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Diagnosed with acute lymphocytic leukemia. Prescribed with Gleevec and oral Methotrexate. Suggestions

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General & Family Physician
Practicing since : 1986
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70 yr old woman in previous great health, diag with ALL in Aug. 2013. 4 wks in hospital got pseudnomas, severe c diff, skipped wk ,back in heavy methotrexate, out, next week drastic drop in platelets, red blood ct, got very sick with nausea (8 days). Back in, home now and on Gleevec and oral methotrexate. Word from oncologists scale back from such aggressive in hospital chemo. I am frightened to think this might lessen my longevity (been told 40 percent for 5 years. I understand the logic of cutting back when I have been so sick and quality of life issues...confused a bit....
Posted Mon, 9 Dec 2013 in Cancer
 
 
Answered by Dr. Haseena Hamdani 1 hour later
Brief Answer: Be Optimistic Detailed Answer: Hi, Welcome to XXXXXXX I can understand your worry, but be optimistic and live happily. Gleevec and oral Methotrexate has very good results and we are getting more and more cancer survivors. Your Doctor has always to monitor you closely and take decision in such a way that benefit of particular drug exceeds the side effects. May be after some interval, your Doctor may take back to full dose of Chemotherapy. Initially you had drastic drops in platelet counts and RBCs also because of associated Pseudomonas, and C difficle infections, and your Doctors must have given you Antibiotics for that. Wish you healthy and happy life. Dr H Hamdani
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Follow-up: Diagnosed with acute lymphocytic leukemia. Prescribed with Gleevec and oral Methotrexate. Suggestions 2 days later
Do antidepressants work well with chemo to address the awful fatigue and hopelessness that is happening? I had a severe bout with depression about 25 years ago and pertofrane brought me out of it and afterward Zoloft. Got to do something...nothing worse than this pain the the mind and soul.....
 
 
Answered by Dr. Haseena Hamdani 8 hours later
Brief Answer: Yes, but with careful monitoring Detailed Answer: Hi, Welcome back to XXXXXXX Usually we need to give antidepressant to most of the patients on cancer treatment. Though antidepressant and chemotherapy usually not a preferable combination, but by proper adjustment of timing, and dosage of medicines, we can get maximum benefits of both drugs while minimizing the side effects. Though Pertrofane, or Zoloft can work very well, latest studies have shown Duloxetine is the best choice for depression as well as it can reduce pain due to chemotherapy. As you had depression before, you must tell your Doctor, and he will advise you the best. While you are taking Antidepressant with chemotherapy, our main concern is on liver side effects, and mental alertness. You must avoid Alcohol , caffeine and other medicines which works on Central nervous system. I would advise you to talk to your Doctor immediately. Dr H Hamdani
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