Xeloda vs 5FU

[lexern]

Doctor is taking hubby off of pump of 5FU and Oxi and putting him on Xeloda only. We wonder if this will be as effective???
4 months ago, he had over 24 cancerous lymph nodes (neck, stomach..none in liver or lungs) when we went to Mayo on Tuesday, all the stomach nodes resolved and he only had 3 in the neck, the largest being only the size of a BB. When we go back in two months, they are doing a scope on him to see the rectal sight and find out if they can take it out. Hubby wants to do some sort of radiation like tomotherapy to shrink everything further for a better chance of surgery...was wondering if anyone had any opinions on this also.

Lexern

[SkiFletch]

Is your husband having worsening side effects from the oxali? Neuropathy? Crappy quality of life? Etc?

[lexern]

Oh my gosh YES!! It was awful...He was out of work for 4 weeks to finish the treatment..by the end, he was having no good days before the next treatment. But...it worked above the norm the doctor said..way above the norm...I'm curious if it will continue to do so without the Oxi.

Lex

[CRguy]

I did Xeloda with radiation and by itself and am currently on FOLFOX with infusional 5-FU. XELOX is an option I would go to if the 5-FU..well FU's me up too much !!

I found Xeloda more tolerable than the 5-FU FWIW...just my experience.

Hope it works out better for you folks
Cheers CRguy

[lexern]

Does the Xeloda alone keep the tumors at bay as well as the %FU with oxi?

[SkiFletch]

From reasearch studies I've read/heard of, Xeloda does the same anti-cancer "work" as 5-FU does and in MOST cancer patients, the Xeloda/5-FU does most of the "heavy lifting" if you will. Oxali usually does less of the "work" than xeloda/5-FU, but you won't really know until you try without the oxali. If the side effects were mounting that badly, it's no wonder your husband was taken off of the oxali. You/he could ask for Irinotecan to replace the oxali. Perhaps he would tolerate that better and still have good results with it

[UFT]

Personally I think Xeloda and 5FU pale beside Japan's UFT(tegafur-uracil) and S-1 or TS-1 formulas with the DPD inhibitors. UFT is now an inexpensive generic, available in most countries, outside of the US.

An amazing paper is Matsumoto (2002) with high 10 year survival using continuous oral 5FU plus cimetidine in new, advanced colorectal cancer cases with CA19-9 biomarker. Japan has since replaced continuous oral 5FU with tegafur based UFT and TS-1.

Based on my reading of papers, UFT appears to have the least side effects (much lower) and (T)S-1 is probably hotter on cancer kill, but still less side effect than Xeloda. My spouse has been on UFT (300 mg tegafur) continuously for two months, no breaks, not one day off. CEA is declining nicely (well under 3), WBC were declining, added a recommended herbal tea from a top board scoring MD, WBC back up. The Japanese (and Koreans and Chinese) have a series of studies with UFT+cimetidine and UFT+PSK.

I went to an oncologists meeting. Roche had more than one salesman per doctor, extra salemen waiting in the wings. Roche seems to own or employ a lot of the oncologists where we stay. Everyone was pushing XELOX or FOLFOX + 1-2 biologicals. Once I realized UFT was available locally, we dumped them, went with prof that had UFT experience.

There are several Japanese case studies on hopeless epithelial cancer cases, including mCRC, that use continuous UFT+cimetidine+PSK for up to 3 years with long term survival.

Spouse started 1600 mg cimetidine, 10,000-15,000 iu vit D3, 900 mg lipoic acid, 600 mcg MeSC selenium, 500 mg coQ10, fish oil, 45mg vit K2(MK4), 4000 mg vit C, 2000 mg N-acetylcysteine(NAC), vit E-succinate, pancreatin daily - for 1 month before surgery. Added 10-60mg vit K3 and IV vitamin C (25,000-75,000 mg/infusion, 3-7 times/week) after surgery and reduced cimetidine to 800mg after 2 months. No serious side effects, perhaps Grade 1 diarrhea sometimes from the UFT, we go out a lot. Spouse was able to walk out of hospital 3 days after surgery. 6 oncologists say micrometastatic CRC case with possible lung mets less than 1 cm.

Spouse dx'd March with obstructive colon cancer, prospective stage III/IV.
1 month of alt chemotherapy and nutritional fortification before surgery (was initially a marginal surgical candidate).
Highly experienced surgeon laid in multiple metal clips for radiation on non-resectable invaded area.
However, pathology showed most invasive material outside colon necrosed before surgery, obstructed channel opened slightly, 2 lymph nodes remained positive.