Hi there,

I have posted a few times in the past. Quick recap - I am 4 years out from SCC treatment and all is well in that area. Last September I presented with a soft tissue sarcoma presumably induced by radiation. I had an exploratory surgery in December '07 in which they found they could not resect at that time. Underwent 3 rounds of chemo in Jan. Feb. and Mar. '08 and then surgery again in May '08 when they were able to resect the sarcoma and do some grafting in the thoracic inlet area with a vein from my ankle. Now the docs want to put me on a 6-month regiment of Methotrexate for maintainence. This consists of 6 pills on a Wednesday once a week. Does anyone have any experience with Methrotrexate such as side effects and tolerance? I was eating pretty well following the treatment of the SCC but each subsequent chemo and surgery takes a little of that ability away and I would like to maintain what ability I currently have. Any input would be appreciated.

Thanks,

Pam

Hi Pam,

First off, let me tell you that I have not had OC - that hit my brother. However, I have Rheumatoid Arthritis and have been taking 25 mg MTX per week since 2001. I can at least tell you what my experience has been.

My medicine comes in 2.5 mg pills, so I take 10 pills per week. I have been told by my rheumatologist that 25 mg/wk is the maximum that one should take. MTX has been used for over 20 years as a standard treatment for RA. There are stronger treatments, but they are harder for people to take.

You used to have to get a liver biopsy every 5 years, but my rheumatologist at Northwestern University doesn't think that is necessary. I'm not sure if that is because of my experience with RA or because of a change in treatment protocol.

I have to get blood work every 6 weeks. Not a big deal.

I used to take the pills all at once, but now I split my dose into 6 pills on Sunday night and 4 pills on Monday morning. This is OK with my doctor. If I didn't split it, then I would have moderate stomach discomfort. Other RA patients have told me that they have experience thinning hair. That has not happened to me. So, basically, the MTX helps me a lot with very few side effects!

One more thing - the label says that you're not supposed to drink when taking this. My rheumatologist told me not to worry about that and it was ok to have a drink once or twice a week.

Jean

Jean,

Thanks for responding so quickly. After reading some of the side effects online and in the patient literature included with the prescription, I was a little apprehensive about taking it. Mine are 2.5 mg pills also and I am to take 6. My doctor did say he would do blood work every 6 weeks. My doctor himself takes it weekly for RA. Really don't want the thinning hair as it is just now growing back from the chemo earlier this year, but I still have my hats and wig! Glad to hear your brother is doing well - I am doing fine as to the OC - it's the sarcoma that is giving me more problems than the oral cancer did. Chemo was really rough on me and I lost a lot of weight I couldn't afford to lose and really don't want to experience that if I can help it. Thanks again and I hope everything continues to go well for you and your brother.

Pam

Pam,

I wonder if you can split the dosage like I do. You might want to ask if you can.

I worked my way up to 10/wk. The first two weeks, I took 5/wk. Then, I added another one each week. My rheumatologist wanted to start out at the lowest dosage that reduced the R.A. inflammation.

Also, MTX can sometimes cause oral sores ... just what you need to hear, I'm sure. They are very, very, very small. Most sores will go away if you take extra folic acid. Mine disappeared about 3 days after I started taking extra folic acid.

You may have seen this already. The Arthritis Foundation website says that these are the most common side effects: Abdominal discomfort; chills; dizziness; fever; general feeling of illness; hair loss; headache; increased sun sensitivity; itching; liver problems; low blood counts; mouth sores; nausea and stomach upset; rashes; shortness of breath; yeast infection.

Nothing bothers me with it now. Hope it is smooth for you, too.

Jean