between doses of Zofran (Ondansetron) is an awful long time to wait when your are miserable! This is essentially the protocol my mom's palliative care team was having her follow for awhile: https://healthonline.washington.edu/sites/default/.. FYI, it can take a couple of doses for the medicines to really start to kick-in. I definitely would consider Ativan, even if your daughter doesn't have "anxiety" per say about getting sick. I'm not quite sure how it works, but it really is like an off-switch for my mom once vomiting has started. Oh, and is your daughter getting IV hydration regularly? My mom has been going to the infusion center once a week, and though the trip tuckers her out, the added nutrition and fluids really help!
Also, if your daughter is constipated, that can make the nausea worse (though I believe this is a common side effect of Zofran). Does she have any medicine to address that? Dulcolax and glycerine suppositories have helped my mom.
As far as the Ibrance, my mom's doctor said that she does expect it to work on the mets (for some time at least, since all of these drugs eventually stop working). At the start of treatment, she said Ibrance could take awhile to start working, but she expected that my mom would start to notice a change in her cancer-related symptoms after about 3 months (if we can just get over the medication-related symptoms! Ugh!). My mom has lung mets, and we actually started to see a resolution in those symptoms almost immediately, which surprised even her doctor! Haven't had a follow-up PET scan yet but we will see what that shows in a few weeks.
Even with the extensive mets, my mom's doctor did not consider her to be "in crisis," which is why she started with the Ibrance. She said if her patients are having immediately life threatening symptoms from their cancer, she will start them off with IV chemo, but she didn't feel my mom was there yet. I have also heard of other doctors giving patients a short course of IV chemo to "kick start" treatment before starting Ibrance (not sure how common this is). Of course, that comes with its own set of challenges, especially if someone is already very sick.
There's so much to try and navigate as a patient or caregiver during this time... it's so hard. Fingers and toes crossed for your daughter and my mom that they are both able to stick with treatment and start to feel better!
Daughter (38F) to MBC Thriver (69F) diagnosed August 2021
8/2021, IDC, Left, Stage IV, metastasized to bone/liver/lungs, Grade 2, ER+/PR+, HER2-