• How do you balance chemo treatment vs. white blood cell issues?

    Asked by Rick1970 on Thursday, May 22, 2014

    How do you balance chemo treatment vs. white blood cell issues?

    My spouse is at a decision point in her 8 month battle with PC, Stage IV. To date, FOLFIRINOX (Fol) treatments have beat back the beast from her liver, but there is still minor cellular activity visible in the tumor on her pancreas based on 3 PET/CT scans in March, April & May. Today, after a 10 week break from Fol-treatments, her white blood count level and regeneration cycle appears to be borderline for continuing Fol-treatments. Your thoughts ... should she stop treatments until future scan show increased PC activity? Lengthen her Fol-treatment cycles (to every 3, 4, + weeks vs. every 2 weeks)? Consider other alternatives, in other words what are we missing?

    We need to decide on our "What next" step next week. Thank you for any thoughts and suggestions you're willing to share.

    Hang-in there all! This neglected beast is beatable, we just need a little time and resources. Rick

    7 Answers from the Community

    7 answers
    • lilymadeline's Avatar

      If she did that well with her treatments, I think that she should go for it and have more to fight it back further. But I am not an oncologist and I don't know her medical details. So if I were you I would go to another cancer center and get a second opinion ASAP from a top oncologist. The reason I am saying to go to another hospital is because that is the best way to get an unbiased opinion. Unfortunately doctors are often hesitant to contradict other doctors that they work with or could possibly know. Good luck and best wishes!

      over 6 years ago
    • kalindria's Avatar

      Our thoughts are not as important as those of your doctors and other medical experts. What choices are they offering your wife? I agree with LilyMadeline that it might be the perfect time for a second opinion.

      That's what I did when faced with a similar decision... reached out to another doctor (she went to high school with my daughter) completely outside my current care practice - the bonus was her Mom is also a doctor and on her local tumor board so I got a whole bunch of different input.

      Alternative opinions can be valuable but in the end, you still have a decision to make and none of us knows what the future holds. All my best to you and to your wife as you decide how to pursue this matter.

      over 6 years ago
    • cam32505's Avatar

      I'm surprised that an onc would ask you how to proceed. When I had chemo, they checked my blood before every treatment. If anything was out of the normal range, they treated it, gave me blood transfusions, etc, and kept me on course to receive my planned chemo. But, after radiation, my gyn onc asked if I wanted to delay treatment because I only had 1 week between the last rad treatment and the next chemo. I had a goal to finish by the end of the year, so I went for it. But, if the patient is too sick to take the treatment, the onc should't allow it to happen. Many people have to stop their treatment before it's done.

      over 6 years ago
    • greatlife's Avatar

      Please get another opinion from an unbiased specialist. Is there a university/teaching hospital in your area? Do a small bit of research and get an appointment with one of the the teaching specialists, if possible (aim high--try for the department head). It is very important to continue with treatment; there may be another drug that can help your wife and cause lesser symptoms...

      As for low A counts: When my husband was on chemo, I tried to get him to eat lots of fruits, vegetables (even in smoothies) and red meat (even liver). I know how difficult it is to pique the appetite--but try (dark chocolate is very high in the stuff that raises white blood cells!) Through his diet, he was able to stay on the chemo and had very good blood counts the entire time. He also took loarge amounts of vitamin D3 (20,000 iu per day) and large amounts of curcumin (30,000 mgs) every day

      See this web site on how to increase white blood cell through diet---it works!

      I hope that you can get her to eat some of these foods---especially all the fruits and veggies...try to buy grass fed beef and organic thin skinned fruits and vegetables. We don' t need more poison on our systems from the pesticides and gmo's and hormones, etc....

      When my husband was ill, he also (although he did not realize it) began to think holistically. He meditated every afternoon (in our hot tub) and really thought about his body and came to be very attuned to it. He still "listens" to his body and reads it and its signs...I know that there is no scientific basis for this type of healing, but after his battle with pancreatic cancer 4 years ago, he is here, he is strong, and he is cancer free. (He still eats lots of fruits and vegetables (organic/non-gmo) grass fed beef and lots of seafood.)

      I hope that this helps...

      over 6 years ago
    • ctine1's Avatar

      I am currently receiving 5FU also and it has lower my neutrophil levels dramatically. I am currently receiving a Neulasta shot after my infusion. If my levels are low enough to warrant it I am also given Nuepagen shots that I give myself for 4 days following chemo. My levels went from .80 to 4.50. I would ask your oncologist why this is not being done.

      over 6 years ago
    • deSmile's Avatar

      Hi Rick1970,

      I agree with many of the above sentiments. Number 1- Are you at a major academic institution for PC. We on the East Coast have Hopkins.. the mecca. Otherwise MD Anderson, Pittsburgh. What do the experts say? Our thoughts.. this is no time to back off as disease progression is worse than anything. Have doctors discussed decreasing dose of one or more of the Folfoinox combo? Do it all but stay aggressive with drugs as the alternative is not great!

      over 6 years ago
    • greatlife's Avatar

      As for great west coast hospitals: UC San Francisco, UCLA, Stanford..We have personally gone to both Stanford and UCSF for opinions and actual surgury and treatment, as well as Johns Hopkins. ALos on the East coast: Columbia, Sloan Kettering. Even if you cannot get to one of these or deSmile's, suggestions, try to find another institution that you can travel to, i.e Northwestern, Emory, etc...

      over 6 years ago

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