IP Chemo

• By Jennali
• Posted June 20, 2009 at 12:39 am
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I had 11 IP treatments over the course of my 6 rounds of Taxol/Cisplatin. I was the 2nd guinea pig for my hospital, so had many nurses watching and learning.

I tolerated it extremely well. I would even go so far as to say it went textbook perfect. The skill of your nurses will be a big factor in the administration of it. Since the port is hidden under your skin, they have to be able to feel and even sense exactly where the rubber membrane is to poke. I had my share of false pokes, but you don't feel it, so no biggie.

The needle looks like a hornet on steroids, but don't worry. It doesn't hurt!

You will be given a cream to apply, probably Emla, that will numb the whole area where your port is. I found that 1/2 hour as the label suggested was not enough time for it to numb me completely. So we went for an hour, and that worked great.

You will be lying down, so wear comfortable clothes. I resorted to a hospital gown for the Cisplatin, because I had to pee so frequently. The Taxol is a slow administration. They push the Cisplatin and give lots of fluids, as well as Lasix. Your bladder will notice. You have to remain lying down in the bed, however, so as not to dislodge the needle in your port. Hello, bedpan!
I usually had to pee about every 10 to 15 minutes. Just a heads up for that possibility. It gets easier with practice. You might bring an extra pair of undies just in case. I needed them more than once!

You will want to drink a lot afterwards, especially for the Cisplatin. My nurse wanted me to have to get up in the night a couple of times. So drink lots and lots of water to help flush it out.

After the chemo is administered, your hospital bed will be put in what is called Trendellingburg. Fancy word for tilting your bed with the head down for about 15 minutes, then with head still down, turning onto each side for about 15 minutes. I usually snoozed.

Some women complain of feeling really bloated after IP chemo. That was never an issue for me, so I suspect it is as individual as many things are relating to ovca.

Good luck to you. I hope your treatment goes well.

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• By meghany
• Posted June 20, 2009 at 8:44 am
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I had six IP treatments. I was very anxious before my first treatment, I think because of all of the talk about getting as many treatments as you can tollerate and that some people don't make it through all of their treatments. I did not end up having the taxol IP due to my taxol allergy so I just had the cisplatin.

My first treatment was definately no cake walk but it got easier the more I had. They think my cramping/contraction like pain after my first treatment was from the chemo reaching my muscles that had not healed from my surgery.

I was able to get up and go to the bathroom except for the time I was in the Trendellingburg positions.

I would definately agree about the comfortable clothing, nothing tight. I just stayed in my sweats the whole time and then wore sweats until the bloating went down.

I hope your treatment goes smoothly next week.

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• By BarbP
• Posted June 20, 2009 at 9:19 am
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I had 6 IP carboplatin treatments and a week later, 6 IP taxol treatments. I didn't have to numb the area around the port.I did wear loose clothing....sweats.... I did have to go to the bathroom often, but wore a pad....in case.....I had wonderful nurses and wonderful care. I tolerated all the treatments beautifully with little side effects except being tired. I could live with that!!! I know two women who played golf within a couple of days of IP treatment. (I don't play golf!!)..
Good luck.....

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• By EnjoyEveryDay
• Posted June 20, 2009 at 12:36 pm
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Hi Debra,


I found that have IV hydration post treatment helped enormously. Also, ask you docs for a "variety" of antiemetics so you can figure out what works best for you post treatment.

For many of my treatments, Aloxi ( given IV) and Emend have been great. Post I have hydration, and use ativan, kytril or zofran, Reglan is another option.

Good luck with your treatment.
One day at a time.

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• By quacker
• Posted June 20, 2009 at 10:46 pm
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Did it and it wasn't bad after the first round. One of the side effects is intestinal paralysis. Do not eat or drink anything that causes gas for two days before and three days after your chemo. Also, start taking laxatives the day before and three days after. This will save a lot of grief.

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• By JanJ
• Posted June 21, 2009 at 2:01 pm
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I had IP as part of my 6 cycles of chemo. Only toward the end of the 5th and 6th, did I have any problems. But I didn't have to be in any special bed and I could get up and pee anytime I wanted. My doctor swears to its effectiveness against ovca. I'm 2 1/2 years since my Stage IIIc diagnosis. Good luck!

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• By Mourton
• Posted June 21, 2009 at 3:32 pm
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I was stage IV oc-- I went through 5 rounds of IP cisplatin--I couldn't finish the last round because the cisplatin was causing kidney damage. I also had taxol IV--for the 6th round they gave me carboplatin. I recommend getting the cream to numb the port area--no pain even if they have trouble finding the port which they did a few times in my case. I too had to drink lots of water during the treatments. TI would get so bloated and it was very painful. The day after and a couple of times during the week I had to do IV hydration to prevent further kidney damage..I wasn't capable of drinking the amount of water they recommended. After each treatment the chemo wiped me out and I was so sick--It felt like the worst flu you could ever have. The feeling of fatigue and nausea got increasingly worse as the treatments progressed. I was pretty much bedridden for six months. The worst is the constipation because the chemo interfers with bowel movements. I had to go to the hospital several times because I wasn't having a bowel movement for a week. You just got to get through it--I have learned that people react differently than others--mine was no walk in the park. I was just glad I could move in with my sister so she could take care of me--because there was no way I could function on my own. But I survived and am in remission since Oct 07--I do have numbness in my feet and hands--but that's a small price to pay for my life. Ovca sucks!!

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• By debraherrera
• Posted June 21, 2009 at 7:26 pm
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Thank you so much for all the feedback. I appreciate you taking the time to reply.

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• By dwell
• Posted June 22, 2009 at 10:29 am
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I just finished 6 rounds of IV/IP treatment. Day one was IV Taxol, day two was IP Cisplatin, day three Neulasta shot and day 8 IP taxol. I was on a 3 week cycle. My IP port is easy to access because it is an external port. I have a tube coming out of my stomach with 2 ports attached, they could use either port. I had my treatments at the cancer center, I could get up when needed, just had to take the IV pole with me. After the IP cisplatin and Taxol were put into me I had to change postitions in my chair every 15 minutes, laying on my sides, back and sitting up. I had to do this for 2 hours. My last round was my worst, I did not drink enough liquids and it made me very sick. So make sure and drink plenty of fluids or go in for hydration. It was hard but I made it through all six rounds. Let's pray that it works!

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• By debraherrera
• Posted June 23, 2009 at 5:09 am
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Thank you so much for sharing. I will take your advice on the fluids..yesterday they just confirmed my schedule as yours schedule with Day 1 etc.. Today is my Day 2.. Water seems to be the critical factor. So you are done with your chemo now?

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• By telly
• Posted June 23, 2009 at 8:15 am
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Hi, I completed 6 IP treatments with Taxol and Cisplatin and couldn't take anymore - it was a terrible experience for me, I'm glad I did it though - I hope I have better effectiveness against the cancer, I had incredible difficulties with the port and accessing it, I had horrifying abdominal pain and bloating and constipation, it got worse every treatment
But I'mglad other people didn't have so many problems, it shows everyone is different

I would never do it again, but like I said I did get through it

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• By tg4love
• Posted June 23, 2009 at 10:08 am
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I must say its been a couple years since I had my IP chemo, however, I too was one of the first at the hospital and the nurses were learning "how" to do it. Did anyone have the chemo "warmed" before infusion? They didn't know how to do that either and my husband had to help them. I think we learned together. The main thing I want to know is, how many had a recurrence after this type of chemo? Mine was within a year or so. So the question is.....how successful is this type of IP chemo? Good luck to those who are going through this, anything, doing anything is better than nothing! Right now I'm in limbo with my cancer and I don't like doing nothing while the cancer is still inside of me.

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• By Jennali
• Posted June 23, 2009 at 1:44 pm
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Yes, they warmed my chemo. I had forgotten about that detail until you mentioned it. They wanted it to be body temperature.

I had a recurrence within 6 months of finishing IV/IP chemo. However, there is no tumor activity in my belly. I have enlarged para-aortic lymph nodes. So perhaps the IP did its job in killing any invisible cancer seeds in my abdomen. I would like to think so, anyway.

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• By Mimzi
• Posted June 23, 2009 at 2:23 pm
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I've had 2 rounds so far of IP Cisplatin (plus Taxol) and have felt perfectly comfortable during the treatment. The main side effects I've experienced are a lot of fatigue, which mostly goes away after a week or so, and low white-cell counts, which have been reversed with Neupogen and Neulasta - they're very effective but expensive. I think insurance won't cover it until the lab tests show your count is low.
My doctor tells me that they've adjusted the dosage and refined the procedure, so Cisplatin is not as harsh as it used to be.
Everyone is different. I'm considered "young" (45), I have excellent care here in Seattle, and I have a lot of people praying for me.

EFFECTIVENESS
From what I understand, IP Cisplatin for stage 3 is considered very effective. Here's 1 reference, from the American Cancer Society, titled "Abdominal Chemo Improves Ovarian Cancer Survival":
http://caonline.amcancersoc.org/cgi/content/full/56/3/131
My CA-125 dropped from 900+ before surgery to 38 after 2 rounds of IP Cisplatin and Taxol.

SUN WARNING
If you have Cisplatin, you need to protect yourself when you're in the sun. Wear sunscreen and keep covered.

FLUIDS & WALKING
As others here have said, it's important to get lots of fluids during Cisplatin treatment to protect your kidneys. I've been given lots of fluids via IV before and after - and during too, I think. I also try to drink water and juices. My nurses measure my urine output to make sure I'm hydrated. I would pee a lot - maybe every hour - I must have a large bladder - but didn't have any problems with incontinence. I was surprised that someone had to use a bedpan: My nurses secure my needle with tape and dressings, so I could go to the bathroom and even walk the halls. My naturopath said that his best advice for everyone getting chemo is to drink lots of fluids and to walk every day for 30 minutes, no matter how lousy you feel.

NAUSEA
Cisplatin is ranked as one of the worst chemo drugs for causing nausea, but my nausea has been mild because I've been given good drugs, including
Emend - 125 mg the first day, 80 mg the next 2 days. Usually I only pay $10 for prescriptions, but this one costs $160 per cycle - I need to ask my insurance about that. After I get home, I take Zofran and have Compazine as backup for "breakthrough" nausea (that is, if I start to experience signs of nausea before I'm due for my next Zofran) but so far I haven't needed to take very much of it. As with pain medications, it's important to take nausea medications early, when you're first experiencing symptoms.

CONSTIPATION
Constipation is really common from the surgery and chemo, but I only had constipation from the surgery. I think I've just been fortunate, but it does help to walk every day. My oncologist included on his list of constipation prevention the Traditional Medicinals brand "Smooth Move" tea, which really works - better than prunes and as well as Colace, in my experience.

TURNING
I turn from side to side, 15 mins per side for 1 hour. The nurses told me that they used to lower the head but don't do that anymore, presumably because it wasn't necessary. Doesn't seem like it could do any harm, though.

TAXOL
Assuming you're also getting Taxol ... my naturopath recommended L-Glutamine powder to help prevent neuropathy, which can be irreversible. "Glutamine is the most abundant naturally occurring amino acid in the human body," according to Wikipedia.
I take 8g first thing and mid-afternoon, mixing it in juice that has some body, like apricot nectar, although oj works too. On Taxol days and 3 days after, I take 10g 3x/day, adding a mid-morning dose.
You should be able to buy it at a vitamin/supplement store - weight-lifters use it.

HEALING MEDICINE
Try to see the chemo as healing medicine rather than as toxic poison and to stay happy during my treatments. I believe this really helps. I feel fortunate that I have good medical care and support from friends and family, and I try to remember the people in the hospital and all over the world who are suffering much more than I am.

MORE INFO
Here's a website my surgeon/oncologist gave me for info about chemo. It has good info about various chemo drugs, side effects, etc. This is the page about Cisplatin:
http://chemocare.com/bio/cisplatin.asp

Best wishes - hope everything goes well for you.

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• By sonrisesonset
• Posted August 21, 2009 at 4:29 pm
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I am geting ready to start my 5th cycle of Cisplatin/Taxol. I get day one of Taxol through port in chest, Day two Cisplatin through pelvic port and day 8 Taxol through pelvic port. My only complaint is since I get mine as an inpatient in the hospital, day 2 takes a long time. Two hour pre hydradtion, then benadryl, tagamet, steriods, then the chemo, then a 4 hour post hydration. They say they have to spread it out to justify having it done in the hospital, which seem silly as since I am only the second person here to go through this, they are not equipped yet at the Cancer Center so it is done in the hospital. I do drink lots of water. In fact, I go to the nurses station about every half an hour and get a cup with ice. After the chemo and right before the post hydration, I go for a ten minute or so walk so I don't do the "turning" right after the post hydration I go for another ten or 15 minute walk. And with the steriods, I may be outside walking at midnight (LOL). I do not have nausea or vomiting, but do get a little constipated. I have tried the laxatives, but it is uncomfortable. So I drink lots of water, and if I have not had a bowel movement by the second day, I use a fleet enema or a suppository. I also try to eat lots of fruit and salads. This seems to help. I do get tired after the second day and it is usually Saturday or Sunday until I feel like doing much. I get my treatments on a Monday and Tuesay and come home on Wednesday morning. I then go back on the following Monday (outpatient) and on Tuesday for my Nuelasta. I do have some bone/muscles pain the next day after the Neulasta shot, but just rest on that day. by that Thursday I am ready to go. It has finally warmed up here and I have been able to get in the pool some. This has been most relaxing. I just use a 30 sunscreen and have not had a problem.
Best of luck to you!!!

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• By Patricia123
• Posted August 21, 2009 at 7:43 pm
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Mimsi,,great post.

The glutamine really works. I take 10 gms twice a day and if I miss a day, I tingle. I increase it to three times a day for three or four days after chemo.

They didn't tredelenberg me but I suggested it thinking it would get up to the diaphragm and upper liver,,the oncologist said "interesting idea"

I regard chemo as a gift from God especiallly for us. I think regarding it as a toxin sort of makes me feel hideous. So I always say thank you when they bring it.

ANd the IP was not bad for me except for the bowel problems. Get them early and treat,,don't let it build up.

And fear of the IP,,you read so much bad about it but I swear I liked it better than the IV. I did have leaks twice out the vagina but the surgeon sewed it up and then had to redo the tube via lapscope. So my first three were all IV then followed by six IV/IP to "make up" for the early misses.

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• By MarysSon
• Posted August 31, 2009 at 5:27 pm
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Hello All,

This is my first post,

Just checking on behalf of my Mom. She started her 1st round of IV/IP Taxol/Cisplatin treatment. She received her first IP Cisplatin as outpatient in infusion center and it took approx. 8 1/2 hours. The regular chemo nurse that usually handles this type of IP was on vacation last week and when checking in with her today I relayed the length of the treatment and she said it shouldn't have taken that long as the IV's for hydration could have been infused at a faster rate.

The IP was done in a regular chemo chair w/ Mom reclining back. The Gynonc mentioned that Trendelenburg bed was not necessary because the amount of the Fluids and Cisplatin in the abdominal cavity would be more than enough to cover the entire area.

Has anyone had outpatient IP/Cisplatin done and how long did the infusion take?

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• By debraherrera
• Posted August 31, 2009 at 7:17 pm
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Hi! Yes, I am having outpatient IV/IP chemo. I am in the middle of my 7th one right now. My treatments our day 1 -- iv chemo, day 2 ip chemo cisplatin,day 5 hydration, day 8 IP Chemo taxol. I am usually there around 7:30 and get vitals, and bloodwork..by 9:00 they start my IP chemo...I am usually out of there by 2 or 3:00 depending on if they have to give me magnesium which the chemo pulls from my system and/or hydration. I know the IVs for hydration and IP can be run simultaneously. They were doing it in a regular bed in the Infusion area and having me roll back and forth every 15 minutes, but there is a new study out saying that the "rolling about" doesn't seem to bear out any benefit..I have to look online and find that study. So now I don't have to roll about. I will follow-up on finding that study. I am having my treatment at Burlington Lahey in Massachusetts.

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