3C Chemo Combo

[Tron103]

Hi!

I’m posting on behalf of my mum who’s 67 and was recently diagnosed with Stage 3C HGS Ovarian Cancer that’s spread to the peritoneum and omentum. She’s due to start Chemo in the next few weeks (hopefully beginning of July) as surgery wasn’t an immediate possibility. She’s having a combination of Carboplatin, Paclitaxel and Avastin as they have assessed that she’s relatively fit.

I was wondering if anyone’s had this combination? From what I’ve read it looks intense with quite brutal side effects. We’re positive that they are throwing everything at it but hoping to understand more of what to expect.

Big thanks!

[Katmal-UK]

Hi. I was diagnosed with the same in Oct 2007, albeit I was stage 3b, and at that time Avastin was added to Carbo and Paclitaxel as a trial drug which I took every 3 weeks for a year after 6 cycles alongside the other two. It’s no picnic but it’s doable. The effects are cumulative so side effects intensify with each cycle as in it took longer to recover before the next was due but I did get at least a very good week and a half before the next visit. Make sure your mum gets the right anti sickness drugs in place, if the ones she is prescribed aren’t taking the nausea away then ask for stronger, she shouldn’t need to suffer unnecessarily. The fatigue can be bad so plenty of rest. For me the worst part of Avastin was the joint pain (for which I was prescribed strong painkillers, and again ask for stronger if needed) and a congested nose which usually needed half a box of tissues each morning to clear. Nose bleeds was another issue. After 6 cycles I returned full time to work and took each 3rd wednesday off work to have the Avastin, going back into work the next day (Avastin on its own is a lot less to cope with). I think the best piece of advice I can give is with regard to getting the anti sickness sorted and painkillers as required. I wish your Mum well xx Kathy.

[Bowieisking]

Hi, I'm currently having weekly carboplatin and paclitaxel. As the weekly dose is lower than that of the three weekly cycle, it has been OK after the first week which was rough. I work with a nutritionist who advises that cruciferous vegetables (particularly broccoli and cauliflower) are very helpful to reduce chemo effects. I eat a lot of these and in week three side effects were absolutely minimal. Obviously this is just my experience and weekly is very different to the three week cycle. I hope she gets on OK.

[Motiva]

Hello,

That is my regime too. Days 4-6 are peak SE days for me then quickly wears off. Some nausea which Ondansetrone/Metoclopramide helped.

Watch out for constipation. Either that or the chemo gave abdominal pain which I used Buscopan for with lots of cordial in water as peppermint tea and water tasted awful ( my usual staples)!

The first time leg pain/cramps but it barely returned the second time.

The fatigue was the most intense. Sleep if possible or yoga nidra was lovely.

Good luck to you and your Mum,

F x

[NewtonEmma1900]

Hi Tron, I was age 69 in Autumn 2021 when I was diagnosed hg Stage 3c carcinoma (peritoneal). I had the 3 chemo combo. It is indeed very hard on the body. The worst side effects for me was neuropathy in my toes, sometimes bowel issues(either way), general fatigue and at the beginning nausea. With Paclitaxel your Mum will lose her hair unless she explores the option of a cold cap (which I opted not to have). I did not go to work during the period as I also had debulking surgery after 4 rounds. For me it was mixed success; all went well until post surgery when the CA125 started to rise despite being back on chemo. After the 6 rounds of the 3 chemo combo, I was on Avastin alone for 2 rounds, this did not work for me, indeed I had further spread. Following 6 rounds of carbo/caelyx I am now on a maintenance drug and doing very well so far.

So my advice to your Mum would be, ALWAYS take anti-sickness as recommended don’t be frightened to call your specialist nurse, they are there to help. Expect to be tired but go out a little each day if she can and eat well. As previously said the first week or so can be awful, so get on with life and plan to see friends and family before the next round.

The chemo days are long, especially day 1 as the infusions are delivered more slowly in case of adverse reaction. I was given piriton to counter effects from the taxol this made me very sleepy so I would advise that someone takes your Mum and picks her up until you know how she reacts to the drugs. The days are long, particularly day 1 so perhaps take a book or I pad. My hospital offered coffee, tea or water and a sandwich lunch but she might want to take her own food and drink. Hope that helps. Katy🙏 x

[Lolathestaffie]

my mum is stage 4b. She had this combo and is 80. Sadly it had not been a great response ( most people have a great response ) but she did tolerate it well. Her main problem was the fatigue and after the last one some slight neuropathy in her feet. They stopped it at the fifth due to this although she could have had the sixth

[Kjpip]

Hi Tron, I was diagnosed in Oct 21 and had 6 rounds of this combo with surgery in between. I was diagnosed stage 4a, also with spread to peritoneum and omentum. I'm a bit younger than your mum (I was 48 when I had this combo) but tolerated it fairly well. I was feeling very poorly, and was huge with ascites, before I started chemo so for me the chemo was very welcome and I think that positive state of mind helps get you through .For me, the absolutely worst thing was constipation, as the anti-sickness drugs can have this side effect. (But I would still recommend taking the anti-sickness drugs otherwise your mum will feel rotten!) My best advice would be to get some lactulose prescribed, drink lots and lots of water, and try to exercise a little every day, even when your mum's feeling really tired, just to move things around a bit. My constipation was only during the first week of each cycle and I felt relatively well for the next 2 weeks.

As Katy above said, the chemo days are really long, so your mum should take something to keep her occupied, and some snacks etc. My chemo unit served hot drinks and biscuits, really nice hot lunches, and sandwiches for tea, but even if the food is nice, it's nice to know you've got some snacks you know you like that you can graze on through the day!

I hope she manages the chemo ok, and that it works well for her xx

[thejoannabell]

I had basically the same diagnosis in March 2020. I had 3 rounds of Carbo and Paclitaxel, then surgery, and then 3 more rounds of Carbo and Paclitaxel. I had Avastin later as a maintenance treatment. I didn't have too much nausea with the first treatment, I was just very fatigued and lost my appetite and my hair. At that point in treatment my family and friends rallied around so much, sent flowers, brought food (which my husband appreciated). All that support makes it easier; I found it harder after a relapse and during maintenance when the attention and support tend to subside. Physically, Avastin caused a great deal of joint pain for me, so I hope the combination of the three isn't painful for her. If she can tolerate strong pain medication, don't hesitate to ask for it, and/or to be referred to palliative care. In my experience the support and compassion of palliative care was very helpful; oncology staff often don't have the time to work with you to find what brings the best relief. Also, everyone reacts differently, so she may not find it to be as bad as it sounds. Best to you and your Mom!