Chemotherapy Side Effects in Early-Stage Gastric Cancer Patients

Side effects

Hello! A friend of mine's father has been diagnosed with stage I gastric cancer, as there is no lymphadenopathy observed on the CT scan.
He opted for chemotherapy instead of surgery.
However, 12 hours after the first chemotherapy session, the patient experienced respiratory distress and loss of consciousness.
After emergency intervention and intubation, he was transferred to the intensive care unit (ICU) and was on a ventilator for two days before extubation and transfer out of the ICU.
Although he was saved, my friend is struggling to understand why this happened, as the attending physician did not provide a detailed explanation.
Additionally, my friend is confused about why such a high dosage of chemotherapy was necessary for treatment.
I hope you can clarify these concerns.
Thank you! Here are the patient's basic details: Height: 166 cm, Weight: 55 kg, Age: 74 years.
Chemotherapy regimen: 5-FU 4000 mg + Antrex 420 mg in 250 ml Normal Saline, administered over 24 hours.
Medical history: CVA, CAD, Gout, Hypertension.

yao, 70~79 year old female. Ask Date: 2001/08/24

Dr. Yang Youhua reply Oncology

Your chemotherapy attending physician has the obligation to explain to you.
Since I am not familiar with the patient's condition, I cannot make any comments casually; I apologize for that.
Please discuss this with your primary physician.

Reply Date: 2001/08/24

More Info

Chemotherapy is a common treatment for various types of cancer, including gastric cancer. However, it can lead to significant side effects, especially in patients with pre-existing health conditions. In the case of your friend's father, who is 74 years old and has a history of cerebrovascular accident (CVA), coronary artery disease (CAD), gout, and hypertension, the administration of chemotherapy could have posed additional risks.

The specific chemotherapy regimen mentioned—5-Fluorouracil (5FU) at a high dose of 4000 mg combined with Antrex (likely referring to a drug like Ondansetron, used to prevent nausea)—is known to be effective against certain cancers but can also lead to severe side effects. The high dose of 5FU, in particular, can cause toxicity, especially in older patients or those with compromised health.
The immediate reaction of respiratory distress and loss of consciousness following the chemotherapy administration could be attributed to several factors:
1. Allergic Reaction: Some patients may experience an allergic reaction to chemotherapy drugs, which can manifest as difficulty breathing, swelling, or even loss of consciousness.

2. Cardiovascular Complications: Given the patient's history of CAD and hypertension, the stress of chemotherapy could have triggered cardiovascular issues, leading to respiratory failure.

3. Metabolic Disturbances: Chemotherapy can cause electrolyte imbalances or metabolic disturbances, particularly in older patients or those with comorbidities, which could lead to confusion or loss of consciousness.

4. Drug Interaction: The combination of chemotherapy with other medications for his pre-existing conditions may have led to adverse interactions, exacerbating side effects.

Regarding the high dosage of chemotherapy, it is essential to understand that oncologists often tailor treatment plans based on the cancer's stage, type, and the patient's overall health. In some cases, higher doses may be necessary to achieve the desired therapeutic effect, especially if the cancer is aggressive. However, this must be balanced against the potential for severe side effects, particularly in older patients or those with significant comorbidities.

In your friend's case, it would be beneficial for them to have a detailed discussion with the oncologist about the treatment plan, including the rationale behind the chosen chemotherapy regimen and the potential risks involved. Understanding the reasons for the high dosage and the expected benefits can help alleviate some of the concerns.

Moreover, it is crucial for healthcare providers to communicate effectively with patients and their families about the risks and benefits of chemotherapy, especially in vulnerable populations. This includes discussing potential side effects, monitoring for adverse reactions, and having a plan in place for managing any complications that arise during treatment.

In conclusion, while chemotherapy can be an effective treatment for gastric cancer, it carries risks, particularly for older patients with existing health issues. Close monitoring and open communication with healthcare providers are essential to ensure the best possible outcomes while minimizing risks.

Similar Q&A

Understanding Chemotherapy Effectiveness in Advanced Stomach Cancer

Hello Dr. Chen, my mother was diagnosed with stage 4 gastric cancer with ovarian metastasis in July of last year (it has spread to the diaphragm). During surgery, only the ovary was removed, and a gastric bypass was performed. Chemotherapy started in mid-August with the regimen o...

Dr. Chen Junyi reply Oncology
Based on your description, it may be effective; however, it is advisable to discuss the specific situation with the attending physician.

Understanding the Side Effects of Chemotherapy in Cancer Treatment

What are the side effects of chemotherapy?

Dr. Zeng Yuhua reply Oncology
Hello! Chemotherapy is administered through oral and intravenous routes, with the drugs being absorbed and transported by the circulatory system to the tumors, exerting their anti-cancer effects. Chemotherapy is a systemic treatment. Common side effects include nausea, vomiting, ...

Dietary Recommendations for Managing Gastric Cancer and Chemotherapy Side Effects

My family member is approximately 78 years old and is male. He has been diagnosed with stomach cancer and underwent surgery to remove a little less than two-thirds of his stomach. Subsequent examinations indicated slight spread to the lymph nodes, and he is currently undergoing c...

Dr. Lai Yicheng reply Oncology
Dear Mr. Wang, Thank you for your letter. Here are my responses: Your family member is currently undergoing chemotherapy after gastric cancer surgery. You inquired about dietary supplements that may alleviate side effects and discomfort. 1. I recommend discussing with your phy...

Managing Side Effects of Third Chemotherapy for Thymic Tumors

The patient is in the advanced stage of malignant thymoma (approximately 7.5 cm at diagnosis, encasing major blood vessels and close to the heart). After two rounds of chemotherapy, the doctor mentioned some shrinkage, but did not specify the exact size. Following the third round...

Dr. Lai Yicheng reply Oncology
Dear Madam, Thank you for your inquiry. The treatment for malignant thymoma primarily involves surgical resection, followed by postoperative pathological evaluation to determine the necessity for further radiotherapy or chemotherapy. In the case you described, which falls under ...