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I am currently doing chemotherapy for the third time: Paclitaxol and Carboplatin in 2020; Caelyx and Carboplatin in 2022; and now Paclitaxol and Carboplatin again.

Because of having it multiple times, the risk of an allergic reaction increases.  For the first treatment on the 2nd, the dosage began slowly and was gradually increased.  I made for a very long day, but I was fine with the drugs.

Today, as soon as the dosage was raised the first time, I could feel my heart beginning to race and soon afterwards developed lower back pain --- my kidneys protested!  My bed was soon surrounded by nurses, stopping the chemo and giving more steroids, etc.  It kept the other symptoms at bay.

A doctor from gyne oncology was called up and she called my gyne oncologist who happened to be between surgeries.  After discussing it, they decided that I would be given another version of each drug.  Apparently, the allergic reaction is actually caused by the preservatives.  The new drugs will be very expensive preservative-free versions saved for those of us who have trouble with the 'cheaper' ones.  I think they have different names than Paclitaxol and Carboplatin, but I didn't catch them today.

I go back tomorrow for them and was told that it will take only a couple of hours.  I haven't been told if there are different side effects or anything else, yet. Have any of you had any experience with them?  I'd appreciate anything you can tell me.

Hello @GGail

I wish I could tell you something, but unfortunately I have no insights to offer.  Where are you located?

I'm in Calgary and I also had horrible reaction to Paclitaxel/Carbo in 2023 and for my recurrence this year we tried the Caelyx (I call it orange Kool-Aid) and Carbo and it hasn't worked for shrinking the para-aortic lymph node for me; in fact it increased in size.  I'm hoping to get a new treatment plan when I see my Oncologist Monday May 26.  If I learn something new there, I'll come back to share with you. :) 

I wonder if @Alwayslearning may have more advice to offer?

Thank you for replying. I got through the treatment yesterday without a reaction, so far anyway.

I was wrong about one thing. I was still given Carboplatin. There was also a difference in the pre-meds. Instead of bags of steroids and Benadryl, I had to take only anti nausea tablets and a steroid tablet. I could hardly believe the difference from one day to the next. On Thursday, I had to take advantage of a wheelchair to get to the main entrance. Yesterday, I skipped the elevator and walked down two flight of stairs.

The pharmacist visited me yesterday and discussed the ‘Cadillac' Paclitaxel, including that the side effects are basically the same.

Sorry to hear that Caelyx didn’t work for you. I had surgeries both times before so the chemotherapy was insurance. This time, though, the tumour is too close to the blood and nerve supply to my intestines, so we’re hoping chemotherapy will do the trick.

None of this is easy, is it?

Hi @GGail and @DiamondGoddessYYC 

Sorry for being late to the discussion. I had a LOT of reaction to Pac and had a steroid regime that started the day before PLUS two more steroids and two antihistamines given intravenously prior to starting my infusions. Plus after Tx1 they reduce the formulation of my chemo (both Pac and Carbo) by 10% (but I think that was more for peripheral neuropathy that I experienced). It took me about 6-7 hours for each of my infusions because like you, they went slow with the Pac. I did however make it through my 6 infusions without them changing the product. 

I did a google search and saw there is a Paclitaxel called "nanoparticle albumin-bound paclitaxel" that can be used if a patient experiences side effects from standard Pac. It's designed to reduce some of the side effects. Perhaps that's what they used. They do have quite a few tricks up their sleeves. I'm pretty sure I remember someone else in OVDialogue who spoke about this. If you are interested you may want to start another post about alternate types of Pac or something like that. 

I'm glad you made it through much better for Tx2. Let's hope that continues for you. 

#Nab-Paclitaxel #Abraxane 

@Alwayslearning My goodness, you’ve been through the wringer! The 6 - 7 hour infusion was what I was anticipating. My first one was like that, but Thursday’s was cut short because of the reaction. Yesterday’s was supposed to be much shorter but we were waiting and waiting for the recipe to be ‘cooked’. Theoretically it was supposed to be the pre-med tablets, 45-min Nab-Paclitaxel, 1-hour for the slowed Carboplatin. My appointment was at 10 am and I was unhooked shortly after 3 pm. Still shorter than yours though.

I’m taking steroids tablets (Dexamethasone) now for three days and I feel like I’m trying to function in a cloud. I’m sure we all know what that feels like.

Thank you for responding and for the suggestion about starting a post about this different version of Paclitaxol. I’ll keep it in mind.

@DiamondGoddessYYC

You asked where I'm located and, sorry, I didn't answer in my first response.  I'm in rural Newfoundland and I go to the Cancer Centre in St. John's for my treatments.

Hi @DiamonGoddessYYC

I'm sorry to hear that this chemo regimen isn't working. Have you spoken to your team about the possibility of radiation? There is some evidence that clear cell is more sensitive to radiation therapy.