Cabozantinib Begins

The chemistry of Cabozantinib

The chemistry of Cabozantinib

And so it begins again. This will be sixth different treatment over the last three years. It’s the third chemotherapy after Pazoponib and Sunitinib and seemingly has all the same trappings as the others.

That being said I really hope I tolerate it more like the Sunitinib as the Pazoponib really kicked my ass. But in fairness Pazoponib was my first treatment and I was neither psychologically prepared or physically steadied as I am now.

Let the games begin.

On Thursday I started the first dose of chemotherapy. It comes in a 60 mg pill form that I am to take for two days and then rest a day before repeating. As per google it is a prescription medicine used to treat:

  • people with advanced kidney cancer (renal cell carcinoma)

  • people with liver cancer (hepatocellular carcinoma) who have been previously treated with the medicine sorafenib

 How does it work? All cells have signals that tell the cell when to grow, divide, or die. Unlike normal cells, cancer cells don’t stop growing and dividing when they should. This out-of-control growth can cause tumours to form.

Cabozantinib, also known as Cabometyx, is thought to work by helping to block some signals that:

  • encourage growth of new blood vessels that feed cancer cells

  • tell cells to grow and divide 

Blocking these actions can lead to cell death. When the cancer cells die, tumours are more likely to stop growing and may even shrink.


This drug has been waiting in the pharmacy for me for a while. It was going to precede IPI/Nivo but since the side effects were theoretically strong we thought we would do the round of immunotherapy first. Turns out IPI/Nivo wasn’t effective so here we are at Cabozantinib.

And I’ve been steeling myself up for this treatment as I am being given all sorts of indications that it’s been a tough ride for others.

If you really want to know how much you need a positive mental game to go through this all you need to do is review the side effects and try not to believe they are coming for you. Having experienced many of these already I can only assume I need the same mental and physical plan as has served me before.

And that means being patient, be full of gratitude, accept the physical changes and maintain a good diet, sleep and exercise program. In general just be happy. Happy for so many things. It is way too easy to go down a negative route, which I did with Pazoponib, and that is seriously counter productive.

All that to say, the game is on and I’m wearing my jockstrap so feel free to kick away Cabozantinib!!

For those keen to see side effects, grab a comfy chair it’s a long list. No unlike like the last list.


CABOMETYX may cause serious side effects, including:

  • Bleeding (hemorrhage). CABOMETYX can cause severe bleeding that may lead to death. Tell your healthcare provider right away if you get any signs of bleeding during treatment with CABOMETYX, including:

    • Coughing up blood or blood clots

    • Vomiting blood or if your vomit looks like coffee-grounds

    • Red or black (looks like tar) stools

    • Menstrual bleeding that is heavier than normal

    • Any unusual or heavy bleeding

  • A tear in your stomach or intestinal wall (perforation) or an abnormal connection between 2 parts of your body (fistula). Tell your healthcare provider right away if you get tenderness or pain in your stomach-area (abdomen).

  • Blood clots, stroke, heart attack, and chest pain. Get emergency help right away if you get:

    • Swelling or pain in your arms or legs

    • Shortness of breath

    • Feel lightheaded or faint

    • Sweating more than usual

    • Numbness or weakness of your face, arm or leg, especially on one side of your body

    • Sudden confusion, trouble speaking or understanding

    • Sudden trouble seeing in one or both eyes

    • Sudden trouble walking

    • Dizziness, loss of balance or coordination

    • A sudden severe headache

  • High blood pressure (hypertension). Hypertension is common with CABOMETYX and sometimes can be severe. Your healthcare provider will check your blood pressure before starting CABOMETYX and during treatment with CABOMETYX. If needed, your healthcare provider may prescribe medicine to treat your high blood pressure.

  • Diarrhea. Diarrhea is common with CABOMETYX and can be severe. If needed, your healthcare provider may prescribe medicine to treat your diarrhea. Tell your healthcare provider right away if you have frequent loose, watery bowel movements.

  • A skin problem called hand-foot skin reaction. Hand-foot skin reactions are common and can be severe. Tell your healthcare provider right away if you have rashes, redness, pain, swelling, or blisters on the palms of your hands or soles of your feet.

  • Protein in your urine and possible kidney problems.Symptoms may include swelling in your hands, arms, legs, or feet.

  • Severe jaw bone problems (osteonecrosis).Symptoms may include jaw pain, toothache, or sores on your gums. Your healthcare provider should examine your mouth before you start and during treatment with CABOMETYX. Tell your dentist that you are taking CABOMETYX. It is important for you to practice good mouth care during treatment with CABOMETYX.

  • Wound healing problems. If you need to have surgery, tell your healthcare provider that you are taking CABOMETYX. Your healthcare provider should stop your treatment with CABOMETYX at least 28 days before any planned surgery, including invasive dental procedures. Your healthcare provider should tell you when you may start taking CABOMETYX again after surgery.

  • Reversible Posterior Leukoencephalopathy Syndrome (RPLS). A condition called reversible posterior leukoencephalopathy syndrome can happen during treatment with CABOMETYX. Tell your healthcare provider right away if you have headaches, seizures, confusion, changes in vision, or problems thinking.

  • CABOMETYX may cause fertility problems in females and males, which may affect your ability to have children. Talk to your healthcare provider if you have concerns about fertility.

Your healthcare provider may change your dose, temporarily stop, or permanently stop treatment with CABOMETYX if you have certain side effects.

The most common side effects of CABOMETYX include:

  • Tiredness

  • Decreased appetite

  • Weight loss

  • Nausea

  • Vomiting

  • Changes in certain blood tests

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of CABOMETYX. 

Love the legal disclaimer in the last line…or maybe it’s more of a Made for TV product ‘AND WAIT!! IF YOU ORDER NOW THERE ARE EVEN MORE SIDE EFFECTS!!’