Wednesday, August 8, 2007

Xeloda

And so it begins. This evening I start my new chemotherapy regimen, with 3 500 mg tablets of Xeloda. I'll take 3 tablets every morning and evening for the next 2 weeks, then I'll get a week off before starting again. Repeat till (1) we know it doesn't work or (2) we're fairly confident that my disease has stabilized. According the link, xeloda "is a prodrug that is enzymatically converted to 5-fluorouacil in the tumor by the tumor-specific enzyme PynPase, where it inhibits DNA synthesis and slows growth of tumor tissue." I've had 5-fluorouacil (5-FU) as part of the very first chemo regimen I took back in the Spring of '04. It's really hard to say how effective it was -- we know that there was no visible growth on my CT scans during that Spring, and that my ca19-9 (the best tumor marker we've got) was at a reasonably low 80 ("normal" is less than 35 or so...right now, my level is somewhere around 250) when I finished. We weren't tracking the ca19-9 during those months of treatment, not knowing till the first Sugarbaker surgery that this was a viable indicator of the level of cancer in my body. The main difference with xeloda is that the poison is activated in the tumor -- the highest concentrations, if I'm understanding things right, will be in the tumors themselves. I can imagine that this might lessen the over-all side effects, though I'll experience to some degree or other the "usual" -- fatigue, nausea, etc.

I'm always a bit anxious at the start of a new regimen. Never quite sure how well it's going to work...hoping that it works well, shrinking tumors and otherwise halting their growth for an extended period...fearing that it won't work at all, leaving me in 3 months with still larger tumors. And big questions about where exactly we might head next.

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