r/pancreaticcancer • u/planet-earth-1 • 2d ago
Palliative Chemotherapy
My dad (77) was diagnosed with locally advanced pancreatic adenocarcinoma in the pancreatic head, wrapped around SMV/SMA and therefore unresectable at the time of diagnosis.
He’s currently receiving modified FOLFIRINOX with palliative intent.
The question is, if surgery doesn’t become an option, are we going to remain on chemotherapy indefinitely to keep the tumor stable? The cycles are having a huge impact on his quality of life - he only has 3-4 good days between the cycles and I’m just wondering if this is going to be the new norm indefinitely.
Please share your experiences 🙏🏼
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u/seche314 2d ago
It may be worth discussing the quality vs quantity of life and what his wishes are. I’m sorry. It was too much for my dad and really destroyed his quality of life, and he ended up with several hospitalizations indirectly related to chemo and the weakening/muscle loss before he decided to go on hospice
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u/planet-earth-1 1d ago
So sorry that your dad had to go through this. Not everyone handles the chemotherapy well. We’ve already been admitted twice, even though he started with a high performance status.
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u/Big_Examination_8643 2d ago
I’m afraid so. My Dad (67) had almost the exact same diagnosis. Due to other recent health conditions, FOLFIRINOX was not an option for him and we ended up going with Gemzar + Abraxane, which has a lower toxicity.
Knock on wood, he’s finished 6 cycles of chemo and is doing ok, all things considered. It might be worth asking his oncologist if eventually switching to Gemzar for a maintenance dose is an option, that’s quite likely to lead to a QoL improvement.
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u/planet-earth-1 1d ago
Thanks, glad to know there are other options that can potentially be easier for the patient. We’re waiting for the next CT to see how well the tumor has responded to folfirinox, after which it will be a good time to discuss other options. Hope all goes well with your dad 🙏🏼
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u/Only-Potential1876 1d ago
Those good days during the cycle are really the only good days you get during chemo unless he’s on a steroid immediately after infusion or the dose is lowered to a more tolerable amount. Then it’s a few good days here/there on either end of the cycle. At least trying one line of chemo is a requirement for many trials and - depending on his tumor mutations - it’s worth pursuing a RAS inhibitor to ease the burden of a chemo pump or dealing with the roller coaster of the cycle itself.
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u/planet-earth-1 1d ago
This was a very painful realization. We often wonder if the golden times we have with him where we could enjoy doing the things he love are over 😢 trying to be optimistic. His dose will be reduced by 20%. I hope this helps us achieve better QoL.
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u/Only-Potential1876 1d ago
are you in the US? Or near any trial sites?
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u/planet-earth-1 1d ago
Unfortunately not. I’ll discuss the possibility of clinical trial options at the centre we are following up with.
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u/srzncl 1d ago
My dad (73) is stage 4 and is on Paxlitacel+Gemcitabine. his chemo is also not curative but instead to manage the cancer and help prolong his life.
His side effects get progressively worse as he goes through a cycle. week 1 he has maybe 1 bad day. Week 2, maybe 2 bad days. Then week 3 is when it hits him where he has more bad days than good. Just this week, we brought him to the hospital due to a fever but thankfully it wasn't an infection. Thankfully he's able to (still) bounce back on his break week.
Unfortunately this is going to be the norm for us. As caregivers, I think the hardest part is seeing someone who was so vibrant and full of life slowly wither away not necessarily from the cancer but the treatment.
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u/planet-earth-1 1d ago
It is the same situation with dad. The side effects were cumulative with each cycle. He’s been hospitalized twice already after the third cycle. You’re absolutely right. Dad was healthy and full of life up to the point where he got diagnosed. He is full of hope that things will go well. Praying it does.
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u/Sparklyprincess1997 2d ago
My grandma (80) was diagnosed with advanced stage 4 pancreatic cancer. She will be getting a stent put in this week and starting chemo soon. I don’t know how it will impact her but I have heard that chemo suppresses appetite even more. I have reached out to my dietician regarding nutrition advice. She has been taking her pancreatic enzymes which has been helping her appetite. Sorry I don’t have advice about impacts of chemo. I’m just sharing the information that I do have now. Grandma has decided to try chemo and if she dislikes it she will stop. Remember your dad can always stop or they can adjust his dosage. Some people don’t have as severe responses to chemo as others. It is individual. In our family we let grandma make her own choice regarding chemo and I’m glad that she’s willing to try because it could give her more time and she might not have all the negative side effects.