Peg...I have been on all three...Sprycel last and it seems to be working  
well.  I have atrial Fib and am on Flecanide which can be problematic with  
Sprycel...but so far, no arrhythmia and good blood results.  My short hand  
history is below.  I am lobbying for all of us to used some form of this  
when we communicate with each other so we have a quick summary of our journeys  
to share with one another.
 
My experience suggests that each of us react differently to these drugs and 
 that the side effects can be extreme.  Fortunately there are  
options...different TKI's (Sprycel, Gleevec, Tasigna) and they can also adjust  
dosage. 
 
Hang in there!
 
Tom in KY
 
Tom Dunham, BD:8/1941
DX CML 12-23-2008
MDA Protocol:  Tasigna-400mg; 2xday-1/09
Q PCR bone@ 0.17 7/09
Acute  Pancreatitis-7/5/09
Stopped Tasigna-7/13/09
Q PCRU blood-7-29-09  !
Started Gleevec-400mg/day-7/31/09
Developed rash ~ 8/19/09
Rash  treated with Steriods..improvement
Rash worsens~9/22/09
Stopped  Gleevec-9/28/09
Restarted Gleevec @300mg/day-10/8/09
Stopped  Gleevec-10/13/09-toxic rash\
Q PCR bone-0.05
Started Sprycel @  100mg/day-10/20/09
Some bi-lateral peripheral neuroapathy in  feet
 Q PCR blood-7-10... 0.01
Zavie Miller's Zero Club  1292
 
 
In a message dated 8/21/2010 12:03:34 P.M. Eastern Daylight Time,  
[email protected] writes:

Hi  Peg....Actually, my Onc. had me on Sprycel after Gleevec, but I had 
other  
issues and he felt that changing me to Tasigna was the right move.  I  have 
joint pain, and one of the side effects of Sprycel was that and he  felt at 
the time, due to the fact that I was in so much pain, that Tasigna  might 
be 
a better option.

I wish you luck with the Sprycel.  I  know that it's a big move and can be 
frightening to change meds.  I  know that I was scared at first, but it has 
been working well for  me.

Hang in there and let us know how you're doing.

Many  hugs,
Millie
----- Original Message ----- 
From: "peg"  <[email protected]>
To: "CMLHope"  <[email protected]>
Sent: Saturday, August 21, 2010 11:41  AM
Subject: [CMLHope] Re: Changing to Sprycel not Tasigna after  all.


Hi Jeanie,

Since Gleevec has been the gold standard in  the US, many hemotologists
are simply not as familiar with the other  options as they possibly
could be.  Now that Tasigna has been approved  as a 2nd, sometimes
better, front line treatment there is just an  assumption that this is
the next natural step for all patients who are  Gleevec resistant or
intolerant.  A kind of cookie cutter medicine,  one size fits all.  I
had sought a 2nd oncology opinion, who also  recommended Tasigna, with
no consideration for Sprycel.

An  additional problem is that medical care is sometimes fragmented out
so,  each to his own specialty....with doctors not really having
problem solving  discussions with each other, as a healthcare team,
like they did in the old  days. When my original cardiologist was
consulted regarding monitoring of  QT risk with Tasigna he did not even
know there was another option, and as  most non-oncology doctors he was
not familiar with any of the TKI's.   It was only by accident that the
oncologist referred me to a different  cardiologist at the last minute,
simply because he was in the same building  making monitoring a bit
more consolidated. Thanks to all the information  and courage everyone
at CMLHope provided me, I took it upon my self to  educate this new
cardiologist about ALL the options and varying  risks.

To him it was a slam dunk, the Tasigna just posed more of  an
uncontrollable risk for me than Sprycel.  Obviously this will not  be
the same for everyone, but it does go to show how much we must all  be
our own best advocates.  Knowledge is indeed power.  I thank  you and
everyone here for arming me with the support I needed to do  this.

Things are only going to get more complicated in a few years  when
Gleevec becomes the first TKI to lose it's patent and go  generic.  We
are bound to see many, if not most, US insurance  providers limit
coverage of CML treatment to generic Geevec, and not paying  for, or
charging extremely huge co-pays, for all other options.  Let  the games
begin....let's all pray for a cure to come before that  day!

Thanks again and blessings to you also, (WE can do all through  Him...)
peg

On Aug 20, 2:55 pm, [email protected] wrote:
>  Hi Peg good for you and I hope you do really well on it.
> I didn't  think they gave Tasigna for anyone with a QT problem.
>  Blessings
> Jeanie<3
>
> In a message dated 8/18/2010  6:59:09 P.M. Pacific Daylight Time,
>
> [email protected]  writes:
>
> Hey all,
>
> Thank you so much for all of  you taking the time to respond to me
> through this. It has been a  difficult week, sometimes leaving me
> feeling almost bi-polar...with up  days and down! You all shared
> valuable experience and concerns that  helped give me hope through this
> process. In the end, today, after a  cardiology consult requested by
> my oncologist, the decision is to  cancel the order for Tasigna and
> submit one for Sprycel due to the  additional risk posed by my existing
> arrhythmia. The cardiologist felt  that when he weighed the
> risk...just in my case...of LongQT (tasigna)  vs Plural Effusion
> (sprycel), the Plural Effusion was far more  predictible, controllable
> and non-life threatening. He said that it  was not one vs the other as
> much as what the safest order to put them  in was.... for me. But once
> again, having a brother and sisterhood to  call on has been, and
> continues to be, an honor. You are all  wonderful. Thanks again so
> much, peg
>
> --
>  [CMLHope]
> A support group of http://cmlhope.com
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