Adding ginger capsules to standard treatment for chemotherapy nausea reduced nausea and vomiting from chemotherapy.

Patients who got ginger (Zingiber Officinale) in capsules twice a day for three days before chemo and three days after reported significantly less nausea that those who were treated with placebo.  All patients in the study also received standard anti-nausea therapy on the day of chemo.

Almost 650 patients, mostly women, were randomly assigned to ginger supplements or a placebo in a blinded trial that will be reported at the 2009 ASCO annual meeting. Read the rest of this entry »

We need to monitor not only for liver function but also for kidney function. However kidney problems are much less frequent.

Patients who undergo chemotherapy know that every time they receive chemotherapy, oncologists take blood to test for blood counts and also for liver and kidney function. Read the rest of this entry »

Adding Erbitux to standard first line treatment for colorectal cancer of CAPOX with Avastin doesn’t help.  In fact, patients who receive the additional agent have a shorter time until their cancer gets worse and have worse side effects.

Results of a randomized phase III clinical trial that added the monoclonal antibody Erbitux® (cetuximab) to Xeloda® (capecitabine), oxaliplatin, and Avastin® (bevacizumab) showed shorter time to cancer progression for patients who got Erbitux in addition to the standard treatment. There was no difference in whether the tumor shrank or overall survival time. Patients who got Erbitux were about 20 percent more likely to have tumors get worse or to die than patients who didn’t.

This was the first chemotherapy treatment for metastatic cancer that these patients were given.  All of them had metastatic tumors that had spread beyond their colons.

While patients with wild-type (normal) KRAS genes in their tumors had longer progression-free time on Erbitux than those with KRAS mutations, that time did not reach the median progression-free interval for patients in the standard treatment group. Read the rest of this entry »

Most of us love cocktails. . .Manhattan, gin and tonic etc. We know, depending on what we use and how they are mixed, they may taste different.

Well, for the treatment of colon cancer patients we have different cocktails to choose from such as FOLFOX and FOLFIRI. Both are combinations of 5-FU and leucovorin and either irinotecan or oxaliplatin. Both regimens have similar efficacy and similar extent of side effects, with oxaliplatin having more neurotoxicity and irinotecan more diarrhea.

However, depending how you mix and deliver the three drugs you may have significant differences in toxicity. It is amazing what differences exist among oncologists in how they mix up their chemotherapeutic cocktails. Not only the doses but also the timing of administration can differ dramatically, which can result in differences in toxicities for patients.

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Many patients with metastatic disease ask how long we should do chemotherapy. This is astonishing since when we are diagnosed with diabetes or hypertension we usually would not ask the same question. Of course, for patients with metastatic disease we continue as long the chemotherapy works.

A lot of patients ask whether you can take a break from chemotherapy, particularly around the holidays or vacation times. Do you take a break from insulin or your high blood pressure medication? In the last two years, clinical trials have been conducted to answer exactly this question.
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