I've noticed most people have had Cisplatin as part of their chemotherapy protocol. My friend has BOT cancer and just completed radiation 11 days ago, but still has more chemo treatments to finish. He's had two bouts of low white blood counts with fever. He takes Carboplatin. Did anyone receive Carboplatin and take Leukine to rebuild white blood cells?

Andie
Friend to Stage 1A BOT patient; Dx April 6, 2008. 35 IMRT treatments ended June 23, 2008. 10 more Carboplatin treatments to go.

I had cisplatin initially (2x) the was switched to carboplatin (5x).

After 3 carboplatin treatments my white count tanked as well and I was given Neupogen (which is similar to Leukine, different source and company). This was concurrent with the radiation.

M

I was told by my chemo doc after I suffered permanent hearing loss from the Cisplatin that had he known I would have had that bad reaction he would have given me Carboplatin. Not to comforting after the fact but he said that Carbo seems to be just as effective as Cis but without Cis' bad side effects. Two years ago Cis was the "Gold Standard" chemo for SCC and it still appears it is now.

Thanks for the info. Markus, were you given Neupogen 24 hours after each treatment? My friend wasn't given the Leukine until his WBC had plummeted to 1.5 and a fever developed. They are talking to the oncologist on Monday about giving him the Leukine after each treatment to prevent the WBC from falling to such dangerous levels. It seems prevention is the order of the day instead of treating the neutropenia once it's appeared. Have a great weekend!

Andie

Well
carboplatin is not without problems either, it appears to be more myelosuppressive than cisplatin. I was also told that Carbo- is just as efficient as Cisplatin. Which begs the question why they start you with Cisplatin. Right?, right!. Also, if you look at my signature you see that the dose is 6(!) times higher. They combat the mediocre performance with a much higher dosage. What is perhaps more important is that your friend get a large number of smaller dosages, which in my mind makes a lot more sense.
As far as I recall I got the neupogen shot a before the chemo, I think it was a couple of days before. However, that was at the end of my treatment and things are a tad hazy... also I only got 2 shots....

Best
M

Markus, he's had 5 Carbos so far. He has 10 more weekly treatments to go. Since he has hearing loss from Vietnam, they decided to go with Carbo. He has 3 treatments a month and then a week off. At the end of each month his WBC has bottomed out. If they know that he is predisposed to this side effect, why don't they go ahead and give him the shot after the treatment. They gave him chemo one week when his WBC was 3.1. You can only imagine what happened two days later. Fever of 103.5 and a WBC of 1.5. Did you take Carbo every 3 weeks or on a weekly basis.Still think prevention is better. How long before you went back to work?

Andie

Andie,
I had 7 weeks of cis/carboplatin (2xcis and 5xcarbo). This was concurrent with IMRT.
From what I understand is that the low point in WBC occurs usually 3-4 weeks after the first carboplatin infusion, after which it recovers by itself. I am not sure if they refer to weekly or other regimen (dose etc). However, this seems to fit with what I had my WBC tanked after 3 weeks of carboplatin. So it could make sense to give the neupogen shot prophylactically for a few weeks. My guess is that they cannot give you the drug unless they have a clear indication that you need it... i.e. when the WBC is in the basement.
These would be things to discuss with your MO, preferably in advance.
Getting back to work...
I looked at my old calendar just to make sure... I went back to "work" on the 30 of July (07). This was (way) too early; I recall that just walking from the parking deck to the lab totally exhausted me and I had to take a nap.


M

Thanks Markus. He went to his ENT today and he put him on another antibiotic and a steroid. DId you take a steroid? He plans to go back to work Aug.4, but with the way he still feels right now, it seems rather unlikely. MO said he'd watch the WBC very closely. His WBC today was 3.9 after 4 shots last week. Hopefully, it will get higher before his next chemo treatment on July 25. it seems like it takes the WBC to regenerate themselves. Hope all his well with you. Have a great week.

Andie

Andie,
I did not have steroid shots. The recovery after IMRT is (very) slow. There is no comparison to a surgical procedure, although if you look at my signature, this was minor to what other people had to go through. The "rule" is one month for each week of radiation, this however in absence of any ongoing chemo treatments. If you read this board you find that there is quite a bit of variation with down- and recovery times. At this point I still see progress (taste, food tolerance etc).

M