Doxil effect

[msjazz]

I am on doxil, after gemzar/carbo, gemzar cytoxan for recurrence last Nov.. I have  nausea for about a week, as I did with the others, but now when that passes, I have terrible reflux, and stomach burning before I finish half a meal. I was already on Nexium. Two weeks ago, my dr. called in carafate suspension. I used it with nexium.  I was to have the 3rd dose of doxil this past week, but Monday nite, I ate a small bowl of softened raisen bran, and had terrible stomach burning, and then threw up 3 times before it stopped at 2 am. I told my dr last week and she gave me protonics. I cant tell it has helped either, I have to eat small portions of bland food, and have a bad mucous taste all the time. Is this the doxil? She said I might need the stomach scope done by my gi dr, but it seems like a waste of time, since it started with doxil. My ca125 went from 376 to 272 with the 2 treatments, so she is wanting me to stay with it. Every chemo has made me nauseated for up to a week, but after that, I could eat most anything. Now I don't want to eat. Any ideas on what might help other than what I have done, or should I push her to change to something else. I realize there aren't a lot more chemos left, and I did test estrogen rec.. Thanks Donna  ( stage3c)

[Annekathryn Goodman, M.D.]

Dear Donna

I agree with your doctor's recommendation to evaluate your stomach by endoscopy. it is not typical of doxil to cause such symptoms. Doxil can most definitely cause ulcers in the mouth. It is possible that that is what is going on. I agree with nexium, carafate , and protonix.

But there are several other possibilities to consider:

-a yeast infection of your esophagus. If so appropriate yeast medicine will help. endoscopy can determine that.
-an active bleeding ulcer
-H. Pylori infection (can check a blood test for that). It is treated with antibiotics
-tumor involvement of the stomach. Endoscopy will determine that.

It is also possible that your cancer is causing a partial gastric outlet obstruction. The cancer can coat the outside of the stomach and prevent the stomach from normally distending when you eat. Then when you eat more than a small volume, you throw up. That can be determined by a CT scan. If that is part of what is going on, you should consider frequent small meals.

If your evaluation for these issues is negative and the conclusion is that it is your reaction to doxil, ask your doctor about reducing the dose of doxil.

best wishes

[msjazz]

Thank you for you response. She did a ct last month, and felt I did not need one for another month as it was ned. Yeast is a possibility, I did have nystatin powder, but can't find it now. I will check in Memphis Wednesday. If it continues I will make an appointment with my G.I. Dr.     Donna