Help!! I received different 2nd opinions!

[margotmagoo]

Thanks to all who have responded to my previous posts....your support is SO appreciated! I am at a crossroads. My onco and the onco at Johns Hopkins concur on treatment -- Folfiri for 12 cycles (5FU, Leukovoran, Ironotecan) with Avastin. The onco I saw at Stanford today recommended Xeloda and Avastin only and to look into radiation of the pelvic region. My colon cancer spread to my ovaries only. I finished my Folfox in July of 2006 and had my most recent surgery to remove ovarian tumors (colon cancer not ovarian cancer) 3 weeks ago. I am now not sure what to do. Any thoughts or experiences????? Thanks! Margot

[sean]

My thought would be to talk to the 1st opinion doc about the 2nd opinion and ask about the pros and cons of each. An oncologist told me that the practice is part art and part medicine. For me, this means I want to get as much info as possible about treatment options and make the decision I feel most comfortable with. Unfortunately there isn't always an obvious choice, but there are lots of options that are available if the 1st or 2nd line treatment choices don't work. Above all, I'd want to be treated by an oncologist I feel comfortable with & trust will value your input.

[Lifes2short]

I've just been dx with more mets. I finished four months of Folfox in January. My oncologist wants me to do Folfuiri with Avastin. From what I've read, it seems to be the standard second line of chemo for colon cancer. I also know that my doc considered doing Folfox again but decided against it because it's been less than six month. You've been off chemo a bit longer, might be worth looking looking into Folfox if it worked for you before.

[Frank G]

The xeloda and Avastin are just as effective and easier to take than 5fu(less intravenious).Based on my experience I would want avastin as part of any regime.I would make sure the first orno is just not experienced with xeloda.

[klryder02]

Margotmagoo-

You may have already heard this, but the nurses at my hospital said Xeloda causes more side effects than 5_FU.

Others on this site may be able to speak more to it, but based on what I have heard, I would want 5-FU.

Good luck in your decision.

I think Sean has a point with picking the doctor you like the most.

[ASTEPHENS33]

I second Sean's suggestion of brining up the information with the other oncologist. Being open and having the information is important.

As for Xeloda vs 5FU, as I understand it, the definitive study on this is a New England Journal Medical from June 30, 2005 about a study done with about 2000 patients taking either 5FU or Xeloda. The study basically indicated that Xeloda was as effective as the 5FU. The toxic effects were also shown to be less and delayed with Xeloda, except in the instance of getting what is called hand-foot syndrome where you get redness or possibly blisters. What I do not think has had a thorough trial (is probably in-process now) is Xeloda with other chemo drugs. In other words, all the field trials for Avastin were done with 5FU. There is an assumption that since Xeloda works as well as 5FU, it would be the same with the Avastin. 5FU has been around for a very long time, so they know alot about it.

I did Xeloda and found the administration of it was easier.

[margotmagoo]

Thank you everyone for your thoughts and input. It seems that it is a matter of preference rather than efficacy. I am not a big pill taker to begin with which makes me shy away from Xeloda. This biggest diffence between the different opinions was in the use of Ironoteacan....the Stanford doc said to not use it. My onc and the onc at Johns Hopkins said to use it. My doc and Johns Hopkins are aggressive and the Stanford doc was not so much by saying let's go for less side effects and as things pop up we will treat them like a chronic problem....so he said save Ironoteacan for down the road. I start chemo today and I decided to go aggressive. I would like to be rid of any remaining cells rather than manage them!
Thanks again and best to all of you as well,
Margot

[sue]

3 1/2 years ago I was on 5fu IV and it was awful I could barley leave the house from uncontrollable diareha for at least 4 days after each infusion. I am now on Xeloda and have found it so much easier with hardly any side effects, just tired the second week and very mild nausa once in awhile, which I can get rid of with one Zofran.

02"]Margotmagoo-

You may have already heard this, but the nurses at my hospital said Xeloda causes more side effects than 5_FU.

Others on this site may be able to speak more to it, but based on what I have heard, I would want 5-FU.

Good luck in your decision.

I think Sean has a point with picking the doctor you like the most.