This webinar covered oral chemotherapy options for colorectal cancer. The speaker discussed commonly used intravenous drugs as well as the two FDA-approved oral options: capecitabine and regorafenib. Capecitabine is an oral prodrug of 5-FU that is used as an alternative to intravenous 5-FU for stages II-IV disease. Regorafenib is used for metastatic colorectal cancer that has progressed on all standard therapies. The talk outlined how the drugs work, their administration schedules, common side effects, and factors to consider when determining if oral chemotherapy is appropriate. It emphasized that oral chemotherapy still requires vigilance regarding side effects and medication adherence.
The Trial Assigning IndividuaLized Options for Treatment (Rx) -TAILORx,TAILORx clinical trial showed that most women with hormone receptor (HR)–positive, HER2-negative, axillary node–negative early-stage breast cancer and a mid-range score on a 21-tumor gene expression assay (Oncotype DX® Breast Recurrence Score) do not need chemotherapy after surgery
The Trial Assigning IndividuaLized Options for Treatment (Rx) -TAILORx,TAILORx clinical trial showed that most women with hormone receptor (HR)–positive, HER2-negative, axillary node–negative early-stage breast cancer and a mid-range score on a 21-tumor gene expression assay (Oncotype DX® Breast Recurrence Score) do not need chemotherapy after surgery
Pathways and targets how might these affect my treatment decisions gail eckh...Fight Colorectal Cancer
Dr. Gail Eckhardt
Professor and Head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center.
Join us for an exciting webinar about pathways and targets. Dr. Eckhardt will discuss the basic of pathways within a cancer cell, and how (and why) they can affect treatment options for patients. She'll explain how we learn about how new pathways are discovered, and how this information tell us what drugs may work in certain patients and why some drugs don’t.
Dr. Eckhardt will discuss the idea of targeted therapies, and the difference between them and regular chemotherapy. She'll talk about the relationship between pathways and targeted drugs, and how this may impact drug development in the future.
Many colorectal cancer patients take chemotherapy as part of their treatment plan. Join Ashley Glode, Pharm.D, as she discusses chemo information and education, supportive care management for patients, and toxicity monitoring. She will discuss the importance of communicating with your doctors and care team to ensure you stay safe and comfortable throughout your treatment plan.
Each January, the best and brightest minds in colorectal cancer research meet at the Gastrointestinal Cancers Symposium. Fight Colorectal Cancer and the Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the 2013 symposium.
Join us to learn more about these topics:
- Can aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) keep cancer from returning?
- The relationship of body mass index (BMI) and exercise in colorectal cancer
- What scientists are learning about how your immune system can fight cancer
- The latest on what biomarkers can tell us about your cancer
- Rectal cancer treatment that is based on your biological make-up
The webinar will be led by Dr. Richard Goldberg, an internationally renowned gastrointestinal oncologist who specializes in colorectal cancer. He is a tenured professor in the Department of Internal Medicine at The Ohio State University and serves as physician-in-chief at Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
use of omega-transaminase enzyme chemistry in the synthesis of JAK2 kinase in...Kashif Haider
use of enzyme chemistry is discussed with example of drugs in there synthesis. drugs in clinical trail of jak-2 enzyme inhibitors , and different scheme for enzyme synthesis is covered.
From bowel frequency, pain, and more, many colorectal cancer treatments lead to digestive side effects. Join this webinar with Dr. Cathy Eng to learn all about the digestive system, the side effects that are common due to CRC treatment, and how to manage those side effects.
Understand the concept of Colorectal Cancer clinical trials and the differences across the phases. Presented by Dr. Sam J. Lubner MD, FACP University of Wisconsin Carbone Cancer Center
Nutrition is an important part of any cancer treatment plan, especially for those individuals who are undergoing colorectal cancer treatment and have had surgery to remove part of the colon. Another important consideration for patients who have had surgery to remove part of the colon is avoiding a bowel obstruction. Knowing which foods you should and shouldn’t eat can be a helpful part of the treatment and the surgery recovery process. In this webinar, we will talk about how nutrition and avoiding bowel blockages can be helpful to you after a colorectal cancer treatment procedure and what foods to eat as we enter the holiday season.
Margaret Martin, RD, MS, LDN, CDE is a Licensed Dietitian and Nutritionist in the State of Tennessee and James D. Waller, Jr., MD present this lively session.
In this Obesity treatment PPT, we hope these help you to guide and consider more information about the treatment. For more details contact us at 00442031295133 or Mail us: info@PragueMedicalInstitute.cz
Pain is a common side effect of colorectal cancer treatment that can be hard to manage. If you or someone you know is experiencing pain, Dr. Ann Navarro-Leahy from the University of Colorado Hospital will cover reasons for pain, different types of pain, and ways to treat and control pain. http://fightcrc.org/Webinar
Advance in diagnosis & treatment of cancers has led to high cure rate & longer survival.
Nearly 1 in 12 cases detected before 40 years age.
Survivors have to face infertility or early menopause.
Similar to Chemo In a Bottle: Oral Chemotherapy for Colorectal Cancer (20)
Dr. Murphy presents slides discussing general screening trends in the US, including how the US compares to other countries, different screening modalities, and differences in screening by:
-Age
-Gender
-Geography
-Race/Ethnicity
Looking to kick start your physical activity? Hoping to learn about how body movement can be a huge benefit for CRC patients and survivors? Curious about Climb for a Cure? Join this interactive webinar featuring Karia Coleman, MSK, personal trainer and athletic strength coach, and Fight CRC advocates as they discuss the importance, challenges, and joys of physical activity.
Maine recently passed major colorectal cancer (CRC) policy at the state level. Join us to listen to their story and learn what worked well for CRC state advocacy!
Indiana just passed major colorectal cancer (CRC) policy this year. Join us to listen to their story and learn what worked well for CRC advocacy in Indiana!
Kentucky was one of the first states in the US to pass major colorectal cancer (CRC) policy. Join us to listen to their story and learn what worked well for CRC state advocacy!
Join Fight CRC in a webinar about biomarkers. In this session, Dr. Chris Lieu will focus the discussion on the NTRK biomarker, in addition to ctDNA, and Next-Generation Sequencing.
Join us as Eden Stotsky-Himelfarb, BSN, RN from Johns Hopkins Medicine discusses how to manage after a colorectal cancer diagnosis. In this session, she will cover understanding diagnoses, shared decision making, managing mental health, talking to family and colleagues, and more.
Some colorectal cancer treatments lead to side effects of the skin. In this webinar, Dr. Nicole LeBoeuf will discuss these specific side effects. She will talk about why they occur, how to prepare for them, and how to manage them.
Hear about the latest breaking colorectal cancer research! Fight CRC will be joined by Dr. Axel Grothey who will spend the hour detailing the research presented at the 2020 Gastrointestinal (GI) Cancers Symposium hosted by the American Society of Clinical Oncology.
Anticipating the end of life and making decisions about medical care at this time can be difficult and distressing for people with cancer and their loved ones. However, it is incredibly important to plan for the transition to end-of-life care.
In this webinar, we will discuss questions to ask when considering an end to curative treatment, what to expect with hospice and end-of-life care, a new medical care team, advance directives and healthcare proxies, options for pain, the role of caregivers and loved ones, and more.
In this webinar, Dr. Angela Nicholas, Dr. Chris Heery, and Wenora Johnson discuss all things clinical trials. Dr. Nicholas, a family practitioner and caregiver to her late husband, John MacCleod will dive into her experience searching for clinical trials along with advice to those currently searching, or planning on searching in the future. Dr. Heery, Chief Medical Officer for Precision Biosciences will spend time dispelling myths around clinical trials and challenges to enrollment, and Wenora Johnson, a stage III colon cancer survivor will describe the process and her point of view curating trials in the Fight CRC trial finder.
In this webinar, Dr. Popp will discuss everything you need to know about palliative care! This is an important webinar for colorectal cancer patients and their loved ones.
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
In this webinar, Dr. Azad discusses colorectal cancer recurrence. She addresses things to do to help reduce the risk of recurrence, in addition to what steps should be taken if colon or rectal cancer returns.
Join Fight CRC and Dr. Scott Kopetz to learn about the latest breaking colorectal cancer research from the American Society of Clinical Oncology 2019 Annual Conference.
May 2019 – What You Need to Know About Chemotherapy Induced Neuropathy WebinarFight Colorectal Cancer
Neuropathy is a common side effect for colorectal cancer patients. It is a side effect that can be incredibly challenging to manage, and can affect daily living. Join this informative webinar to learn all about neuropathy—why it happens, how to prepare for it, and methods to try and reduce its effects. This is an important webinar for all survivors and patients! Dana will speak from both the medical professional and patient angle, as she is a colon cancer survivor herself!
A cancer diagnosis and cancer treatment can be traumatic. An experience with cancer can lead to serious psychological distress that should be addressed. In this webinar, Schuyler Cunningham, Clinical Social Worker, talks about what trauma is, how to identify it, and what steps to take next.
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. • Speaker(s): Dr. Anna Varghese
• Archived Webinars: FightColorectalCancer.org/Webinars
• AFTER THE WEBINAR: Expect an email with links to the material &
a survey. If you fill it out, we’ll send you a Blue Star pin.
• Ask a question in the panel on the RIGHT SIDE of your screen
• Follow along via Twitter – use the hashtag #CRCWebinar
Today’s Webinar:
3. Established in 2006, our Lisa Fund has
raised thousands of dollars and directly
funded talented scientists focused on
late-stage (stage III & IV) colorectal
cancer research.
100% of the funds donated go
directly to our research grant.
Learn more or donate:
FightColorectalCancer.org/LisaFund
Funding Science:
5. Disclaimer:
The information and services provided by Fight Colorectal Cancer are for
general informational purposes only. The information and services are not
intended to be substitutes for professional medical advice, diagnoses or
treatment.
If you are ill, or suspect that you are ill, see a doctor immediately. In an
emergency, call 911 or go to the nearest emergency room.
Fight Colorectal Cancer never recommends or endorses any specific
physicians, products or treatments for any condition.
6. Speakers:
Dr. Anna Varghese is an assistant attending in the
Gastrointestinal Oncology Service at Memorial
Sloan-Kettering Cancer Center. She completed
medical school at Case Western Reserve
University in Cleveland, Ohio, her internal
medicine residency at Beth Israel Deaconess
Medical Center in Boston, Massachusetts, and
her medical oncology fellowship training at
MSKCC in New York City. At MSKCC, her clinical
and research interests center on developing new
treatments for patients with colorectal cancers
and cancers of unknown primary.
8. Outline
• Commonly used medications for colorectal
cancer
• Standard oral chemotherapy for colorectal
cancer
– Capecitabine
– Regorafenib
• Experimental oral chemotherapy
– TAS-102
9. Commonly used medications for
colorectal cancer
Chemotherapy Brand Name Other Names Intravenous
(IV) or oral
5-Fluorouracil Adrucil ™ 5-FU Intravenous
Oxaliplatin Eloxatin™ Oxali Intravenous
Irinotecan Camptosar™ CPT-11, Irino Intravenous
Cetuximab Erbitux™ Cetux Intravenous
Bevacizumab Avastin™ Bev Intravenous
Panitumumab Vectibix™ P-mab Intravenous
Capecitabine Xeloda™ Cape Oral
Regorafenib Stivarga™ Oral
10. Commonly used medications for
colorectal cancer
Commonly given combinations:
FOLFOX : 5-Fluorouracil + Leucovorin +
Oxaliplatin
FOLFIRI: 5-Fluororuacil + Leucovorin +
Irinotecan
Capeox = XELOX = Capecitabine and Oxaliplatin
Capeiri : Capecitabine and Irinotecan
Chemotherapy
5-Fluorouracil
Oxaliplatin
Irinotecan
Cetuximab
Bevacizumab
Panitumumab
Capecitabine
Regorafenib
11. Commonly used medications for
colorectal cancer
Commonly given combinations:
FOLFOX: 5-Fluorouracil + Leucovorin + Oxaliplatin
FOLFIRI: 5-Fluororuacil + Leucovorin + Irinotecan
Capeox (XELOX): Capecitabine and Oxaliplatin
Capeiri: Capecitabine and Irinotecan
Chemotherapy Brand Name Other Names Intravenous
(IV) or oral
5-Fluorouracil Adrucil ™ 5-FU Intravenous
Oxaliplatin Eloxatin™ Oxali Intravenous
Irinotecan Camptosar™ CPT-11, Irino Intravenous
Cetuximab Erbitux™ Cetux Intravenous
Bevacizumab Avastin™ Bev Intravenous
Panitumumab Vectibix™ P-mab Intravenous
Capecitabine Xeloda™ Cape Oral
Regorafenib Stivarga™ Oral
13. Capecitabine: The Basics
• What is it?
– Oral form of 5-FU
• How is it given?
– Oral
– Tablets
• 150mg or 500mg tablets
• How often do you have to take it?
– Twice a day
– Multiple possible schedules
• 3 week schedule: 2 weeks on / 1 week off
• 2 week schedule: 1 week on / 1 week off
Genentech.com
14. Capecitabine: When can you use it?
• Stage II or Stage III colon cancer
– 6 months of adjuvant chemotherapy
• Oral / IV option: Capeox
• All IV option: FOLFOX
• Stage II or III rectal cancer
– Chemotherapy with FOLFOX or Capeox
– Concurrent radiation therapy and chemotherapy
• Stage IV colorectal cancer
15. Capecitabine: Is the pill as good as the
intravenous form of 5-FU?
• Yes!
• We use these interchangeably.
• Capecitabine is as effective as 5-FU.
– Studies comparing capeox and FOLFOX
demonstrated that capeox is no worse than
FOLFOX in first-line treatment.
16. Capecitabine: What are the common
side effects?
• Lowering of the neutrophil count (neutropenia)
• Lowering of the platelet count (thrombocytopenia)
• Rash on the hands and feet (hand-foot syndrome)
• Nausea and vomiting
• Diarrhea or constipation
• Poor appetite
• Cardiac complications
Ascopost.com
17. Capecitabine: Who should not take it?
• People with poor kidney function.
• People who cannot metabolize the drug.
18. Capecitabine: How do you know if it’s
right for you?
• Your doctor can help you decide, but only you
can know this.
• How do you feel about a mediport?
• How important is it to limit visits to the clinic?
• Are you the kind of person who can take pills
reliably?
• Will the burden of twice daily medications
become overwhelming?
19. Example
• You have just undergone surgery for your
colon cancer and were found to have stage III
colon cancer in which 2 lymph nodes had
evidence of cancer.
• Your doctor has recommended 6 months of
“adjuvant” chemotherapy with either FOLFOX
or Capeox.
• How do you decide which one?
20. Adjuvant Capeox vs. Adjuvant FOLFOX
FOLFOX Capeox
Medications 5-Fluorouracil,
leucovorin, and
oxaliplatin
Capecitabine and oxaliplatin
Method of administration IV
Requires mediport
Oral and IV
Visits Every 2 weeks Every 3 weeks
Number of treatments /
clinic visits
12 8
PROS •Requires a mediport •Does not require a mediport
or 48 hour infusion
•Fewer visits
CONS •Requires a mediport
•More visits
•Fewer doses of oxaliplatin
higher dose of oxaliplatin
increased side effects
•Increased pressure on patient
•Adherence
21. Capecitabine: How do you think you
get it?
Doctor writes a
prescription.
Pharmacy
mails drug to
your home.
22. Capecitabine: How should you get it?
Doctor writes a prescription.
Doctor’s office calls your insurance company
to find out what specialty pharmacy to use.
Doctor’s office sends prescription to
specialty pharmacy.
Doctor’s office may need to complete a
prior authorization form.
Pharmacy then coordinates mailing
the drug to your home.
23. Capecitabine: How do you actually
get it?
Doctor writes a prescription.
Doctor’s office calls your insurance company
to find out what specialty pharmacy to use.
Doctor’s office sends prescription to
specialty pharmacy.
Doctor’s office may need to complete a
prior authorization form.
Pharmacy then coordinates mailing
the drug to your home.
Patient calls doctor’s office.
Patient calls insurance.
Patient calls pharmacy.
Patient calls doctor’s office.
Patient calls insurance.
Patient calls pharmacy.
Patient calls doctor’s office.
Patient calls insurance.
Patient calls pharmacy.
24. Capecitabine: How do you take it?
• Twice a day
• Within 30 minutes of eating a meal
• Swallow whole
26. Regorafenib: The Basics
• What is it?
– Blocks several different proteins thought to be
important in cancer growth
• How is it given?
– Oral
– 40mg Tablets
• How often do you have to take it?
– Once a day
– 4 tablets
– 4 week schedule: 3 weeks on / 1 week off
27. Regorafenib: When can you use it?
• Metastatic colorectal cancer that has
progressed or grown despite 5-FU,
capecitabine, oxaliplatin, irinotecan,
cetuximab, and panitumumab
28. Regorafenib: What are the side effects?
• Fatigue and weakness
• Rash on the hands and feet (hand-foot syndrome)
• Bleeding
• High blood pressure (hypertension)
• Neurologic abnormalities
• Bowel perforation
• Impaired wound healing
• Liver damage
29. Regorafenib: How do you know if it’s
right for you?
• Your doctor can help you decide, but only you
can know this.
• Are you the kind of person who can take pills
reliably?
• Will the burden of taking daily medications
become overwhelming?
30. Regorafenib: How do you get it?
Doctor writes a prescription.
Doctor’s office calls your insurance company
to find out what specialty pharmacy to use.
Doctor’s office sends prescription to
specialty pharmacy.
Doctor’s office may need to complete a
prior authorization form.
Pharmacy then coordinates mailing
the drug to your home.
31. Regorafenib: How do you take it?
• Once a day at the same time each day
• Swallow whole
• Take with a meal
32. Oral chemo: How do you remember
to take it?
• Alarms
• Pill box – separate from your other
medications
33. When should you call your doctor or
go to a local Emergency Room?
Question ER or 911 Call your
doctor
If you develop chest pain, chest pressure,
or unexplained shortness of breath?
X
If you develop new neurologic changes? X
If you develop a rash on your hands and
feet?
X
If you develop unexplained fatigue, but
you can still get out of bed and take care of
your personal care?
X
If you develop darkening of your skin, eyes,
or urine, but you still otherwise feel OK?
X
If you are worried about a symptom? XXXXXXX
34. Question Do Don’t
What if I miss my dose? Do skip the dose. Do not take extra or double
the dose.
What if I can’t swallow the
pills?
Do talk to your doctor.
Do take the pills whole.
Do not crush the pills
unless you talk with your
doctor or pharmacist.
What if I’m having side
effects?
Do talk to your doctor. Do not ignore your
symptoms! Trust your
instincts.
Dos and Don’ts of Oral Chemotherapy
36. TAS-102: The Basics
• What is it?
– Inhibits DNA synthesis directly
– Inhibits an enzyme important for DNA replication
• How is it given?
– Oral
– Tablets
38. TAS-102: What side effects have been
seen?
• Fatigue
• Diarrhea
• Nausea and Vomiting
• Poor appetite
• Lowering of the blood counts – neutrophils,
platelets, and hemoglobin
39. Summary
• Oral chemotherapy is an option for patients with
stages II, III, and IV colorectal cancer.
• The two FDA approved oral agents for colorectal
cancer are capecitabine and regorafenib.
• Oral chemotherapy is not right for everyone, but
it can be a good option for the right patient.
• Oral chemotherapy is still chemotherapy and
comes with risks.
40. Question & Answer:
SNAP A
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