All about Xeloda

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  • SandiBeach57
    SandiBeach57 Member Posts: 1,617
    edited April 2020

    Just a note about Xeloda. The drug is metabolized first by the liver into a form of 5FU, then again in the tumor cell, where it is further metabolized into 5FU. This is where the RNA or DNA is destroyed within that cell to stop division and cause cell death. Our kidneys have the big job to clear the drug from our body. This is how my MO explained it to me.

    Even with previous widespread liver mets in 2016 and again recently, I have enough healthy liver tissue to handle this drug. Both liver and kidney labs will be monitored.

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  • JoynerL
    JoynerL Member Posts: 1,393
    edited April 2020

    Sandi, that's so interesting. I didn't realize any of that.

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  • NicoleRod
    NicoleRod Member Posts: 2,906
    edited April 2020

    Thriving... :)

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  • snooky1954
    snooky1954 Member Posts: 883
    edited April 2020

    Wish me luck everyone. Onc appt. this morning had scans earlier this week. I suspect he'll take me off of it. He wanted to 2mos ago but I talked him into awhile longer. He wants me back on IV chemo

    Good luck to you Nichole, I think I read you were scanning this week. Really hope it's working for you.

    I'll report back.

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  • goldie0827
    goldie0827 Member Posts: 6,595
    edited April 2020

    Wishing you all the luck in the world Snooky!

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  • LisaPizza
    LisaPizza Member Posts: 10
    edited April 2020

    Hello all. I haven't been here for a while. Thought I'd share with you this graph I found on NCBI which explains the whole food thing with xeloda. Group A fasted and only was tested for one dose. Group B ate 30 minutes before tablets taken twice daily for 14 days.

    Capecitabine (Left graphs) gets converted by the liver into 5FU (right graphs).

    However 5FU is most effective the longer it is in your system (ie. area under curve).

    Longer duration = less time for tumours to grow.

    So you can see the point of the food is to extend how long the 5FU is in the system. (Middle row, right graph)

    Side notes on fasting:

    • 5FU is absorbed 10 times more by tumours than healthy cells.
    • Separate studies suggest that if you fast (~16 hours) before chemo there is even less uptake of chemo by healthy cells (less side effects).
    • there appears to be little difference between day 1 fasting and day 14 nonfasting in this study. So perhaps the person who commented earlier that they got told to fast pre chem was having bad side effects? and you can see why fasting might be an option to consider? Maybe you get enough 5FU but less is absorbed by healthy cells? Maybe.


    Thank you for listening to my TED talk 😁

    image

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  • snooky1954
    snooky1954 Member Posts: 883
    edited April 2020

    Well, I thought today's visit would go so much different. two months ago, the Onc tried to take me off zeloda and put me back on Taxol. I pleaded for more time. Well, my scans were good, no new growth anywhere. So he's keeping me on zeloda, I'm so happy.

    Goldie, you wished me just the right amount of luck!

    Heart

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  • goldie0827
    goldie0827 Member Posts: 6,595
    edited April 2020

    Snooky, I did 5 years on Xeloda, wishing you at the very least, the same if not more. It has it's down side, but I'll take that over the inevitable. Not sure I will ever go back to IV chemo.

    Heart

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  • DivineMrsM
    DivineMrsM Member Posts: 9,620
    edited April 2020

    snooky, great news to hear! Very happy for you. So glad you went with your instincts and convinced your oncologist to stay the course!


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  • Denny123
    Denny123 Member Posts: 1,886
    edited April 2020

    Good luck snooky! I have been on IV chemo for 18 years, but no biggie for me.

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  • Kattysmith
    Kattysmith Member Posts: 738
    edited April 2020

    Snooky, that is GREAT NEWS!!!

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  • snooky1954
    snooky1954 Member Posts: 883
    edited April 2020

    Thanks for all your well wishes. It truly means a lot.


    Heart
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  • JoynerL
    JoynerL Member Posts: 1,393
    edited April 2020

    Snooky, great new! Hooray!

    LisaPizza, thanks for the very interesting data! I hadn't known a lot of that. Here's to years on Xeloda for us all-

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  • snooky1954
    snooky1954 Member Posts: 883
    edited April 2020

    Amen to years for all of us! Thank you Joyner for your warm wishes

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  • lizo1
    lizo1 Member Posts: 91
    edited April 2020

    Snooky - Very happy to hear the good news for you! Prayers for continued good health!

    Grant

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  • SandiBeach57
    SandiBeach57 Member Posts: 1,617
    edited April 2020

    Does Xeloda cross BBB? Cannot find definitive data.

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  • snooky1954
    snooky1954 Member Posts: 883
    edited April 2020

    Thank you Lizo

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  • Imagine
    Imagine Member Posts: 165
    edited April 2020

    Lynn

    What a view! I love the Northern Neck, we stayed at the Tides Inn a few times and a really cute Bed and Breakfast, cant remember the name?! I have still not even had my first scan after starting TX because of the virus, they have shut down the Pet Scan Mobile Unit for now, hopefully by next month. I’m on Ibrance and Falsodex and just noticed this is the Xeloda thread, not even sure I have heard of that medicine yet. Trying to learn how to navigate thru the virus and mets...so much to get used to. Hope you are well

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  • JoynerL
    JoynerL Member Posts: 1,393
    edited April 2020

    Hi, Imagine. We're one mile from the Tides Inn, and I'll bet that the inn was either the Hope and Glory or the King Carter Inn. It was the King Carter Inn for decades, and the new owner years agos changed it to the Hope and Glory. Good luck on ibrance and faslodex. I had wonderful results for 23 months on that combination before needing to go on to xelota. So far, so good on Xeloda.

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  • SandiBeach57
    SandiBeach57 Member Posts: 1,617
    edited April 2020

    Well Day 14, cycle 1, feel like crap. Been in bed 5 days..too tired. Heels are swollen and red, so keep on ice and elevate (not hard as I am in bed..ha). The D started today. I think my MO is trying to secretly kill me.

    But alas, no, I am to hold last dose and go in for labs tomorrow. Guess she cares afterall..

    But if it means I might lose opportunity to kill liver mets, I will do it again. I am on 3300 mg total daily dose. 5'5 and 123 pounds. It was the right starting dose.

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  • JoynerL
    JoynerL Member Posts: 1,393
    edited April 2020

    Oh, Sandi...that's rough. I'm wondering if she'll reduce your dosage and/or put you on 7/7.

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited April 2020

    Sandi, well, define “right starting dose”. Based on a trial where they determined the dose by what almost killed people but not quite? Sometimes dose reduction is what it takes. How can you be on 3300 when the pills are 500 each? I started at 2500 and after a while went to 2000. There is data showing efficacy with doses that still allow people to get out of bed.

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  • SandiBeach57
    SandiBeach57 Member Posts: 1,617
    edited April 2020

    JoynerL, my MO said 14/7 for now to hit the liver mets hard. Then maybe later..

    SP, yeah, the tablets also come in 150mg size. So three 500mg, plus one 150 mg, taken twice a day.

    Guessing that standard dose is not working for me..I am being sarcastic.l

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  • lizo1
    lizo1 Member Posts: 91
    edited April 2020

    Sandi - My wife Liz is also on 3300mg/day, 14/7. She is 6' and 160lbs. Her starting dose was 3600mg and they reduced it after about 10 cycles.

    Grant

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  • snooky1954
    snooky1954 Member Posts: 883
    edited April 2020

    Wow so many different doses so many different Onc opinions! My situation is strange. Back in July I was put on 3000 per day. Problem with Medicare (all straightened out now) so I had to buy first script. My thinking was I can't afford this so while I was trying to get benefits straightened out I started (on own just 2000 per day 14/7. Then the state stepped in and purchased 2mos whi' le I was working with Medicare. So I upped the dose to 2500 per day. The second week was awful, so I switched to 7/7 at 2500. Please understand I did all these changes on my own.

    So time for Onc visit. He was not amused that I was on 7/7. He insisted that I go back to 14/7 but he said to drop it back to 2000 a day. Well, it's working. Last visist I offered to go back up to 2500 and he said it wouldn't make any difference as far as the cancer is concerned it would just cause more SE. He said we found the dose, that works for me with great QOL we'll stick with it.

    I have no side effects no HFS no stomach issues, just fatigue in 2nd week.

    I know I am very blessed and thank God daily.

    For those interested, I'm 5'3 and 140 #



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  • JoynerL
    JoynerL Member Posts: 1,393
    edited April 2020

    Great news, Snooky! And an excellent assessment.

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  • SandiBeach57
    SandiBeach57 Member Posts: 1,617
    edited April 2020

    Snooky, it is good to know that effacy still works at lower dose.

    Today, I ended up getting fluids, stupid of me to let "D" get upper hand. But found out my labs were great, well, except SGPT and SGOT - were still elevated. Afterall, it has only been 14 days.

    What really surprised me is that my white cells, hemoglobin and platelets were the highest that I have seen them since 2017. Wow. Good job bone marrow.

    So, if hemoglobin is normal, why am I so fatigued to the point of being bedridden? My body must be really working hard to kill cancer....

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  • Denny123
    Denny123 Member Posts: 1,886
    edited April 2020

    Sandi, my nurses have told me that the reason for my fatigue is because my body is fighting the cancer cells. That, and I guess also the fact that I have been on chemo for 18 years.

    My blood counts are good.

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  • SandiBeach57
    SandiBeach57 Member Posts: 1,617
    edited April 2020

    I think I am heading towards dose reduction.

    9 days of bed/reclined position due to fatigue

    4 days diarrhea, improved with immodium, zofran, BRAT diet, gatorade and water, IV fluids

    5 days fire feet, improving while on OFF cycle, but now deep inflammation in feet, so cannot walk (on naproxin, ice) or put pressure on feet. Advice needed.

    Cycle 1: Currently on 3300 mg/day, 5'5", now weigh 122 lbs. Hoping for reduction to 2500 mg/day with same efficacy to kill liver mets. We will see what is advised.

    The good news, my labs were the best that I have seen since coming off I/L. Hgb, platelets, ANC were almost normal. This does not include my SGPT, SGOT..still elevated from new mets.

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  • Denny123
    Denny123 Member Posts: 1,886
    edited April 2020

    Sandi-that sounds really bad. A lower dosage should definitely be considered.

    I am only 5'1" and weigh more than you do, and doing okay on 2,000 at one week on, one week off. It has kept me NED for over 2 years.

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