› Forums › General Melanoma Community › Starting Biochemotherapy Monday. Would love to hear from others who have done it!
- This topic has 36 replies, 11 voices, and was last updated 14 years, 7 months ago by
JuleFL.
- Post
-
- June 3, 2011 at 12:00 am
I start my first ever treatment for my stage IV melanoma on Monday, June 6th at California Pacific Medical Center with Dr. Wang and Dr. Minor. The regimen is IL-2 + interferon + 3 chemo drugs. Here's a link to a whitepaper that helped to convince me to go this route. http://theoncologist.alphamedpress.org/content/14/10/995.full That, and the fact that my mutation is wild type NRAS Q61 so the new BRAF stuff isn't available to me.
I start my first ever treatment for my stage IV melanoma on Monday, June 6th at California Pacific Medical Center with Dr. Wang and Dr. Minor. The regimen is IL-2 + interferon + 3 chemo drugs. Here's a link to a whitepaper that helped to convince me to go this route. http://theoncologist.alphamedpress.org/content/14/10/995.full That, and the fact that my mutation is wild type NRAS Q61 so the new BRAF stuff isn't available to me. Although I like the approach of TIL therapy at NIH, I do not have a big enough tumor for them to work with, just many in the lungs, one lymph node and a bone met on my rib.
Choel, username boot2boot on this board, started her biochemo today at a hospital in Ohio. I spoke with her Tuesday and she seemed to be doing pretty well, but about as fearful as I am of the treatment. Are there any veterans out there of biochemo or even IL-2 who can chime in and help me get my head into a better place? I will be sure and post my experience as soon as I am able.
Thank you in advance for your comments. This board has been invaluable to me.
God Bless.
Robert
- Replies
-
-
- June 3, 2011 at 12:47 am
If you go to my "Patient's Perspectives" section on my website, you will see info from Rusty and Gregory on their experiences with biochemo. Scroll down until you see BioChemo
-
- June 3, 2011 at 12:47 am
If you go to my "Patient's Perspectives" section on my website, you will see info from Rusty and Gregory on their experiences with biochemo. Scroll down until you see BioChemo
-
- June 3, 2011 at 1:49 am
As you have visceral mets and one lymph node met, I wonder how beneficial this treatment
regimen will be to you?I would just like to quote from the interesting article that you mentioned:
"For overall survival … normal LDH level, albumin level >2.5 mg/dl, AJCC stage, the
absence of visceral metastases, the presence of skin or node metastases, and only one or
two metastatic sites were favorable factors.""Patients in group 1, with normal LDH levels and skin or node metastases (with or without
visceral metastases), had a relatively good prognosis, with an estimated median survival
time of 44 months and a 5-year survival rate of 38%."So, it looks like one very important consideration is your LDH level. Do you know what
your LDH level is?For more info on LDH and blood tests, see:
http://www.melanoma.org/community/mpip-melanoma-patients-information-page/blood-tests-yearly-examIt will be good to see what others have to say.
My prayers are with you.
Frank from Australia
-
- June 3, 2011 at 1:49 am
As you have visceral mets and one lymph node met, I wonder how beneficial this treatment
regimen will be to you?I would just like to quote from the interesting article that you mentioned:
"For overall survival … normal LDH level, albumin level >2.5 mg/dl, AJCC stage, the
absence of visceral metastases, the presence of skin or node metastases, and only one or
two metastatic sites were favorable factors.""Patients in group 1, with normal LDH levels and skin or node metastases (with or without
visceral metastases), had a relatively good prognosis, with an estimated median survival
time of 44 months and a 5-year survival rate of 38%."So, it looks like one very important consideration is your LDH level. Do you know what
your LDH level is?For more info on LDH and blood tests, see:
http://www.melanoma.org/community/mpip-melanoma-patients-information-page/blood-tests-yearly-examIt will be good to see what others have to say.
My prayers are with you.
Frank from Australia
-
- June 3, 2011 at 2:58 am
Frank,
My LDH has been 154 since my diagnosis which puts me in the group 1 of their research. I had not seen median survival and 5 year survival rates like this with any other treatment I qualified for. Dr. Minor of CPMC, working with Dr. O'Day at The Angeles Clinic have continued to tweak the treatment after clinical trials. They are now using IPI as the "maintenance" phase of the treatment. Although IPI was an option for me upfront, now that it is approved by FDA, BSM is getting $120k for a 4 dose regimen. The question is, will insurance companies cover a 2nd or 3rd round of IPI costs? During clinical trials, many IPI patients were given multiple rounds before getting a good effect.
In addition to the glowing report I linked to, I read some negative papers about biochemo as well. What I noticed was that the dosage and sequencing was not like MD Anderson and CPMC, and now most biochemo facilities are following the regimen outlined in the report. Boot2boot who started at a hospital in Ohio today is on a very similar regimen.
Thank you for your comments and your prayers.
Robert in El Dorado Hills, California
-
- June 3, 2011 at 2:58 am
Frank,
My LDH has been 154 since my diagnosis which puts me in the group 1 of their research. I had not seen median survival and 5 year survival rates like this with any other treatment I qualified for. Dr. Minor of CPMC, working with Dr. O'Day at The Angeles Clinic have continued to tweak the treatment after clinical trials. They are now using IPI as the "maintenance" phase of the treatment. Although IPI was an option for me upfront, now that it is approved by FDA, BSM is getting $120k for a 4 dose regimen. The question is, will insurance companies cover a 2nd or 3rd round of IPI costs? During clinical trials, many IPI patients were given multiple rounds before getting a good effect.
In addition to the glowing report I linked to, I read some negative papers about biochemo as well. What I noticed was that the dosage and sequencing was not like MD Anderson and CPMC, and now most biochemo facilities are following the regimen outlined in the report. Boot2boot who started at a hospital in Ohio today is on a very similar regimen.
Thank you for your comments and your prayers.
Robert in El Dorado Hills, California
-
- June 3, 2011 at 2:12 am
Hi Robert…
Survivor and complete responder to IL-2. Was able to tolerate 57 treatments over a an 11 month period. Blessed to say NED since 2008. No doubt, tough battle…but if I can do it…anyone can! Would be happy to help you with whatever questions you may have.
Best to you,
Debbie Stage 4 NED
-
- June 3, 2011 at 2:12 am
Hi Robert…
Survivor and complete responder to IL-2. Was able to tolerate 57 treatments over a an 11 month period. Blessed to say NED since 2008. No doubt, tough battle…but if I can do it…anyone can! Would be happy to help you with whatever questions you may have.
Best to you,
Debbie Stage 4 NED
-
- June 3, 2011 at 2:38 am
Debbie,
Thank you, YOU MADE MY DAY! Wow, 57 treatments…you are a true warrior. No wonder you're a survivor. I pray that you have many more years of NED. You can be sure I will be asking you questions as I move forward.
God Bless,
Robert in El Dorado Hills, California
-
- June 3, 2011 at 2:38 am
Debbie,
Thank you, YOU MADE MY DAY! Wow, 57 treatments…you are a true warrior. No wonder you're a survivor. I pray that you have many more years of NED. You can be sure I will be asking you questions as I move forward.
God Bless,
Robert in El Dorado Hills, California
-
- June 3, 2011 at 3:05 am
Hi Robert
I am glad to hear you are seeing Dr Minor! I personally met 3 of his long term success stories/complete responders with biochemo at the MRF gala in May in SF. Suzanne and Kari were both honored at the event. They would be the ones to talk to about this treatment and I hope they see this. In addition, one of my friends Christina completed biochemo last year with good results…all but one stubborn tumor disappeared and she is now doing Ipi – you can see her blog here:http://strongenough-christina.blogspot.com/
I also know of another woman in the Bay Area who was a complete responder with Dr Minor and biochemo.
I wish you all the best – you are truly in good hands.
You can see my blog for more info about our journey – http://www.emandmichael.com
Best,
Emily
-
- June 3, 2011 at 3:05 am
Hi Robert
I am glad to hear you are seeing Dr Minor! I personally met 3 of his long term success stories/complete responders with biochemo at the MRF gala in May in SF. Suzanne and Kari were both honored at the event. They would be the ones to talk to about this treatment and I hope they see this. In addition, one of my friends Christina completed biochemo last year with good results…all but one stubborn tumor disappeared and she is now doing Ipi – you can see her blog here:http://strongenough-christina.blogspot.com/
I also know of another woman in the Bay Area who was a complete responder with Dr Minor and biochemo.
I wish you all the best – you are truly in good hands.
You can see my blog for more info about our journey – http://www.emandmichael.com
Best,
Emily
-
- June 4, 2011 at 1:30 am
Thank you Emily for posting and for the others blogs as well. I just back back home from CPMC and Dr. Wang, and doing my "chemo training" they call it, with Kristin. She was great and really helped calm me down with her explanation of the process, logistics, and side effects. It doesn't seem quite as daunting when you meet the staff in the ICU and hear from others on this board about the successes.
Thanks again!
Robert.
-
- June 4, 2011 at 1:30 am
Thank you Emily for posting and for the others blogs as well. I just back back home from CPMC and Dr. Wang, and doing my "chemo training" they call it, with Kristin. She was great and really helped calm me down with her explanation of the process, logistics, and side effects. It doesn't seem quite as daunting when you meet the staff in the ICU and hear from others on this board about the successes.
Thanks again!
Robert.
-
- June 3, 2011 at 5:17 am
Hi Robert,
Here is a link for Christina who as best I can recall did biochemo for her melanoma.
I wish you the best with your fight against "the beast".Best wishes,Gene -
- June 3, 2011 at 5:17 am
Hi Robert,
Here is a link for Christina who as best I can recall did biochemo for her melanoma.
I wish you the best with your fight against "the beast".Best wishes,Gene -
- June 3, 2011 at 11:57 am
Hi Robert,
I have not done this treatment but just wanted to wish you all the best as you start this part of your journey. Stay positive and stay strong!
Laurie
-
- June 3, 2011 at 11:57 am
Hi Robert,
I have not done this treatment but just wanted to wish you all the best as you start this part of your journey. Stay positive and stay strong!
Laurie
-
- June 3, 2011 at 12:29 pm
Robert, I did biochemo at the University of Colorado Cancer Center in 2003 after receiving a Stage IIIc (I call it 3.9) diagnosis. Seems to have worked for me, I'm healthy and NED today. Biochemo is very rough stuff, but doable. The great blessing of being hospitalized is that you'll be quite sedated most of the time– every time my fever shakes got too bad, the nurses simply knocked me out with a nice shot of Demerol in the IV line.
Best wishes. Rich
-
- June 3, 2011 at 12:29 pm
Robert, I did biochemo at the University of Colorado Cancer Center in 2003 after receiving a Stage IIIc (I call it 3.9) diagnosis. Seems to have worked for me, I'm healthy and NED today. Biochemo is very rough stuff, but doable. The great blessing of being hospitalized is that you'll be quite sedated most of the time– every time my fever shakes got too bad, the nurses simply knocked me out with a nice shot of Demerol in the IV line.
Best wishes. Rich
-
- June 4, 2011 at 1:47 am
Rich,
First off, CONGRATS on being NED for so long. I had heard good things about the Uof C Cancer Center bio chemo treatment. Yeah, being in the ICU with a biochemo staff managing things helps relieve a lot of the worry of a tough treatment. Here's to Demerol!
God Bless
Robert
-
- June 4, 2011 at 1:47 am
Rich,
First off, CONGRATS on being NED for so long. I had heard good things about the Uof C Cancer Center bio chemo treatment. Yeah, being in the ICU with a biochemo staff managing things helps relieve a lot of the worry of a tough treatment. Here's to Demerol!
God Bless
Robert
-
- June 3, 2011 at 12:44 pm
I do not know if you have read Jane from Maines IL-2 tipsheet, so maybe it will help some.
http://www.operationsunshield.org/tipsheet.html
Not sure if you are aware that JerryfromFaq, Jane from Maine, Kim K, Debbie H and others have gone the IL-2 route. If I recall correctly, Jane and Debbie (and Kim?) were in the complete responder group, and Jerry was a partial responder. Maybe they will chime in.
Good luck. Keep saying to yourself "durable complete responder"
Michael
P.S.
Here is a post from Kim you may also find helpful:
Some other things to bring are:
Some sort of rear end protection. My first round I had severe diarrhea and it hurt sooooo bad when I exploded…. Yes, I said exploded…. If your BP drops too low they won't let you out of bed. I still insisted on using the commode but it was right at my bedside. I had one accident – very humiliating but by then I was sooo sick I just said G-d damn…. HINT- make sure nobody is in the direct path of your commode when needing to go. You won't have much time to get there. Be prepared for "accidents".
I used EMLA cream for round 2. Prep H just didn't cut it, I needed pain relief. EMLA is a topical lidocaine which lubricated and numbed my rear end.
Bring "the drops" or one drop – it is a Japanese product that is a powerful odor eliminator. Trust me, the runs you get are a magnitude of order beyond anything most have experienced. It is embarrassing to have people come in to your room after a blow out. Sorry to be graphic, but the drops work instantly and effectively. I need to be honest, it smelled like something had died inside of me….
Bring lubricating eye drops – in addition to your eyelids, ears, and everything else peeling, your eyes will dry out and hurt. The eye drops and eyelid cream help. So did the SARNA.
Bring cancker sore medicine. I had ulcers in my mouth, throat, and inside of my nose.
zero water and ensure saved me. I quit drinking everything and eating after 3 days because of the severe fluid build up I had. I was too bloated to take anything else in. The ensure did keep my electrolytes in better shape than had I not been able to keep it down.
Mostly you will sleep.
My symptoms came on suddenly around 25 min after my first infusion. Was doing perfectly well and then suddenly got light headed and puked. I learned from then on that was my pattern. The nurses were able to adjust my meds so that they were working by the time I would have gotten sick.
Be aware of any side effects, don't hide them just so you can get more IL-2.
At the end of my first round, I started to bleed from my kidneys. The first nurse blew it off saying I had my period. Yeah except I had just finished it 10 days prior! She didn't report it, I was too embarrassed. Within a few hours I was hemorraging into my urine. It was like kool-aid. The second nurse was astute, called it in. I almost needed a transfusion and another dose of IL-2 would have killed me. Speak up. My clotting factors and blood counts had dropped dangerously low in only a few hours time.
HAVE SOMEONE STAY WITH YOU AT ALL TIMES. They can keep an eye on you for when stuff like that happens. My mom rang the nurse to empty my commode. I just couldn't do it. If your nurse sucks, then tell someone. Likewise, if they are attentive to you and are watching you like a hawk – tell someone. Try to get them again for round 2.
One of my nurses couldn't care less that I was starting to have serious heart arrythmias. No one came in to talk to us and I was too wiped out to care. I know how to read EKG's and it was getting worrysome. They watched me but I had stopped the IL-2 the day previously. It was unnerving to feel your heart jump around in your chest, skip beats, and leave you breathless.
Not to scare you, but you will have some sort of toxicity. Keep an eye out for it. The patient is going to be drained and taken to the edge of what is humanly tolerable.
For me it worked.
After a total of 23 bags, I am, and remain NED since last summer, almost 8 months…. I was diagnosed in July '09, had surgery Feb. 10, and did IL-2 only for my one remaining met in my chest wall June – July 10.
Once you stop the IL-2, it only takes 2 weeks to be relatively back to normal. The peeling took the longest to go away, and some fatiuge. I went back to work 5 days after I was discharged from my second dose of IL-2 (out of vac & sick leave). It is worth the effort, the recovery is VERY quick and IL-2 is still the best thing out there so far. If it doesn't work then you can get into some great clinical trials.
Take pictures to document your remarkable jouney. It is still hard for me to wrap my head around the fact I gained 33 pounds in 5 days. My body became alien to me. I needed to take pictures to remind me how hard I fought to become NED, or to at least show my young girls how hard mommy fought to be with them for as long as possible. My pictues of my kids kept me going.
Best of luck, I am saving a spot for you in the 6% club – hope to see you here.
(PS – look in the archives for IL-2) I have a detailed account of my experiences, much of what I have forgotten. Jane's list is a good start, I added a few extras though.
-
- June 3, 2011 at 12:44 pm
I do not know if you have read Jane from Maines IL-2 tipsheet, so maybe it will help some.
http://www.operationsunshield.org/tipsheet.html
Not sure if you are aware that JerryfromFaq, Jane from Maine, Kim K, Debbie H and others have gone the IL-2 route. If I recall correctly, Jane and Debbie (and Kim?) were in the complete responder group, and Jerry was a partial responder. Maybe they will chime in.
Good luck. Keep saying to yourself "durable complete responder"
Michael
P.S.
Here is a post from Kim you may also find helpful:
Re: Interluekin II Treatments
Kim K – (3/28/2011 – 3:32am)
Some other things to bring are:
Some sort of rear end protection. My first round I had severe diarrhea and it hurt sooooo bad when I exploded…. Yes, I said exploded…. If your BP drops too low they won't let you out of bed. I still insisted on using the commode but it was right at my bedside. I had one accident – very humiliating but by then I was sooo sick I just said G-d damn…. HINT- make sure nobody is in the direct path of your commode when needing to go. You won't have much time to get there. Be prepared for "accidents".
I used EMLA cream for round 2. Prep H just didn't cut it, I needed pain relief. EMLA is a topical lidocaine which lubricated and numbed my rear end.
Bring "the drops" or one drop – it is a Japanese product that is a powerful odor eliminator. Trust me, the runs you get are a magnitude of order beyond anything most have experienced. It is embarrassing to have people come in to your room after a blow out. Sorry to be graphic, but the drops work instantly and effectively. I need to be honest, it smelled like something had died inside of me….
Bring lubricating eye drops – in addition to your eyelids, ears, and everything else peeling, your eyes will dry out and hurt. The eye drops and eyelid cream help. So did the SARNA.
Bring cancker sore medicine. I had ulcers in my mouth, throat, and inside of my nose.
zero water and ensure saved me. I quit drinking everything and eating after 3 days because of the severe fluid build up I had. I was too bloated to take anything else in. The ensure did keep my electrolytes in better shape than had I not been able to keep it down.
Mostly you will sleep.
My symptoms came on suddenly around 25 min after my first infusion. Was doing perfectly well and then suddenly got light headed and puked. I learned from then on that was my pattern. The nurses were able to adjust my meds so that they were working by the time I would have gotten sick.
Be aware of any side effects, don't hide them just so you can get more IL-2.
At the end of my first round, I started to bleed from my kidneys. The first nurse blew it off saying I had my period. Yeah except I had just finished it 10 days prior! She didn't report it, I was too embarrassed. Within a few hours I was hemorraging into my urine. It was like kool-aid. The second nurse was astute, called it in. I almost needed a transfusion and another dose of IL-2 would have killed me. Speak up. My clotting factors and blood counts had dropped dangerously low in only a few hours time.
HAVE SOMEONE STAY WITH YOU AT ALL TIMES. They can keep an eye on you for when stuff like that happens. My mom rang the nurse to empty my commode. I just couldn't do it. If your nurse sucks, then tell someone. Likewise, if they are attentive to you and are watching you like a hawk – tell someone. Try to get them again for round 2.
One of my nurses couldn't care less that I was starting to have serious heart arrythmias. No one came in to talk to us and I was too wiped out to care. I know how to read EKG's and it was getting worrysome. They watched me but I had stopped the IL-2 the day previously. It was unnerving to feel your heart jump around in your chest, skip beats, and leave you breathless.
Not to scare you, but you will have some sort of toxicity. Keep an eye out for it. The patient is going to be drained and taken to the edge of what is humanly tolerable.
For me it worked.
After a total of 23 bags, I am, and remain NED since last summer, almost 8 months…. I was diagnosed in July '09, had surgery Feb. 10, and did IL-2 only for my one remaining met in my chest wall June – July 10.
Once you stop the IL-2, it only takes 2 weeks to be relatively back to normal. The peeling took the longest to go away, and some fatiuge. I went back to work 5 days after I was discharged from my second dose of IL-2 (out of vac & sick leave). It is worth the effort, the recovery is VERY quick and IL-2 is still the best thing out there so far. If it doesn't work then you can get into some great clinical trials.
Take pictures to document your remarkable jouney. It is still hard for me to wrap my head around the fact I gained 33 pounds in 5 days. My body became alien to me. I needed to take pictures to remind me how hard I fought to become NED, or to at least show my young girls how hard mommy fought to be with them for as long as possible. My pictues of my kids kept me going.
Best of luck, I am saving a spot for you in the 6% club – hope to see you here.
(PS – look in the archives for IL-2) I have a detailed account of my experiences, much of what I have forgotten. Jane's list is a good start, I added a few extras though.
-
- June 3, 2011 at 4:20 pm
I wish i could tell you how it is going…but the mel decided to make another appearance…change of plans…surgery,radiation then rescan before biochemo to redetermine stages…good luck bruce…i think you and your docs are informed…keep your inmune system in optimal condition and when you feel bad do med. Guidance mpg..i will keep in touch
Boots -
- June 3, 2011 at 4:20 pm
I wish i could tell you how it is going…but the mel decided to make another appearance…change of plans…surgery,radiation then rescan before biochemo to redetermine stages…good luck bruce…i think you and your docs are informed…keep your inmune system in optimal condition and when you feel bad do med. Guidance mpg..i will keep in touch
Boots -
- June 4, 2011 at 3:16 am
My husband went through biochemo, but his melanoma was much more advanced. The first couple of cycles were tough, but he seemed to be better able to tolerate it later. He hated the hospital food so I became adept at making him protein shakes. The effects are not as dramatic as straight IL-2, but there will be some effects from that part of the “cocktail”. Initially, he had very strong chills which scared me. The nurse brought him warm blankets and dilaulid. Be sure to ring the nurse as soon as you begin to shiver. They had drugs that kept him “out of it” so he did not remember too much. During his last treatment (he went though 3) he had blood pressure issues that were controlled by dopamine. The diarrhea occurred toward the end of each cycle and was not terrible. He did gain 10-20lbs of fluid which he lost within a week or so. His biggest problem was lack of appetite. It is extremely important to eat nutritious food and to keep hydrated. Load up during your 2 weeks off. The stronger you are, the better you will tolerate the treatment. My husband was taken off the biochemo because he did not recover enough between treatments. Many others are able to do the full regimen. The biochemo did keep him stable while he was doing it.I wish you success with this. Eat and hydrate 😉
Jule -
- June 4, 2011 at 3:16 am
My husband went through biochemo, but his melanoma was much more advanced. The first couple of cycles were tough, but he seemed to be better able to tolerate it later. He hated the hospital food so I became adept at making him protein shakes. The effects are not as dramatic as straight IL-2, but there will be some effects from that part of the “cocktail”. Initially, he had very strong chills which scared me. The nurse brought him warm blankets and dilaulid. Be sure to ring the nurse as soon as you begin to shiver. They had drugs that kept him “out of it” so he did not remember too much. During his last treatment (he went though 3) he had blood pressure issues that were controlled by dopamine. The diarrhea occurred toward the end of each cycle and was not terrible. He did gain 10-20lbs of fluid which he lost within a week or so. His biggest problem was lack of appetite. It is extremely important to eat nutritious food and to keep hydrated. Load up during your 2 weeks off. The stronger you are, the better you will tolerate the treatment. My husband was taken off the biochemo because he did not recover enough between treatments. Many others are able to do the full regimen. The biochemo did keep him stable while he was doing it.I wish you success with this. Eat and hydrate 😉
Jule
-
- You must be logged in to reply to this topic.
Re: Interluekin II Treatments
Kim K – (3/28/2011 – 3:32am)