Getting ready for Alimta/cisplatin chemotherapy for mesothelioma

This was written by Lois Schwarting, regarding her husband’s experience with Alimta/cisplatin chemotherapy for his mesothelioma.

Marty got Alimta/cisplatin. Carboplatin is a little bit easier on the body, or at least easier on the kidneys. Here’s some things to do to prepare for the chemos! If your husband has more trouble with being constipated than he does having loose stools, buy a stool softener and have ready for him. Here in the states we can easily get Dulcolax and that is what Marty uses.

Now, with Alimta Marty was to take folic acid something like 600 to 1000 mcg or 1 mg each day for one week prior to chemo. We bought 400 mcg tablets at COSTCO–anyhow, he took one tab in a.m. and one tab in evening since two to take for good dosage. I have decided to scan his calendar for last May (2007) and you can see how I marked calendar so be sure to have him taking his meds properly! Guess better to know what your husband is going to be given as chemo b4 tellyouwhat all….

Ah! Anyhow, using Alimta/cisplatin…Day before, day of and day after chemo – dexamethasone to be taken twice day. Day following chemo go back to doc office for Neulasta shot (this is to increase white blood cells to help fight off any infection or bacteria from ANYTHING – because the chemo is hopefully going to destroy all cells, including cancer ones, but it is not “smart enough” to detect the good red and white cells are needed so destroys them too. So, reason for the Neulasta and also the B12 shots the doc will give you as necessary! Anyhow the Neulasta shot can cause bone pain and/or body rash or itching, so we were told to buy over-the-counter Claritin D & Aleve and Marty was to take one tablet of each after receiving the Neulasta shot – we bought on way home and he swallowed them with water when we got home. He took one of each of those tablets the day of the Neulasta shot and one of each tab on all three days following. Marty did not have any bone pain, and he did not have any rash. Some times he would have some itching, but slight.

To begin with, Marty had his chemo on Thursday. One week we switched it to Friday, and so he went back for his Neulasta shot on Monday, and it didn’t seem to make any difference.

Now, on the calendar, you will see where I had written blood draw on Wednesdays. That is because he was to have his blood drawn the day prior to chemo infusion. If his blood counts were too low, the doctor would not have given him chemo the next day. However, he never had that problem and always was able to get the chemo every 21 days until he had a total of 7 infusions.

Marty was released from hospital, Mar 9, 2007.

On Mar 14, 2007 he went to doctor office and agreed to chemo and we were told which meds used and given Rx for dexamethasone. Marty was given a B12 shot and we were told to get the folic acid and he was to start on that the same day so he would be on it for one week prior to chemo. (also, be aware that ALWAYS schedule and plan to take Folic Acid (FA on my calendar notes) every day and mark out at least 21 days from the day of chemo — NO MATTER WHAT… Because even at the end of chemotherapy, the patients are to take folic acid for 21 days following last Alimta chemo treatment.

Be sure you have a prescription for compazine (brand name) was given for nausea – JUST IN CASE! We got that filled, as well. Oh, note that I wrote compazine on the days of chemo as well as the day following chemo. YOU DO NOT WANT TO WAIT UNTIL NAUSEA SETS IN AND THEN TRY TO FIGHT IT. TRY TO WARD IT OFF BY TAKING THE COMPAZINE AFTER YOU GET HOME THE DAY OF CHEMO, AND TAKE EVERY 4 HOURS TIL BEDTIME. NEXT A.M. start the day off with compazine and continue every 4 hours. If not trouble with nausea, could discontinue taking it.
Ask for a prescription of Ondansetron Orally Disintegrating Tablets (ODT) – they are a bit expensive and may have to get prior approval by insurance. We had to! I’d actually gotten these before we were to go on a cruise in case Marty might have problems with nausea even though would be off chemo by then. We happened to have in the house already when he got the “dry heaves” and I gave him a tablet and it stopped the dry heaves RIGHT NOW! YEP, RIGHT NOW IT WORKS!

FOOD: I made puddings and soups and gravy with WHOLE MILK (not less fat or fat free) and even used HALF & HALF. I tried whipping cream but it was so rich and thick it was yuck or not good! The texture more like ice cream! Anyhow, I hope you like to make home made food, Marjory. If so, cook lots of fresh vegetables and protein foods. It is better for your husband to eat small portions several times a day — try to get him to eat every 3 hours or so. Use plastic sandwich bags or some small containers to freeze little “meals” for your husband to eat “on demand”…. if you have food put away in the freezer from each meal you cook, you can say: “I have ________, _________, ___________ and __________ tell me which one you want! Then, you can just reheat and give him a meal.” At first Marty liked sweets, and I’d made triple batches of strawberry/rhubarb cobbler and would freeze packages of it. I’d make puddings. Bought all kinds of fresh fruits. Had bought Ensure for him. After his second chemo he no longer wanted to eat sweets – the “taste buds” on the tongue are affected by chemo! He liked salty foods! Like pork roast cooked with sauerkraut. Dill pickles.

He has ALWAYS wanted to eat eggs and though you will read to make sure you cook the eggs until they are “hard” we did not abide by that!

If your husband likes deviled eggs (cut the hard-boiled egg in half, scrape out the yolk and mix with “stuff” then place back in the hard-cooked white of the egg) – fix some of them for him. At first I would mix the yolk with mayonnaise and little bit of mustard and maybe bit of chopped onion for more flavor. When he wanted “salty” or “sour” type, then I would add some vinegar to the yolk.

Anyhow, EVERY SINGLE MORNING SINCE CANCER WAS DIAGNOSED, I have fixed him two eggs “over easy” (with the yolk still runny), two slices of bacon, one slice of wheat bread, and gravy made with milk or half and half and the bacon drippings. He has ALWAYS LIKED THAT. Before cancer I did not cook breakfast for him. I worked and he often times would not even eat breakfast. Since “Mr. Meso” breakfast is his FAVORITE MEAL of the day, and so I always fix it for him about 1/2 hour after he awakens.

For a full profile on Marty and Lois, click here.

“Flush with cash” mass poisoner can’t yet write off its asbestos liability

The Associated Press reported that “Several W.R. Grace & Co. lenders have refused to continue offering bankruptcy loans to the company, forcing it to cut back its Chapter 11 finance package from $250 million to $200 million, a lawyer said Monday. ‘We have yet to receive the full amount … that we have been asking, Janet Baer, attorney for the company told the judge overseeing Grace’s long-running bankruptcy restructuring.”

Click here for complete story 

The article goes on to say that Grace is “flush with cash” as it maneuvers to get out of Chapter 11 bankruptcy, discharge all of its debts for poisoning thousands, and return to business with a healthy bottom line. This bankruptcy scam has been pursued by dozens of major companies as they stick victims with minuscule payouts for death and terminal disease, then return from faux bankruptcy to continue earning millions in profits—with neither the bankruptcy courts nor the public every questioning why profitable companies should be allowed to put their profits into the pockets of shareholders rather than the pockets of the people they poisoned.

Cancer commentary #2

Patient “S.G.”

You can’t believe it’s happening to you, really you can’t. First they cut out my colon and then radiated me twenty-five times each time was like being put in a microwave and then I had ten chemo treatments and each one of those made me sick beyond belief, then more surgery for blockages and things you just can’t even bear to know what they are, they’re so bad.

And all the time you can’t believe it’s you and your body, the one you’ve had all your life that’s just failing on you. You want to know about faith in God? That’s my rock. God, my family, and my doctors, in that order, faith like a rock and the will to live. Your will to live has to be more tenacious than the cancer. Take it one day at a time, beat back the depression that’s dogging you at every turn, beat it back with with a smile, an iron smile that refuses to bend.

Cancer commentary #1

Patient “M.N.”

Do not accept the first thing you’re told if something inside you rebels. I went to my family doctor in 2006 only to have my complaints ignored. “You’re stressed out,” and “Take some time off,” was the best I could get. Excuse me, Mr. MD, but my cancer wasn’t taking any time off. It was spreading like wildfire.

You have to listen to your inner voice, and I didn’t listen to mine. I listened to the words of an expert, who it turns out wasn’t an expert at all. He’d never seen a case of mesothelioma in 25 years. Because I was only 32 nobody pushed to get real answers.

But nothing in life is all good or all bad. It varies depending on your mood, your situation, and the ebb and flow of the illness itself. My cancer brought me closer to my family. I learned who my friends were, and I cherish them now. I have changed my approach to life, because there’s so much less of it left. The minutes, the seconds, really do matter, and the funny thing is, they mattered all along—it just took a terrible disease to show me. The me that used to hold grudges is gone, or rather the grudges are gone, replaced with a funny kind of clearness.

French company hit with fines, prison, for poisoning workers

The Court of Appeal in Douai, northern France, has upheld the decision to fine a power generation equipment manufacturer that exposed its workers to harmful asbestos dust. The ruling is a first in France, as the company was also ordered to pay damages to all employees exposed to the risk, regardless of whether they had been directly affected or not.

From 1998 to 2001, workers at Alstom Power Boilers’ site in Lily-lez-Lannoy were exposed to asbestos dust in what the court described as a “deliberate violation” of the firm’s health and safety obligations. The list of Alstom’s failures included not providing sufficient information for workers regarding protection from the harmful substance.

As a result of sustained exposure, seven of the company’s employees died, and 30 per cent of the workforce developed some form of asbestos-related disease. On Thursday, 6 March, the French Court of Appeal ruled to uphold Alstom Power Boilers’ €75000 fine – the maximum penalty available. However, former plant manager Bernard Gomez, had his suspended prison sentence reduced – from nine months in the original judgement at the court of Lille in September 2006 to just three months. His €3000 fine was upheld at appeal.

In December last year, civil proceedings saw Alstom ordered to pay €10,000 in damages to each one of the 150 workers who were employed on the site during the three-year period.

Ford Motor Company appeals record asbestos judgment in Australia

Ford Australia has lodged an appeal against a landmark decision to award a former mechanic $840,000 compensation for exposure to asbestos when he worked at Ford car dealerships. Antonino Lo Presti, 58, was the first motor mechanic in Australia to win a successful negligence verdict against a car company for exposure to asbestos, last month in the West Australian Supreme Court. Mr Lo Presti used compressed air to blow out the brake drums and handled asbestos brake linings when brakes were serviced or changed between 1970 and 1971 at two Ford dealerships he worked at.

Complete story here.

Information about mesothelioma medical and legal options provided by the Law Office of Roger G. Worthington, P.C., www.mesothel.com.

Epidemiology of mesothelioma in South East England: multimodal treatment increases survival times

This study describes trends in the incidence of mesothelioma for men and women in South East England and the geographical variation at the level of primary care trust. It also describes treatment patterns by cancer network of residence, and relative survival by cancer network, disease stage and treatment modality.

5753 cases were extracted from the Thames Cancer Registry database. Men had five times higher incidence of mesothelioma than women. In men, there was an overall 4% increase per year between 1985 and 2002. Over the same period, the overall increase in incidence for women was 5% per year. The incidence was highest in men aged over 70 years and men aged over 80 years had the highest increase of 8% per year. The incidence rate ratio increased for men born between 1892 and 1942 and started to slow for those born from 1947 onwards. Areas along the Thames and its estuary had the highest incidence. There was some variation by cancer network in the proportion of patients receiving cancer surgery, radiotherapy and chemotherapy. There were no discernable difference in relative survival by cancer network of residence or disease stage but those receiving combined treatment had higher 5 year survival.

Mesothelioma incidence has increased in South East England, particularly for men aged over 70 years. The highest incidence occurs along the Thames and its estuary reflecting areas of asbestos use in shipbuilding and industry in the past. More research is needed to understand the interrelationships of prognostic factors, treatment choices, and survival and to determine the best care and support for these patients and their families.

From PubMed: Thorax. 2007 Aug 3; The epidemiology and treatment of mesothelioma in South East England 1985-2002, Mak V, Davies EA, Putcha V, Choodari-Oskooei B, Moller H., King’s College London School of Medicine at Guy’s, King’s and St Thomas’ Hospitals, United Kingdom.

Information about mesothelioma medical and legal options provided by the Law Office of Roger G. Worthington, P.C., www.mesothel.com.

P/D v. EPP: results in 663 patients

OBJECTIVE: The optimal procedure for resection of malignant pleural mesothelioma is controversial, partly because previous analyses include small numbers of patients. We performed a multi-institutional study to increase statistical power to detect significant differences in outcome between extrapleural pneumonectomy and pleurectomy/decortication.

METHODS: Patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy or pleurectomy/decortication at 3 institutions were identified. Survival and prognostic factors were analyzed by the Kaplan-Meier method, log-rank test, and Cox proportional hazards analysis.

RESULTS: From 1990 to 2006, 663 consecutive patients (538 men and 125 women) underwent resection. The median age was 63 years (range, 26-93 years). The operative mortality was 7% for extrapleural pneumonectomy (n = 27/385) and 4% for pleurectomy/decortication (n = 13/278). Significant survival differences were seen for American Joint Committee on Cancer stages 1 to 4 (P < .001), epithelioid versus non-epithelioid histology (P < .001), extrapleural pneumonectomy versus pleurectomy/decortication (P < .001), multimodality therapy versus surgery alone (P < .001), and gender (P < .001). Multivariate analysis demonstrated a hazard rate of 1.4 for extrapleural pneumonectomy (P < .001) controlling for stage, histology, gender, and multimodality therapy.

CONCLUSION: Patients who underwent pleurectomy/decortication had a better survival than those who underwent extrapleural pneumonectomy; however, the reasons are multifactorial and subject to selection bias. At present, the choice of resection should be tailored to the extent of disease, patient comorbidities, and type of multimodality therapy planned.

J Thorac Cardiovasc Surg. 2008 Mar;135(3):620-626.e3. Epub 2008 Feb 14
Flores RM, Pass HI, Seshan VE, Dycoco J, Zakowski M, Carbone M, Bains MS, Rusch VW.
Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.

PMID: 18329481 [PubMed – in process]

Funding for study of Iron Range mesothelioma moving through House

Funding for a study of mesothelioma and its connection to mining taconite is moving through the state House. Representative Tom Rukavina says Iron Rangers have been waiting 30 years to find out if taconite does, or does not, produce asbesto-like fibers that cause the cancer.

His funding bill was passed last week by the House’s Higher Education and Work Force Development Policy committee. If adopted, $4.9 million for the University of Minnesota study would come from the state Worker’s Compensation Fund. The bill has another House committee to clear before going to the floor for a vote. The Senate has yet to hold a hearing on the issue. The latest count from the state Health Department says 58 people in the area have died from mesothelioma.

Associated Press, March 2008.

4th annual asbestos awareness day conference

The 4th Annual Asbestos Awareness Day Conference will be held on March 29th with a Remembrance Service on March 30th 2008. This conference is made possible with the support and collaborative efforts from Barbara Ann Karmanos Cancer Institute, Wayne State University, and the International Ban Asbestos Secretariat (IBAS). Their mission is to provide the most advanced medical, occupational and environmental information available about asbestos related disease to individuals throughout the world.