Side effects lessen after initial chemo?


Question from Marita: After an initial, very aggressive chemo round, will the side effects and manageability of a single chemo drug, possibly Xeloda, be improved?
Answers - Musa Mayer In the experience of many of the women I talk with who have tried Xeloda, it is one of the best chemotherapy drugs we have for advanced breast cancer. Not only can a woman take it at home by pill, but also it seems to be unusually long-lasting and effective for men and women. I'd also like to know from Dr. Winer if he believes that Xeloda can be effectively administered at a somewhat reduced dosage than that prescribed on the drug label.
Eric Winer, M.D. I agree with all of your comments, and I use Xeloda a great deal. It is very much a drug, though, where the dosing has to be individualized and has to be adjusted over time. My sense is that lower doses than were initially used in the first clinical trials can be very effective. And, yes, I suspect a drug like Xeloda can be administered with far fewer side effects than the typical combination chemotherapy regimen that I think you were referring to.

The three biggest side effects with Xeloda are peeling of the skin and pain on the palms and soles, diarrhea, and mouth sores. Generally speaking, all of these are best managed by adjusting the dose. Sometimes, various moisturizers and creams can be useful in terms of the hand/foot problems, but at least in my experience, the real benefit comes from adjusting the dose.
Musa Mayer Sometimes women will wait until their next appointment to tell their doctors that they're starting to experience real soreness and irritation of the skin of their palms and the soles of their feet. You should call your doctor as soon as you have any symptoms for a possible dose adjustment. Don't wait until the symptoms get unbearable, because then you may actually have to stop taking the drug for a period of time in order for the skin to heal.

On Wednesday, September 17, 2003, our Ask-the-Expert Online Conference was called Metastatic Breast Cancer. Musa Mayer, Eric P. Winer, M.D., and Marisa Weiss, M.D. answered your questions about treatment and quality of life issues related to advanced (metastatic) breast cancer.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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