Maybe..??

Maybe tonight??

Blood Counts Back UP!!

Had Radiation treatment # 21 today.. 7 to go!!

Keeping My Fingers Crossed

Blood work being drawn today to see that I continue my radiation.. 8 sessions left.. hoping!

Basketball Sunday!!

It helps showing up late.. gives everyone else a chance to get tired..

BIG Shout Out!!

To Lester Kwock, in North Carolina..

Lester is a five year esophageal cancer survivor and had been instrumental in the commencement of my journey. His compassion, spirit, good nature and positive attitude had really shaped my approach and mental attitude prior to my treatment and gave me my belief that "I will" be beating this with ease.

Lester was introduced to us thru our dear friends Linda and Kevin and as Linda believes, God puts people in our paths for a reason. I now know it was to be able to connect with their dear friend, Lester Kwock.

Les is and always will be a survivor and I thank him for his strength, kindness and compassion! Good luck to you Les as you continue along your path of good health and happiness.. your friends are wonderful and that makes you a success!

Cousins..Thank You Karen!

Can you all tell which one is me?? And my sis and bro?? Grandma in the middle.. rest are cousins..

My cousin Karen sent it over.. first I had ever seen of it at Green Lakes State Park in NY! Click on the pic to enlarge..

OH..and this is my Mom's side of the family.. the Hughes.. missing my cousin Kathy and includes one friend on the end not related.

My brother and I on each end.. yeah I without my shirt.. and my sister Renee with head turned next to my grandmother..

Maybe...

Hard to tell at my age.. is it real or imagined.. time will tell?? But this morning looks different..

Radiation Day #21 Postponed..

Radiation Day #21 Postponed.. apparently my blood counts are too low to continue so looks like more blood work on Monday and a decision as when to continue.. 3 Day Weekend!!

To All My Cousins..

I just wanted to thank all of you so much from the bottom of my heart! I know for most, it has been well over 35 years since we have talked. But your kind words from all have brought back so many memories, so much love and so many feeling that i cannot begin to express in words what it has meant to myself and family.

Call it what you would like, lineage, bloodlines.. family or bonding.. It's stronger than one could imagine and I thank you all for your efforts and support.

And Becky, Bernadette, it was Mark not I that destroyed your dollhouse.. I've tried for years to control his moods and I warned him that day.. but you both know how he can be.. sorry Mark.. you are the elder and should have known better..

Love you all.. and yes the pic is prior to weight loss..

Bouncing Back!!

"Success is how high you bounce when you hit bottom."

"The test of success is not what you do when you are on top. Success is how high you bounce when you hit bottom."

"No matter how far life pushes you down, no matter how much you hurt, you can always bounce back."


OK so..I do look like shit..literally... and it's embarrassing.. but I have to post this pic.. sorry Mom!

But today, would be considered my "chemical low". The point at which I've received the maximum amount of chemoradiation therapy. Yes I do have 8 sessions of radiation left but.. after 20 sessions completed along with today's completion of my chemotherapy, my body physically has received at this point, the most it will be accepting.

I do have surgery sometime in October however, today.. after my last chemo session, this should be considered my bottom.

So from this point on, I begin my recovery!! And I promise to get stronger every day. Yes tomorrow may bring back the nausea, the vomiting, the diarrhea and the rash.. I may feel like puking every time I sneeze or strain to stand straight when rising from my chair. But from this day forward I begin my ascent.

My stats, weighing in at 149lbs..... or about a 34lb loss.. My strength is half of what it should be but will be getting better by the day. My white blood count should be between 4-11 and it's 1.2 today, my reds top out at 30 when my normal is 43. Yes I will be dropping down again after surgery. But surgery is a day of pain and immediate recovery. Chemo and radiation are weeks of injury and decline.

So my picture you ask?? It's my commitment, my reminder that I may look weak... may look sick, may lack my physical strength.. may be pale and may be gaunt. But I am strong.. I am positive and I am confident. I know the odds, 14 percent survival rate for 5 years.. ranking 3rd worst on the list behind pancreatic and liver..

But the odds don't know me.. my persistence, attitudes, beliefs and drive.

I actually am ahead of schedule.. been on a self imposed emotional and spiritual incline since last weeks chemo. Feeling like beating those odds.. willing my way back to good health. Yes the tube is gone until surgery, the negative feelings are suppressed.. and my energy is skyrocketing.

And I want to thank everyone around me.. my friends my family, Cathi.. my new found cousins.. most of whom I haven't spoken a word to in more than 35 years but everyone..EVERYONE is stepping up and I cannot thank you all enough and only wish I could be the person you all have been for me.

Most important is my mom and dad.. my mom, the sweetest person I know and is struggling with both my illness and my dad's recurrence of lung cancer. My mom actually was at my dad's oncologist the day I received my news.. talk about pain.. talk about the burden of your spouse and your youngest child getting the dreaded news at the same time. I only wish I had her strength!

And my dad.. the most positive man I know and I thank him for my guidance.

I have to mention, still working in his late 70's.. still working through chemo and previous radiation for lung and prostate cancer. Going to work with the fatigue, digestive problems, pain and mouth sores..

When you ask.. "I'm doing great Michael, there is nothing wrong with me!" but dad, you have cancer.. and I always get back.. "I'm alright!"

So how could I even begin to complain..

My brother Mark.. my best friend, my confidant and my strength in knowing that he will always be there in his support and love..

My sister Renee.. when I look at her I see my mom, kind, sweet caring and a rock among the waves.. and only wish I could express what she means to me and my life.

So 149 lbs is how you see me today.. for those of you that haven't seen me in over 35 years, I'll post a current pic prior to my current situation so you know where I'm going to be by Thanksgiving..

So hang in here with me.. I'm no longer sick, no longer negative and no longer struggling. I'm at my bottom and and beginning anew.. I'M BOUNCING BACK!!

Last chemo happening now!! Radiation ending Sept 8th!!

White counts are down and almost postponed my chemo but the decision was made to continue..

OH No!! Cisplatin Peripheral Neuropathy!

Peripheral sensory neuropathy is the main non-hematological side-effect related to Cisplatin chemotherapy. Think I'm feeling some tingling and burning in my upper extremities..??

Click the image to see more..

I Guess..

.. it's great when I'm too busy working to post.. feeling great this week and looking forward to ending my chemo tomorrow.. will write an update later..

Blood Counts Are UP!!

I guess I went from 1300 last week to about 27500 this week... they usually refuse treatment when it drops below 1500.. however they let me continue last week at 1300. Guess real food may make the difference??

Radiation Day #17 Out of 28

Eleven to Go!!

Real Food!!

..been off the tube since Thursday.. better days ahead!

My Apologies..

.. To Bill.. apparently he may be suffering from more than a cold and I wish him a speedy recovery.. my humor sometimes gets ahead of me.. sorry Bill. Hope you are feeling better very soon.!!

Sis and Roy!!

And a very special thanks to Sis and Roy for all that they have done for me, their support, friendship and love.. the burden you have lifted from your daughter is invaluable to my recovery and I cannot thank you both enough for your being with us in your support!

Best Wishes To Bill!!

I'd like everyone to send a little energy to my dear friend Bill.. stuck at home with a sore throat and the sniffles.. We really missed you at basketball this morning and wanted to wish you a speedy recovery.. was really nice seeing Kerry this morning...he he..

Hello Mom, Dad and Renee!!

Sorry about the "Evaluation Copy"... too cheap to purchase the real version... I knew I would make you proud of my "frugality" mom!!

Basketball Sunday!!

FIVE GAMES!!.. and Anonymous from my Aug. 22nd post.. I know who you are and this dunk is for you.. no over you..

OK So...

My second to last chemo treatment was Thursday and I'm feeling pretty good! Did you hear that Bill... yes I will be hitting the court tomorrow morning..

I was planning to go back on my feeding tube on Friday but decided to have a light caloric day gauging how I felt last treatment.. but by Friday night I was eating solid food(Thai from Mapow).. and watermelon this morning and leftovers for lunch.

Nausea is about a 2 and energy is way up... so maybe my system is getting use to the chemo and I'm not reacting so severely however I'm waiting for the hammer to drop.

Great news is my tumor is shrinking enough so that I may eat somewhat normal..so hopefully.. time will tell if I could get a few pounds back??

OH... and I Forgot..

..two more young adults that brought tears to my eyes.. Christine(one of our Trainers) showed up at the Gym with her son Mac.. apparently Mac and sister made bracelets and sold them to friends.. and presented the money to me.. I have to mention that gesture of kindness was so innocent and so thoughtful... Of course I would never have taken the money but Christine knew I couldn't possibly turn it down from her boy..

So.. now I'm thinking of something creative to do with it..hum..??

Hope for the Future, Strength for the Present!

I have to express that I have received so much support that it seems impossible to put into words how important it has become for my progress and positive attitude. I couldn't begin to thank all of you for your encouraging words and actions.

But I have to take a moment to mention some of the young individuals in my life, the ones that I have some constant or even intermittent contact with.. my younger clients that give me strength in the moment and hope for our future.

I was brought to tears today as Martha(a client) mentioned her son and my client Caleb had just selected the confirmation name of "Michael" and his reasoning was related to my struggles. (Sorry Martha... you told me I could tell him..)

Now I know I do not deserve this honor nor do I expect this commitment from anyone, but the simple fact that at 16, Caleb has the maturity and empathy for such a generous decision gives me hope for our future and the strength to continue on with dignity, belief in purpose and a positive attitude.

Caleb, by the way, pulled the swim leg of our team triathlon last year in Amesbury. Along with Jason Cox(running) and myself on the bike, we were able to pull off a victory in the team category. And no..Caleb came out of the water in 11th place, I..yes I lost the lead on the bike as one guy blew by me, and Jason pulled it off with a breathtaking run to capture the win. And...it was a first time entry for both the youths! Not too bad for two 15 year old's standing on the platforms as they collected their golds.

Now that I'm on a roll.. I have to mention 3 others..

Jeff Repucci, a recent Phillips Exeter grad and outstanding hockey player and all around athlete and individual. Jeff has displayed more passion for life's activities, events and experiences and more compassion for others than anyone I have seen for his young age and I respect him for his energy and believe in the decisions he's about to make.. and thank him for becoming part of my life.

Tom Larkin, a dear friend of Jeff's and another outstanding young individual that shared the ice with Jeff as co defense-men. Tom was recently drafted by the Columbus Blue Jackets and actually got the call while training with Jeff at my facility.. After.. no actually during the flurry of calls and text messages that was lasting for a good half hour.. and while walking out the door and still on the phone.. Tom put his excitement on hold, returned inside to thank me for the days workout! I have to mention Tom, because his small gestures go a long way in shaping an individual. Tom has since return from summer in Italy(his home) and while only in town for a brief moment before heading out to training camp, stopped in to check on my progress. Now that gives me strength and hope..

One more.. little Derek.. 6 years old and a bundle of joy from the moment he enters the gym. I know, many of you may think Derek may be too young.. but Derek has had his own struggles as an adopted child from Guatemala.. and Richard had the foresight to make certain Derek has the best opportunities available to him and Derek flourishes and his personality, happy demeanor and innocence give me so much pleasure and strength of purpose.

I know I probably could have been more eloquent in my written thoughts but my point is that with so much positive around me... how could I afford to be negative?

So keep your smiles for me, keep your faith and I'll accept your prayers too if that is your belief.. stay strong, stay positive.. and leave your pity at the door because you know I will..

And Coming this October..

Thank You Dance!

Just wanted to say a quick thanks to all that have provided their support! I know its not requested nor necessary but I could not remain so strong without my family, loved ones and friends... and I could not possibly tell you how important that is to myself and my progress.

And for those of you that have not seen my dance(which is probably all of you), you must click on the image above to see my moves..

Back to My J Tube!

Was good while it lasted..

Sorry...

...Anonymous mentioned mooning.. and I couldn't resist... kind of how i feel about chemo and radiation..

What a Difference..

..a day makes..!! Yesterday we had a half moon.. now today it's almost full!

One more chemo session to go!! May not appear as positive tomorrow as my IV anti-nausea wears off.. but boy do things look better today!

Yup..Cheeseburger in Paradise..

..just finished... first one in a long time.. and during chemo..

Bucket List Items...Front Flip!!

OK so maybe most of you think this maybe a little stretch for someone that is 50... but my initial intention was to master the front flip while I was 50! Looks like my present state may delay this for a bit, but my "Bucket List" still contains the front flip and I will get this accomplished very soon.. currently I've progressed to a break fall.. close but not there yet..

Bill, do you care to join me??

Funny..

I think the nurses like to play cruel jokes on their chemo patient..

They hook me up to fluids for 2 hours prior to treatment, tell me its to protect my kidneys, then they give me Lasix to make me pee.. then watch me run to the bathroom every 5 minutes with my IV trailing.. and 2 more hours more of fluids after treatment is over.. funny huh?

Here We Go Again..

Yup..the Cisplatin is first for a half hour, then the CPT-11.

They tell me my red and white counts are way down so.. if the whites go any lower next week may be in question??

So... all pray that they remain high enough, and I remain strong and healthy enough to get through my last treatment next week. They do have a drug that they can administer that could raise them, yes side effects are severe bone pain as my marrow develops white cells..

On a positive note, I did have real food last evening for the first time in awhile, and I'm sitting here getting my chemo and I just ordered a cheeseburger from the cafe... don't know if I'll be able to swallow it but at least I have a desire to try..

Silver Lining..

OK so maybe some of my recent posts have been a little "dark"..

Just wanted to show you all every cloud... does have a silver lining.. and I still believe it does!!

So..??

I'm still saying "half full"..

Half Way..

Half Way today.. 14 radiation treatments down and 14 to go.. !!

And 2 chemo treatments down and 2 more to go.. 1 more after tomorrow!!!

What a Difference 5 Pounds Makes..

OK so I'm back up 5 lbs from my low of 147. Weigh in Tuesday was 152.. 31 lbs to go..

And for those of you that don't know the size difference between muscle and fat, these pics should help. Sure do hope my return is not fat..

Do You Think?

..Charlie Brown had chemo?? I bet he did..

(Click on the photo to see a larger image)

Cannot Wait...

...until Thursday..

Cisplatin - Drug 2 of 2

Cisplatin

Trade Names: Platinol ®, Platinol®-AQ
Other Name: CDDP

Drug Type:

Cisplatin is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Cisplatin is classified as an "alkylating agent." (For more detail, see "How Cisplatin Works" section below).

What Cisplatin Is Used For:

* Used to treat testicular, ovarian, bladder, head and neck, esophageal, small and non-small cell lung, breast, cervical, stomach and prostate cancers. Also to treat Hodgkin's and non-Hodgkin's lymphomas, neuroblastoma, sarcomas, multiple myeloma, melanoma, and mesothelioma.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Cisplatin Is Given:

* Cisplatin is administered through a vein (intravenously or IV) as an infusion.
* There is no pill form of Cisplatin.
* Cisplatin is an irritant. An irritant is a chemical that can cause inflammation of the vein through which it is given.
* If Cisplatin escapes from the vein it can cause tissue damage. The nurse or doctor who gives Cisplatin must be carefully trained. If you experience pain or notice redness or swelling at the IV site while you are receiving Cisplatin, alert your health care professional immediately.
* Before and/or after the Cisplatin infusion, extra IV fluids are given, care is taken to ensure adequate hydration before, during and after Cisplatin, to protect your kidney function.
* Cisplatin also has been used as an infusion into the abdominal cavity (contains the abdominal organs).
* The amount of Cisplatin that you receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer that you have. Your doctor will determine your dose and schedule.

Cisplatin Side Effects:

Important things to remember about Cisplatin side effects:

* Most people do not experience all of the Cisplatin side effects listed.
* Cisplatin side effects are often predictable in terms of their onset and duration.
* Cisplatin side effects are almost always reversible and will go away after treatment is complete.
* There are many options to help minimize or prevent Cisplatin side effects.
* There is no relationship between the presence or severity of Cisplatin side effects and the effectiveness of Cisplatin.
* The Cisplatin side effects and their severity depend on how much Cisplatin is given. In other words, high doses may produce more severe side effects.

The following Cisplatin side effects are common (occurring in greater than 30%) for patients receiving Cisplatin:

* Nausea and vomiting. Nausea may last up to 1 week after therapy. Anti-nausea medication is given before the infusion, and a prescription is also given for use after.
* Kidney toxicity. Effects on kidney function are dose related, observed 10-20 days after therapy, and are generally reversible.
* Blood test abnormalities (low magnesium, low calcium, low potassium)
* Low white blood cells (this may put you at increased risk for infection)
* Low red blood cells (anemia)

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 10 days
Nadir: 14-23 days
Recovery: 21-39 days

These are less common Cisplatin side effects (occurring in 10-29%) for patients receiving Cisplatin:

* Peripheral neuropathy: Although less common, a serious side effect of decreased sensation and paresthesia (numbness and tingling of the extremities) may be noted. Sensory loss, numbness and tingling, and difficulty in walking may last for at least as long as therapy is continued. These side effects may become progressively more severe with continued treatment, and your doctor may decide to decrease your dose. Neurologic effects may be irreversible.
* High frequency hearing loss. Ringing in the ears.
* Loss of appetite
* Taste changes, metallic taste
* Increases in blood tests measuring liver function. These return to normal once treatment is discontinued. (see liver problems).
* Hair loss
* Your fertility, meaning your ability to conceive or father a child, may be affected by Cisplatin. Please discuss this issue with your health care provider.

Not all Cisplatin side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When To Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

* Fever of 100.5ºF (38ºC) or higher or chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

* Nausea (unable to drink fluids and unrelieved with prescription medication).
* Vomiting (more than 4-5 times in a 24 hour period).
* No urine output in a 12 hour period.
* Unusual bleeding or bruising.
* Black or tarry stools, or blood in your stools or urine.
* Extreme fatigue (unable to carry on self-care activities).
* Swelling, redness and pain in one leg or arm and not the other.
* Yellowing of the skin or eyes.

Always inform your health care provider if you experience any unusual symptoms.

Cisplatin Precautions:

* Before starting Cisplatin treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
* Cisplatin may be inadvisable if you have a history of severe allergic reaction to Cisplatin, carboplatin, other platinum-containing formulations or mannitol.
* Do not receive any kind of immunization or vaccination without your doctor's approval while taking Cisplatin.
* Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Cisplatin may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
* For both men and women: Do not conceive a child (get pregnant) while taking Cisplatin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
* Do not breast feed while taking Cisplatin.

Cisplatin Self Care Tips:

* To reduce nausea, take anti-nausea medications as prescribed by your doctor, eat small amounts of food frequently.
* Try dry cereal, toast, crackers especially in the morning to help curb nausea.
* Maintaining a good fluid intake is very important to help to avoid kidney damage. Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
* You may be at risk of infection so try to avoid crowds or people with colds, and reprt fever or any other signs of infection immediately to your health care provider.
* Wash your hands often.
* To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or salt mixed with 8 ounces of water.
* In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
* Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
* Get plenty of rest.
* Maintain good nutrition.
* If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Cisplatin:

* You will be checked regularly by your doctor while you are taking Cisplatin, to monitor side effects and check your response to therapy. Periodic blood to monitor your complete blood count (CBC), your electrolytes (such as calcium, magnesium, potassium, and sodium levels) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
* Because drug toxicity is seen as numbness and tingling of fingers and toes, a periodic physical examination, which includes a check of your reflexes, is necessary to detect the need for decreased dosages.
* With high dose therapy hearing tests may be ordered as baseline and monitored at times during therapy.

How Cisplatin Works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Cisplatin is classified as an alkylating agent. Alkylating agents are most active in the resting phase of the cell. These drugs are cell cycle non-specific. There are several types of alkylating agents.

* Mustard gas derivatives: Mechlorethamine, Cyclophosphamide, Chlorambucil, Melphalan, and Ifosfamide.
* Ethylenimines: Thiotepa and Hexamethylmelamine.
* Alkylsulfonates: Busulfan.
* Hydrazines and Triazines: Procarbazine, Dacarbazine and Temozolomide.
* Nitrosureas: Carmustine, Lomustine and Streptozocin. Nitrosureas are unique because, unlike most chemotherapy, they can cross the blood-brain barrier. They can be useful in treating brain tumors.
* Metal salts: Carboplatin, Cisplatin, and Oxaliplatin.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Irinotecan - Drug 1 of 2

Chemotherapy Drugs
CPT-11

CPT-11

Generic name: Irinotecan
Trade name: Camptosar®
Other name: Camptothecin-11

Chemocare.com uses generic names in all descriptions of drugs. Camptosar is the trade name for Irinotecan. CPT-11 and Camptothecin-11 are other names for Irinotecan. In some cases, health care professionals may use the trade name Camptosar or other names CPT-11 and Camptothecin-11 when referring to the generic drug name Irinotecan.

Drug type: CPT-11 is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. CPT-11 is classified as a "plant alkaloid" and "topoisomerase I inhibitor." (For more detail, see "How this drug works" section below).

What CPT-11 is used for:

* Metastatic colon or rectal cancer

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How CPT-11 is given:

* This medication is given by infusion through a vein (intravenously, IV).
* There is no pill form of this medication.
* Irinotecan is an irritant. An irritant is a chemical that can cause inflammation of the vein through which it is given. If the medication escapes from the vein it can cause tissue damage. The nurse or doctor who gives this medication must be carefully trained. If you experience pain or notice redness or swelling at the IV site while you are receiving irinotecan, alert your health care professional immediately.
* The amount of irinotecan that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side effects of CPT-11:
Important things to remember about the side effects of irinotecan:

* Most people do not experience all of the side effects listed.
* Side effects are often predictable in terms of their onset and duration.
* Side effects are almost always reversible and will go away after treatment is complete.
* There are many options to help minimize or prevent side effects.
* There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
* The side effects of irinotecan and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in greater than 30%) for patients taking CPT-11:

* Diarrhea; two types early and late forms.
* Early diarrhea: Occurring within 24 hours of receiving drug, accompanied by symptoms runny nose, increased salivation, watery eyes, sweating, flushing, abdominal cramping. (This can occur while the drug is being administered. If so, alert your healthcare professional promptly. Medication can be given to stop and/or lessen this early side effect).
* Late diarrhea: Occurring greater than 24 hours of receiving drug, usually peaks at about 11 days after treatment. Because of concerns of dehydration and electrolyte imbalances with diarrhea it is important to be in contact with health care professionals for monitoring, and for medication and diet modifications advice.
* Nausea and vomiting.
* Weakness.
* Low white blood cell count. (This can put you at increased risk for infection).
* Low red blood cell count (anemia).

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 10 days
Nadir: 14-16 days
Recovery: 21-28 days

* Hair loss
* Poor appetite
* Fever
* Weight loss

These side effects are less common side effects (occurring in about 10-29%) of patients receiving CPT-11:

* Constipation
* Shortness of breath
* Insomnia (see sleep problems)
* Cough
* Headache
* Dehydration
* Chills (see flu-like symptoms)
* Skin rash (see skin reaction)
* Flatulence (see abdominal pain)
* Flushing of face during infusion
* Mouth sores
* Heartburn
* Swelling of feet and ankles

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

* Fever of 100.5º F (38º C) or higher, chills (possible signs of infection)
* Fainting, dizziness, lightheadedness, dark colored urine (symptoms of dehydration)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

* Diarrhea (4-6 episodes in a 24-hour period) despite use of anti-diarrhea medication and diet modifications.
* Nausea (interferes with ability to eat and unrelieved with prescribed medication).
* Vomiting (vomiting more than 4-5 times in a 24 hour period)
* Extreme fatigue (unable to carry on self-care activities)
* Mouth sores (painful redness, swelling or ulcers)

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

* Before starting irinotecan treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
* Do not receive any kind of immunization or vaccination without your doctor's approval while taking irinotecan.
* In general the use of laxatives or stool stimulants should be avoided because of the potential for worsening diarrhea. Discuss any laxative use with your health care professional.
* Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (irinotecan) may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
* For both men and women: Do not conceive a child (get pregnant) while taking irinotecan. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
* Do not breast feed while taking this medication.

Self-care tips:

* If you have redness or pain at the infusion site apply ice and notify your health care professional promptly.
* Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
* Follow regimen of anti-diarrhea medication as prescribed by your health care professional.
* Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
* To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals. Sucking on lozenges and chewing gum may also help.
* You may be at risk of infection so try to avoid crowds or people with colds or not feeling well, and report fever or any other signs of infection immediately to your health care provider.
* Wash your hands often.
* To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
* Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
* In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
* Get plenty of rest.
* Maintain good nutrition.
* If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

You will be checked regularly by your health care professional while you are taking irinotecan, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How CPT-11 works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Irinotecan belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May apple plant. Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division.

* Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine.
* Taxanes: Paclitaxel and Docetaxel.
* Podophyllotoxins: Etoposide and Tenisopide.
* Camptothecan analogs: Irinotecan and Topotecan.

Topoisomerase inhibitors (such as ironotecan) are drugs that interfere with the action of topoisomerase enzymes (topoisomerase I and II). Topoisomerase enzymes control the manipulation of the structure of DNA necessary for replication.

* Topoisomerase I inhibitors: Ironotecan, topotecan.
* Topoisomerase II inhibitors: Amsacrine, etoposide, etoposide phosphate, teniposide.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Radiation Day #12

Day No 12 out of 28.. think last chemo is 8/27 and last radiation is 9/8?

OK So..

OK so my shot was off..way off..and my breathing was horrible.. but I was there and I felt almost normal again.. thanks Nick for not embarrassing me too much.. glad i got to cover you when you were tired also..

Basketball Sunday!!

So I lied... 2 games... he he..

What Are Friends For??

I'll try anything once..

Usually I...

..try to stay very positive however as of late it has not been easy so I haven't posted recently...

But after skipping a week of chemo I'm now feeling a little more normal.. putting in a full Saturday of work.. and getting in and holding about 3500 calories of 2Cal HN.

Basketball is out for tomorrow(may make a surprise appearance)but i am looking forward to training little Derek Sunday morning..

Radiation Day #10

Super Welterweight 148 and Counting

New Weight Class

Super Welterweight (ABC, WBA, WBC) Junior Middleweight (IBF, WBO) Light Middleweight (IBO)
Over 147 lbs to 154 lbs


Old Weight Class

Cruiserweight (ABC, IBF, IBO, WBA, WBC) Junior Heavyweight (WBO)
Over 175 lbs to 200 lbs

It's A Girl!!

Congratulations Heidi and Aaron!!

Aaron called this am... Heidi gave birth at 8:56?? am this morning!! Yeah loser that I am... don't even know her name.. but all are healthy and doing well.

Welcome..

...to my world.... 8 days and counting..

No Chemo Thursday -Tomorrow

Today started bad so my apologies for all my clients that I had to cancel..

Not a lot of positive to say now so will wait until I'm feeling better tomorrow..

Out Again..

It's been hard keeping fluids or calories in lately..up at Exeter Monday for an IV... think maybe I'll be scheduling IV's Mondays from now on...the CPT-11 kicks the shit out of you..literally.

Good news is I have a by this week for the chemo...so 2 down and 2 to go..

Originally thought I was on for 6 weeks but found out for 5 weeks.. then they tell me week 3 is off because my chemo protocol is so harsh..

This is somewhat of a miss communication as i have asked the right questions.. they just cannot get it right.. oh well.. my favor

Out of Work Today

New developments are keeping me out of work today.. running up to hospital for some fluids and nourishment's... a little recharge...

Basketball Sunday

,,didn't happen..too dehydrated, weak, sick and run down..bad Saturday didn't help.

Was nice seeing brother Mark and wife Kathy..

Love You Renee!!

The nut and the tree... don't they look alike??