1. Docetaxel/Taxotere (IV every two weeks)
2. Oxaliplatin/Eloxatin (IV every two weeks)
3. Bevacizumab/Avastin (IV every two weeks)
4. Capecitabine/Xeloda (3 pills in the morning/3 pills in the evening for 7 days)
Because of the Xeloda given in pill form, a round of chemotherapy will take a full week to complete. E. will then have a week off before he begins the next round. He will have four rounds of chemotherapy using this new protocol before he has another check-up at MD Anderson to see how things are working.
As for side effects, they can vary by individual of course. Some of the side effects are compounded when given in conjunction with multiple medications. We are crossing our fingers that E. has minimal side effects and does as well as he did during his first two rounds of chemotherapy using the other protocol.
Side effects mentioned include:
Docetaxel/Taxotere: low blood counts, hair loss, neuropathy (loss of feeling in hands and feet), mouth sores, diarrhea, nausea, hand-foot syndrome, muscle aches, fatigue, changes in nails
Oxaliplatin/Eloxatin: neuropathy, nausea, low blood counts, diarrhea, sensitivity to cold
Bevacizumab/Avastin: high blood-pressure, headaches, fatigue, low blood counts, diarrhea, kidney damage, risk of blood clots
Capecitabine/Xeloda: hand-foot syndrome, diarrhea, mouth ulcers, nausea, low blood counts, sensitivity to sunlight, changes in nails, fatigue, dry skin
The biggest issue with nausea, diarrhea, and vomiting is the risk of dehydration. It is important for E. to remain well hydrated.
Hand foot syndrome and dry skin may also be an issue since E. already has especially dry skin. The symptoms of hand foot syndrome vary in severity but can be extreme . . . purple and red blistering, peeling, painful skin on the palms of his hands and the soles of his feet. In an effort to keep his skin well moisturized, he is using some thick lotions and I'm making him slather it on heavy at night (holding it in by wearing moisturizing socks and gloves . . . you can imagine how well that goes over).
E.'s blood counts will be monitored weekly and hopefully none of the counts go too low, or there can be other complications if that happens.
One of the most frustrating side effects for E. last time were the mouth sores/ulcers. The sores not only appeared in his mouth, but also in his throat. It made eating difficult and also created an uncomfortable chalky film. He is gargling with baking soda as well as a special mouthwash to hopefully keep the sores/ulcers to a minimum.
The doctors will be watching closely for neuropathy. If E. begins to feel tingling or numbness in his hands and/or feet, chemotherapy may have to be discontinued or altered. The sensitivity to cold has been an interesting side effect already. We had read that E. should not eat or drink cold things, and that he should use gloves while removing things from the refrigerator! It seemed a little bizarre to us at the time, but makes sense already. E. can't even get the gallon of milk out of the fridge! He describes it like this . . . touching cold makes his hands feel tingly . . . like they are asleep, but ten times worse . . . and the cold goes all the way to the bone. Cold drinks are out. Heck, even cool drinks are out. Things have to be lukewarm or his throat reacts in the same extreme way. (Even the baby wipes are too cold to touch, so E. just got out of changing the baby diapers too . . . at least temporarily. LOL)
And of course, there's the fatigue. Chemotherapy makes E. tired. In spite of the tiredness though, he's not sleeping great at night. Which makes for more tiredness. He dozes on and off throughout the day, but still tries to do way too much. His independent streak is alive and well and he's reluctant to let others do much for him.
Other than all that, E.'s attitude continues to be extraordinary. He is ornery as all get out . . . just the way we like him. :)
S.
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