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jason222

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Reply with quote  #1 
Hi everyone,

My mother is currently undergoing chemo. She had the first A/C chemo last week, and it only took her about 15 minutes.

I thought it was normal, but when I spoke to other BC survivors who has undergone chemo, it seems that our chemo process is too fast.

3 injections were made through my mother's chemo port, the first was the anti nausea drug, the second was a red fluid (which should be the adriamycin) and the third was a clear fluid which I assume is the Cytoxan.
But it was all over in 15 minutes. Is there anything that I should be concern about or am I just scaring myself off?

And she does not seem to have any side effect after 6 days of chemo.
Need your opinion on this, I hope that the process went well for us. Thanks.

Fancy

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Reply with quote  #2 
I have not had A/C, but my avastin/taxol combo took 3 HOURS.  You're a good guy to notice this.  I would do a little research and then ask.  MAYBE they were pushing it because they had too many  customers waiting?  What a terrible thought!

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zschweeb

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Reply with quote  #3 

i had my adriamyacin(sp) pushed through the IV but i had to drip my cytoxin ...if i remember correctly they first dripped the steroids and anti-nausea meds then they pushed the adriamyacin after that they dripped the cytoxan but my treatments lasted over an hour   maybe its quicker if they push them all instead of letting them drip


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jason222

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Reply with quote  #4 
Thanks for the feedback.

I will ask the oncologist during the next appointment. But it seems that almost everyone does this much slower.

A bit worrisome to me, and I do not know how what's the proper procedure to this. And if the oncologist tells me this is another way of doing chemo, I would not know what to say either.
This is tough.

Carolyn

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Reply with quote  #5 
Hi, Jason.   I am pretty new to all this too as I have only had one treatment so far.   But it was also A/C + Taxotere.    The Adriamycin was administered by hand but the other 2 were thru my port.   I think the Adriamycin took less time because it was by hand but the other 2 took an hour each.   They told me to expect my first treatment to last 5 hours.   They did the pre-chemo things (Benadryl, etc) first and then the actual treatments.   So.....I can't imagine 15 minutes!!!   Hope this helps a little.   Good luck and it's great how you are helping your mom.

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Reply with quote  #6 
Hi Jason,
I wish I had son or daughter, and if I were so lucky, I'd want him/her to be exactly like you.  How loving, special, and beautiful it is; you are there for your mother, and she can love, support and count on you to watch over her health and the doctors.  You are a knight in shining armour, trusting, guiding and searching to find a safe way through a fearful and dark terraine.  That's chemo.  You must watch EVERYTHING the doctors, nurses and technicians do, and never take your eye off them.  Tell the Oncologist (the Chief Oncologist), about your concerns. 
 
That seems awfully fast, as Adriamycin is so Toxic, and some refer to it as the Red Devil.  It affects different people, but one can only receive so much of it in a life-time, due to it's toxicity.  It can damage the veins, capillariy and nervous system if not administered properly. 
 
I don't want to scare you, but I would discuss this topic in full detail with your Oncologist, a Second Opnion Oncologist, and our dear Constantine will know, I am certain, as he is familiar with you and your mother's case. 

When A/C is given, the prevailing advice to patients is to drink a lot of water before, during and after the treatment.  Chew on ice chips to avoid inflammation (avoid inflammation throughout tx, another reason for careful nutrition, an many small meals, never skip breakfast, however light and nutritious), and anti-nausea medications before, during and after; and in my case, I was given steroid, Ativan and anther medication for severe stomach (unusual) reactions.   Along with Ativan, as I recall;  and a Saline drip precending all trieatments, to clear the veins.   Did your mother have a "Port", or is she receiving IV's?  Makes a difference on the time (I didn't have a port). 
 
I hope your mom is doing well; you and she are in my prayers, and with you by her side, I think she will make a complete, healthy, a full recovery.
 
Respectfully yours,
you sweet boy!
 
love
Indi

ShirleyHughes

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Reply with quote  #7 
Jason, I agree with Indi.  You are a very sweet son.  My daughter was there for my first infusion along, of course, with my hubby.
 
When I had AC it didn't take too long.  It was more than 15 minutes, but I don't think it lasted any longer than 45 minutes.  Now, when I had Taxol that was a different story.  My first infusion lasted three hours.  Of course they'll looking for any bad side effects.  I didn't have any.  Therefore, the next three times it sent a little faster.  They dripped it faster.
 
I had a port and all of the chemos were given through the port.  I absolutely LOVED my port and so did the chemo nurses.
 
Good luck to your mom AND to you.  You're a keeper!
Shirley
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Reply with quote  #8 
Hey Jason- Make sure that your mom's port gets flushed after each treatment! The nurses know what that means.... it cleans out the tubing so there will be no clogging the next time it is used.


edge

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Reply with quote  #9 
Jason:

[I repeat my response to you from another thread here to avoid it being overlooked]

You raise an important issue, and have - unsurprisingly - received some excellent advice and perspective from the many good and wise folks in these forums, so I will restrict my attention to a clarification and try to flesh out why it matters, with some corrective guidance.

Anthracycline Administration Techniques
Broadly speaking, the anthracycline doxorubicin (Adriamycin) can be administered either by (1) IV injection (intravenous (IV) needle injection), or by (2) infusion, which may be either (2a) intermittent infusion or (2b) continuous infusion. The first technique, the IV route, is said to be by bolus IV administration, over several minutes, 15 minutes being average (into the tubing of a running IV).

One type of infusion approach is by intermittent infusion into a "minibag", and typically infused slowly over one hour. The other infusion technique, that of continuous infusion, involves a central venous catheter (CVC), a "port", and regardless of how long is spent in prep and priming "at the office", the continuous infusion is infused by port over 48 or 96 hours typically, generally transparently to the patient who is typically unaware of the infusion rate once the drug is loaded into the port (and the patient leaves for home); when administered by continuous infusion on a non-accelerated schedule (every three weeks), infusion is typically over 96 hours, adjusted downward as the schedule is densified. So the bolus IV administration and the intermittent infusion techniques are portless, while the continuous infusion is definitionally via (CVC) port. Of course, practicalities intrude, as for example what other agents need to be coadministered, how and when, but the basic distinction remains in general: portless administration (either bolus or intermittent) versus continuous infusion via CVC port.

So What?
So what's the (any) practical upshot? Quite a lot actually: remembering, as always, that typically no single study is dispositive to an issue, we turn to a meta-analysis of four randomized studies of different modes of anthracycline administration, which found a statistically significant lower rate of clinical heart failure (HF) among those patients who received anthracycline by infusion duration of 6 hours or longer, compared with those patients who received a shorter anthracycline duration, with, in individual studies, the 6 hours or longer infusion duration also appearing to reduce the risk of asymptomatic cardiac damage (this is in adult cancer populations, and so these results cannot be extrapolated to the pediatric oncological context). So we may conclude that slow-DOX - administration of an anthracycline over 6 or more hours of continuous infusion - is significantly more cardioprotective against the intrinsic and well-known cardiotoxicity of anthracyclines than fast-DOX (the administration of an anthracycline either by bolus IV or over less than 6 hour continuous infusion).
 
What To Do?
Given that a fast-DOX administration was used in your mother's case, we can leverage the findings of compelling human clinical cardioprotection studies that have supported a significantly beneficial role for HD-MEL (high-dose melatonin, 20 mg / daily) and for CoQ10 (at 90 - 100 mg /daily), and although these are best if given as pretreatment (before the anthracycline) and thereafter concurrently, significant benefit should still accrue post-treatment. There is also a well-established prescription antioxidant and cardioprotectant, dexrazoxane (Zinecard), but this would require approval by the oncologist and may be a difficult sell after the fact. In the elderly, or in anyone at elevated averse cardiac and cardiovascular risk, I would advise both CoQ10 and melatonin, allowing for easing of the melatonin dosage (20 mg) downward for tolerability, if any, since another cardioprotective is also active, and regular post-treatment cardiac monitoring and evaluation is strongly advised.


Constantine Kaniklidis
Breast Cancer Watch
edge@evidencewatch.com

nosurrender

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Reply with quote  #10 
Oh dear!
When they administered my adriamycin the nurse used a very large syringe and deposited it straight into the tubing from the port in less than 10 minutes, if that.
Then a flushing of saline to follow.
Constantine, what would we do without you?
Thank you for educating us once again!


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jason222

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Reply with quote  #11 
Thank you everyone for your help and feedback.
Now I understand more.

My mother's procedure was done the same way as Gina's.
2 more AC to go and Taxol will be next.


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