I have breast reconstruction revision surgery scheduled for July. Should I stop Sprycel a week before and start it again a couple of weeks after? Or not? My oncologist sees no reason to suspend it, but he will defer to me. On Sprycel I have low-normal or high abnormal blood values; platelets are low but OK. But I'm more concerned about the subtle skin cell stuff, regarding healing. I've had contradictory advice in the past, from surgeons, and I'd like to know what the consensus is. Trey, is there anything persuasive in the literature?
Should I stop Sprycel before and after surgery?
Started by
kat73
, Jun 12 2015 09:39 AM
6 replies to this topic
#1
kat73
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Posted 12 June 2015 - 09:39 AM
Dx July 2009 on routine physical. WBC 94. Started Gleevec 400 mg Sept 2009. MMR at 2yrs. Side effects (malaise, depression/anxiety, fatigue, nausea, periorbital edema) never improved. Kidney issues developed because of Gleevec. Switched to Sprycel 70 mg in Aug 2011. Above side effects disappeared or improved. Have been MR3.5 - 4.5 ever since. Two untreated pleural effusions followed by one treated by stopping Sprycel Jan 2017. After 9 weeks, PCR showed loss of MMR; re-started Sprycel at 50 mg and in 3 months was back to <0.01% IS. Pleural effusion returned within a couple of months, same as before (moderate, left side only). Stopped Sprycel 50 mg for 12 weeks; pleural effusion resolved. At about a monthoff the drug, PCR was 0.03; at 11 weeks it was 2.06 - lost CCyR? Have returned to 50 mg Sprycel for 3 weeks, intending to reduce to 20 mg going forward.
#2
tazdad08
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Posted 12 June 2015 - 10:08 AM
I am on Tasigna and just had neck surgery last month. I had a ruptured disc removed and two vertebra fused. The nuerosurgeon and my onc both recommended staying on the TKI. I didnt have any surgeries during my year on Sprycel, so I dont have specifics while on Sprycel.
Diagnosed in September 2011. Tried one year of Sprycel. Had great response. Became undetectable in a few months. Changed to Tasigna hoping for less side effects. Self medicated myself down to 20% dose and held for 3 years before becoming detectable again. It has been a journey that has helped me realize what life is about! I am all about a balanced life. I firmly agree with my decision to lower my dose. What is life if you aren't living? Mine will never be the way it was, but it is going to be as good as I can make it! Drs PRACTICE medicine, we can guide our dr to help us with a better life! Don't settle until it's acceptable to you!
#3
Trey
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Posted 12 June 2015 - 10:19 AM
As long as you have seen normal clotting and healing times (both) of any skin cuts, abrasions, etc there should be no issue.
#4
kat73
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Posted 12 June 2015 - 10:59 AM
Well, actually, those things - clotting and healing time - have definitely been slower. They happen, but noticeably slower. Oddly - and this is one of those nutty things - this is much more pronounced on my hands. A very minor burn, some poison ivy - things I've had plenty of experience with over the decades - VERY slow to heal. Scars or redness hang around for months, not the usual days or couple of weeks. Old age, TKI, or over-observance?
Dx July 2009 on routine physical. WBC 94. Started Gleevec 400 mg Sept 2009. MMR at 2yrs. Side effects (malaise, depression/anxiety, fatigue, nausea, periorbital edema) never improved. Kidney issues developed because of Gleevec. Switched to Sprycel 70 mg in Aug 2011. Above side effects disappeared or improved. Have been MR3.5 - 4.5 ever since. Two untreated pleural effusions followed by one treated by stopping Sprycel Jan 2017. After 9 weeks, PCR showed loss of MMR; re-started Sprycel at 50 mg and in 3 months was back to <0.01% IS. Pleural effusion returned within a couple of months, same as before (moderate, left side only). Stopped Sprycel 50 mg for 12 weeks; pleural effusion resolved. At about a monthoff the drug, PCR was 0.03; at 11 weeks it was 2.06 - lost CCyR? Have returned to 50 mg Sprycel for 3 weeks, intending to reduce to 20 mg going forward.
#5
mlk210
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Posted 12 June 2015 - 11:02 AM
I had a thyroidectomy after being on Sprycel for a month a half. My oncologist had me stay on it. I took my dose a few hours late the actual day of the surgery, but never missed a dose. I got compliments on my scar from all my doctors. From seeing pictures of other people (not taking Sprycel), I feel fortunate how wonderfully I healed.
7/2014 Diagnosed,8/14 Started 100mg Sprycel, 9/14 Thyroidectomy (thyroid cancer)
8/2015 Undetectable, 12/15 Plural Effusion (3 wk drug break)
1/2016 Started 70mg Sprycel, 3/16 Plural Effusion (4 wk drug break)
3/16 .014 after a wk w/o meds
4/16 Started 400mg Gleevec
4/16 Undetectable, 7/16 Undetectable, 10/16 Undetectable, 2/17 Undetectable, 5/17 Undetectable, 8/17 Undetectable
#6
kat73
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Posted 12 June 2015 - 11:15 AM
Thanks, MLK. I had my thyroid out way back in 1979 (benign adenomas - today they probably would have left it in) and the scar is, indeed, just a teeny thin white line. If I can remember correctly, I think it got that way after about a year. Good luck.
Dx July 2009 on routine physical. WBC 94. Started Gleevec 400 mg Sept 2009. MMR at 2yrs. Side effects (malaise, depression/anxiety, fatigue, nausea, periorbital edema) never improved. Kidney issues developed because of Gleevec. Switched to Sprycel 70 mg in Aug 2011. Above side effects disappeared or improved. Have been MR3.5 - 4.5 ever since. Two untreated pleural effusions followed by one treated by stopping Sprycel Jan 2017. After 9 weeks, PCR showed loss of MMR; re-started Sprycel at 50 mg and in 3 months was back to <0.01% IS. Pleural effusion returned within a couple of months, same as before (moderate, left side only). Stopped Sprycel 50 mg for 12 weeks; pleural effusion resolved. At about a monthoff the drug, PCR was 0.03; at 11 weeks it was 2.06 - lost CCyR? Have returned to 50 mg Sprycel for 3 weeks, intending to reduce to 20 mg going forward.
#7
jjg
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Posted 13 June 2015 - 02:05 AM
My experience with being of TKIs for a few months is that it took a month at least for my skin to improve. You might see some improvement after a week or two or you might just see a rise in your PCR.
Dx Dec 2010 @37
2x IVF egg collection
Glivec 600 & 800mg
PCRU March 2012
Unsuccessful pregnancy attempt - relapsed, 3 months interferon (intron A), bad side effects from interferon
Nilotinib 600mg Oct 2012
PCRU April 2013, 2 years MR4.5 mostly PCRU with a few blips
April 2015 stopped again for pregnancy attempt (donor egg), pregnant first transfer, 0.110 at 10wks, 2.1 at 14wks, 4.2 at 16wks, started interferon, slow dose increase to 25MIU per wk, at full dose PCR< 1 for remainder of pregnancy
Healthy baby girl Jan 2016, breastfed one month
Nilotinib 600mg Feb 2016
MMR May 2016
PCRU Feb 2017
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