Is chemo delivered by pills or infusion?

[Graham2222]

My CLL, newly diagnosed, is becoming aggressive. The consultant has said that chemotherapy is the next step if a blood test in a month remains concerning. He talked about infusion, which I take to be a drip, but the CLLSA articles generally discuss different types of pill. What is the normal method please?

[Cllcanada Top Poster CURE Hero]

Hi and Welcome!

CLL is treated primarily by intravenous infusion IV drip, or by oral medications, but it depends on the drug...or drugs... many are a cocktail of several things, chemo, monoclonal antibodies, steroids etc...

Chemotherapy can be either a tablet, like chlorambucil or an IV fusion like cyclophosphamide. Some like fludarabine can be either pill or IV.

Monoclonal antibodies are a treatment that is primarily done my infusion.

There are other methods but fairly rare. Campath a monoclonal antibody that

is done my subcutaneous infusion, needles under the skin rather than in a vein.

Some of the new drugs called small molecules in clinical trials are often oral

tablets

So, it depends on the treatment you have... most CLL is treated with a combination

of tablet and IV, but it varies.

If you are just diagnosed and your doctor is talking treatment already, you would be advised to have a second opinion... CLL is rarely treated only on blood results.

Are you having enlarged nodes, spleen, etc, night sweats, weight loss, falling platelet numbers? Have you had any prognostic testing, like FISH?

~chris

[fish61 in reply to Cllcanada]

Hi Chris, I guess Clicanada wants me to reply.

I have had 2 bone marrow tests,and probably 3 to4 CT Scans every year with blood tests every 15 days for the past few years

.The first oncologist I met at M.D. Anderson wanted me to go right into Chemo with no other testing...( His stay in my life was very short lived.)

A year and a half later another Oncologist had me set up for Chemo in 2 days.

Then another oncologist at MD Anderson told me that you cannot play the numbers you have to treat the personality... .... he advised against it and we waited 2 months until my lymph nodes were 2 to 3 centimeters . Then we were lucky enough to get into a clinical trial using Ibrutinib (a pill) and it has worked extremely well..it has some of the side effects , especially fatigue but I can take a siesta every afternoon . I have been on it for 5 + months and am very happy.

I found the clinical trial on clinical trials .gov ( I searched over 500 of them) that I thought would get me the medication the last 2 oncologist's said I should have , but it was not available for public consumption . It is not IV CHEMO . They we not aware that it was available but happy to see I did my research and helped them.

If you do not work to keep your body healthy , no one else will , they are dealing with the masses and not you as an individual.

Get more than one opinion, I don't care how friendly or happy you are with your M.D..

It is your body and we only get one per lifetime..This life is not a dress rehersal .. do not be afraid of being a pain in the butt to the medical world. most of them treat your symptoms . I have been lucky enough to be in a place where they try to prevent your illness.

I have been an owner , part owner and trouble shooter for malpractice companies... we see all kinds of problems ...

Most M.D.s are very smart but they tend to "go with the flow" (it is easier ) rather than research individual cases... They have a lot on their plate but I want my plate to be special. Fish 61

[Graham2222]

Many thanks for the advice. My other symptoms are very limited, so I'll check as you suggest.

[fieldmeadow]

I am currently being treated with a combination chemo therapy known as FCR. The R element is by infusion and the F and C elements are generally in tablet form which I take at home for five days.

However, as Chris mentions, treatments vary.

[Kam73]

This brings up another question. How is the IV delivered? Vein or some type of port?

[Cllcanada Top Poster CURE Hero in reply to Kam73]

Some patients have ports installed or perhaps picc lines. They are somewhat invasive and require maintenance. They often try direct vein IV first... more macmillan.org.uk/Cancerinfo...

Also see

en.wikipedia.org/wiki/Port_...

[katier]

Haven't started mine yet, but Dr. suggests it will be via IV BUT, based on my recent experience (treating two infections simultaneously with 3 different antibiotics) PILLS that go to the Stomach are NOT THE WAY TO GO!! I've been 'sick as a dog' for several days, unable to keep even water 'down'.....I vote for the IV....

[homsey]

SUPPOSE I WAS A BIT FORTUNATE TO HAVE NO TROUBLE AFTR TAKING CLARUBISILE THEN FLORIDABINE A FEW WEEKS LATER, HAD NO SICKNESS PROBLEMS.THIS WAS IN 2002, HAD MY SPLEEN REMOVED IN2006, AND NOW HAVE 28 DAY REGULAR I/G TREAT MENT IN HOSPITAL, HAVE NOT HAD A CHEST INFECTION SINCE BEING ON I/G. DIAGNOSED WITH BOWEL CANCER IN 2010, HAD OP TO FIT ME WITH AN ILLEOSTOMY, FEEL OK IN MYSELF, JUST SOON GET TIRED, BUT NEARLY 77 YEARS YOUNG.